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Country response to HIV/AIDS: National Health Accounts on HIV/AIDS in Brazil, Guatemala, Honduras, Mexico and Uruguay

Izazola-Licea, José-Antonioa; Avila-Figueroa, Carlosb; Arán, Danielc; Piola, Sergiod; Perdomo, Rodulioe; Hernandez, Patriciaf; Saavedra-Lopez, Jorge Ag; Valladares-Cardona, Ricardoh

Country reponse to HHIV/AIDS: National Health Accounts on HIV/AIDS in Brazil, Guatemala, Honduras, Mexico and Uruguary

National expenditures on HIV/AIDS were estimated as summary indicators to assess the country's response to HIV/AIDS. The methodology is based on a matrix system describing the level and flow of health expenditures on HIV/AIDS: an adaptation of the National Health Accounts methods. The expenditures were classified by source (public, private, international), by the use of funds (prevention, care), by object, and by type of provider institution. The results are reported in US$ using the official exchange rate for the year of estimation. For international comparisons monetary units were adjusted by the purchasing power parity (US$PPP). National HIV/AIDS total expenditures were: Guatemala US$PPP29.5 million, Uruguay US$PPP32.5 million, Mexico US$PPP257 million, and Brazil US$PPP587.4 million during 1998, and Honduras US$PPP33.9 million for 1999. The total HIV/AIDS expenditures per capita for 1998 were: Brazil US$2.69, Mexico US$1.25, Guatemala US$1.08, Uruguay US$6.63, and Honduras US$3.6 for 1999. The 1998 distribution of the total HIV/AIDS expenditures in prevention and care were, respectively, Brazil 10 and 80%, Guatemala 15 and 70%, Mexico 29 and 66%, Uruguay 36 and 51%, and Honduras 28 and 65% for 1999. The share of total expenditures on antiretroviral drugs ranged from 52% in Guatemala to 75% in Brazil, even when the estimated coverage of antiretroviral therapy was close to 10% in Guatemala and universal in Brazil. The estimated flow from international sources per capita in 1998 was Uruguay US$0.03, Brazil US$0.24, Guatemala US$0.11, Mexico US$0.01, and Honduras US$1.04 in 1999. The data allow international comparisons and provide critical information to improve equity and efficiency in the allocation of scarce resources. The National HIV/AIDS Accounts also constitute a powerful tool to describe the country's response to HIV/AIDS.

From the aFundación Mexicana para la Salud, A.C. (FUNSALUD), Regional AIDS Initiative for Latin America and the Caribbean (SIDALAC), México, DF México; bSecretaría de Salud, México, DF México; cCentro de Estudios de Economía y Salud (CEES), Montevideo, Uruguay; dInstituto de Pesquisa Econômica Aplicada (IPEA), Brasília, Distrito Federal, Brasil; eAsesores y consultores técnicos de Centro América, Tegucigalpa, A.C. Honduras; fNational Health Accounts, World Health Organization, Geneva, Switzerland; gIndependent Consultant on Health & HIV/AIDS Policy and Management, México, DF México; hGSD Consultores Asociados (GSD), Guatemala, Guatemala

Correspondence to: José A. Izazola-Licea, Fundación Mexicana para la Salud, AC, Av. Periferico Sur #4809, México, DF 14610, México. Tel: (52-55) 5655-9011; fax (52-55) 5655-8211.

© 2002 Lippincott Williams & Wilkins, Inc.