International and domestic funding for HIV research: how much and how is it spent?

Since the recognition of AIDS and the HIV pandemic in the early 1980s, the amount of money spent on HIV-related research has increased from millions to billions of US dollars per year. In 2001, the United Nations Special Assembly on HIV/AIDS highlighted the importance of mobilizing massive amounts of newly available resources to mount an effective and comprehensive response to the pandemic. In particular, it called for an increased investment in research related to HIV and AIDS and, more specifically, for the development of sustainable and affordable prevention technologies, such as vaccines and microbicides. These investments contributed to HIV being the most studied virus in research history, both in terms of the number of annual grants, monies available and HIVrelated publications generated through this work. Few organizations can clearly document their specific contributions to HIV-related research, and on the whole it is difficult to ascertain the source and annual amounts of financial support for HIV research at global and national levels. Investments for research are difficult to quantify since the information covers different sources of funding for diverse products and resources are often spent in both donor and recipient countries, creating the possibility of double counting. The different types of HIV research include medical, behavioral, social and economic research at both individual and population levels. Any long-term, sustained and effective response to the HIV pandemic requires multisectoral interventions at the level of the agent, host and environment, and their respective interactions as described by the Ecological Model of Disease Causation [1]. Expenditure on product development includes spending in five stages; basic research, preclinical research, clinical research, cohort and site development, and advocacy and policy development. R&D does not only include product development, but also clinical trials, advocacy and education at the community level, and monitoring and evaluating the implementation of new interventions into routine programs or services. The outcomes and impacts of these research efforts are reflected in terms of a reduction in the number of people newly infected with HIV and improving the morbidity and mortality of people living with HIV, ensuring that they can continue to have productive social and economic lives. To date, resources for HIV-related research have relied on three main sources of funding: