This paper from IDASA makes an initial assessment of how well the budget 2004/5 establishes a sufficient and efficient funding framework for government’s response to HIV/AIDS. It takes a closer look at these new allocations for the anti-retroviral (ARV) treatment program as well as other regular HIV/AIDS conditional grants. Given that the funds being transferred by national government to provincial health departments for HIV/AIDS programs jump by 134% in this budget, the provinces will be under sizable pressure to spend and deliver.
After providing an overview of the total allocations for HIV/AIDS programs, the report looks specifically at the allocations for the new ARV treatment program. The report analyzes the provincial shares of the total ARV funds, examines the criteria used, and discusses key budget issues associated with the new ARV funding stream. These issues underline that roll-out of this massive ARV program will include multiple challenges for intergovernmental fiscal relations and provincial capacity which will be profoundly critical to successful implementation. Finally, the authors look at how these massive increases in allocations for HIV/AIDS compare to the overall national budget, and to spending in the health sector generally.