The Application Of National AIDS Spending Assessment In Dehong Prefecture, Yunnan Province, China

Background:HIV/AIDS has become an important global public health problem and social problem. The prevention and control work of HIV/AIDS is closely related with the investment of resources. Although the AIDS funds have been increasing year by year, there is still shortage of the amount of funds globally compared with the need of expenditure on HTV/AIDS prevention and control work. The contradiction between resource scarcity and urgency of HIV/AIDS prevention and control work had posed a problem to most countries and regions on how to reasonably allocate limited resources to improve its use efficiency. The calculation and assessment of HTV/AIDS spending is the premise for solving this problem. Using a scientific method to reasonably assessment HTV7AIDS spending and providing AIDS related expenditure evaluation has great significance on the rational allocation of HIV/AIDS resources in China.Objective:This study is aimed to build "Dehong prefecture’s AIDS expenditure classification system" using NASA method, and implement the comprehensive tracing of the actual spending in Dehong prefecture in2010. Based on the above, the feasibility of NASA application was discussed and explored. In addition, through the analysis of expenditure-related factors, future suggestions on AIDS expenditure are proposed.Method:Through the establishment of the core technical group of NASA, the AIDS spending classifications in NASA method and the local spending classification was compared and ’Dehong prefecture’s AIDS expenditure classification system’was built. Using quantitative method and questionnaires, the actual HIV/AIDS-related spending was reasonably calculated and the expenditure in this region was also compared and analyzed from multiple dimensions. The need index method was used to do the comparison analysis between the actual spending and the need. The correlation test was used to analyze related factors influencing HIV/AIDS spending in Dehong prefecture in2010.Results:The NASA estimations showed that Dehong prefecture spent a total of45853873.77RMB on HIV/AIDS in2010. Public funds constituted86.3%of the total expenditure (39591203.12RMB), followed by international cooperative programs which accounted for9.8%(4501521.65RMB) and domestic research programs which accounted for3.5%(1611340.00RMB). Findings showed that there were two main funds management systems in this region in2010, which were the health bureau system, accounting for the management and allocation of governmental funds and the CDC system, accounting for the management and allocation of international cooperative program funds. There were89spending organizations, including7AIDS prevention bureau,7CDCs,13hospitals, and blood bank,6women and children health care hospitals,28multi-sectors and28NGOs. Findings based on NASA Categories showed that AIDS spending were mainly on3areas, and expenditure on Care&Treatment was the22918925.25RMB (49.9%of total expenditure), followed by Program Management&Administration which accounted for24.5%(11212030.30RMB), Prevention which accounted for22.4%(10261653.22RMB), and all other activities accounted for3.0%(1461265.00RMB).55.0%of total expenditure benefited PLHIV,23.6%non-targeted populations (i.e., spending on program management activities will flow to this population),10.4%most-at-risk population, including female sex workers, injection drug users, and men having sex with men,3.9%vulnerable and accessible populations, including people attending STI clinics, students, health care providers and others,3.5%the general population and3.4%other key populations, including OVC, migrant populations, sexual partners of PLWHA&others. The number of local population and the number of reported HIV/AIDS cases are tested to be related to the actual spending. The actual spending is consistent with local need. Two counties’preventive spending is related to local transmission route(R=0.999, P=0.032). Treatment and care spending are tested to be related to the number of local AIDS cases (R=0.985, P=0.002).Conclusion:The funds from domestic government departments played a leading role in the AIDS spending of Dehong prefecture in2010, and international cooperation projects play an complementary role. The expenditure in Dehong prefecture in2010was basically reasonable, because it was spent based on the priority of different prevention and control areas ("prevention" and "treatment and care"). In2010, a total of1317277.6RMB was spent by28multi-sectors and28NGOs in Dehong prefecture, which indicated that multi-sectors and NGOs have jointly participated in the AIDS prevention and control to prevent the spread of the spread of AIDS. Expenditure was tested to be related to the number of PLWHA, which indicated that the epidemic was considered as a factor in spending. The AIDS spending in2010was based on local need (Need index analysis showed that local expenditures matched well with needs). The preventive spending in two counties in Dehong prefecture was related to transmission route. Through the matrix form NASA produced, it can reflect the source, the allocation and the flow of funds for HIV/AIDS prevention and control. Based on discussion of the policy, environment, technic, and other factors, it was believed that there was feasibility of NASA application, although some considerations should be explored before application. Our study proved that the application of NASA method was feasible and the generalization of NASA in the calculation of HIV/AIDS prevention and control resources in other regions could be considered and explored.