Zimbabwe's national AIDS levy: A case study
Background: We conducted a case study of the Zimbabwe National AIDS Trust Fund (‘AIDS Levy’) as an approach to domestic government financing of the response to HIV and AIDS. Methods: Data came from three sources: a literature review, including a search for grey literature, review of government docum...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2016-01-01
|
| Series: | SAHARA-J |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/17290376.2015.1123646 |
| _version_ | 1819053818997899264 |
|---|---|
| author | Nisha Bhat Peter H. Kilmarx Freeman Dube Albert Manenji Medelina Dube Tapuwa Magure |
| author_facet | Nisha Bhat Peter H. Kilmarx Freeman Dube Albert Manenji Medelina Dube Tapuwa Magure |
| author_sort | Nisha Bhat |
| collection | DOAJ |
| description | Background: We conducted a case study of the Zimbabwe National AIDS Trust Fund (‘AIDS Levy’) as an approach to domestic government financing of the response to HIV and AIDS. Methods: Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations. Findings: The literature search yielded 139 sources, and 20 key informants were interviewed. Established by legislation in 1999, the AIDS Levy entails a 3% income tax for individuals and 3% tax on profits of employers and trusts (which excluded the mining industry until 2015). It is managed by the parastatal NAC through a decentralized structure of AIDS Action Committees. Revenues increased from inception to 2006 through 2008, a period of economic instability and hyperinflation. Following dollarization in 2009, annual revenues continued to increase, reaching US$38.6 million in 2014. By policy, at least 50% of funds are used for purchase of antiretroviral medications. Other spending includes administration and capital costs, HIV prevention, and monitoring and evaluation. Several financial controls and auditing systems are in place. Key informants perceived the AIDS Levy as a ‘homegrown’ solution that provided country ownership and reduced dependence on donor funding, but called for further increased transparency, accountability, and reduced administrative costs, as well as recommended changes to increase revenue. Conclusions: The Zimbabwe AIDS Levy has generated substantial resources, recently over US$35 million per year, and signals an important commitment by Zimbabweans, which may have helped attract other donor resources. Many key informants considered the Zimbabwe AIDS Levy to be a best practice for other countries to follow. |
| first_indexed | 2024-12-21T12:41:47Z |
| format | Article |
| id | doaj.art-45967b4620ef4d0abfefa8acf7da04b6 |
| institution | Directory Open Access Journal |
| issn | 1729-0376 1813-4424 |
| language | English |
| last_indexed | 2024-12-21T12:41:47Z |
| publishDate | 2016-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | SAHARA-J |
| spelling | doaj.art-45967b4620ef4d0abfefa8acf7da04b62022-12-21T19:03:46ZengTaylor & Francis GroupSAHARA-J1729-03761813-44242016-01-011311710.1080/17290376.2015.11236461123646Zimbabwe's national AIDS levy: A case studyNisha Bhat0Peter H. Kilmarx1Freeman Dube2Albert Manenji3Medelina Dube4Tapuwa Magure5is an International Experience and Technical Assistance Fellow affiliated to US Centers for Disease Control and PreventionMD, is a medical epidemiologist affiliated to US Centers for Disease Control and Preventionis a Research and Documentation Coordinator affiliated to National AIDS Council of Zimbabweis a Finance Director affiliated to National AIDS Council of Zimbabweis a Communications Director affiliated to National AIDS Council of ZimbabweMBcHB, MPH, MBA, is a Chief Executive Officer affiliated to National AIDS Council of ZimbabweBackground: We conducted a case study of the Zimbabwe National AIDS Trust Fund (‘AIDS Levy’) as an approach to domestic government financing of the response to HIV and AIDS. Methods: Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations. Findings: The literature search yielded 139 sources, and 20 key informants were interviewed. Established by legislation in 1999, the AIDS Levy entails a 3% income tax for individuals and 3% tax on profits of employers and trusts (which excluded the mining industry until 2015). It is managed by the parastatal NAC through a decentralized structure of AIDS Action Committees. Revenues increased from inception to 2006 through 2008, a period of economic instability and hyperinflation. Following dollarization in 2009, annual revenues continued to increase, reaching US$38.6 million in 2014. By policy, at least 50% of funds are used for purchase of antiretroviral medications. Other spending includes administration and capital costs, HIV prevention, and monitoring and evaluation. Several financial controls and auditing systems are in place. Key informants perceived the AIDS Levy as a ‘homegrown’ solution that provided country ownership and reduced dependence on donor funding, but called for further increased transparency, accountability, and reduced administrative costs, as well as recommended changes to increase revenue. Conclusions: The Zimbabwe AIDS Levy has generated substantial resources, recently over US$35 million per year, and signals an important commitment by Zimbabweans, which may have helped attract other donor resources. Many key informants considered the Zimbabwe AIDS Levy to be a best practice for other countries to follow.http://dx.doi.org/10.1080/17290376.2015.1123646health care financingHIVAIDSZimbabwe |
| spellingShingle | Nisha Bhat Peter H. Kilmarx Freeman Dube Albert Manenji Medelina Dube Tapuwa Magure Zimbabwe's national AIDS levy: A case study SAHARA-J health care financing HIV AIDS Zimbabwe |
| title | Zimbabwe's national AIDS levy: A case study |
| title_full | Zimbabwe's national AIDS levy: A case study |
| title_fullStr | Zimbabwe's national AIDS levy: A case study |
| title_full_unstemmed | Zimbabwe's national AIDS levy: A case study |
| title_short | Zimbabwe's national AIDS levy: A case study |
| title_sort | zimbabwe s national aids levy a case study |
| topic | health care financing HIV AIDS Zimbabwe |
| url | http://dx.doi.org/10.1080/17290376.2015.1123646 |
| work_keys_str_mv | AT nishabhat zimbabwesnationalaidslevyacasestudy AT peterhkilmarx zimbabwesnationalaidslevyacasestudy AT freemandube zimbabwesnationalaidslevyacasestudy AT albertmanenji zimbabwesnationalaidslevyacasestudy AT medelinadube zimbabwesnationalaidslevyacasestudy AT tapuwamagure zimbabwesnationalaidslevyacasestudy |