First supplementary memorandum submitted
by the Department for International Development
(HIV/AIDS IMPACT
ON SOCIO-ECONOMIC
DEVELOPMENT)
Additional Evidence requested by the IDC from
DFID
1. DFID SPENDING
ON HIV/AIDS (PARAS
64 AND 69)
Current spending is running at £20-£30
million over the past four years. Anticipated to rise to over
£40 million 1999-2000, and increase further year on year,
as projects and programmes currently at the early stage of development
come on line.
This will significantly exceed the Prime Minister's
commitment of £100 million made at CHOGM.
2. DFID SPENDING
ON CONDOMS
Between £8-£10 million each year over
the past three years rising to £12 million 1999-2000.
3. AVAILABILITY
OF CONDOMS
IN DEVELOPING
COUNTRIES
Information about trends in condom supplies
is notoriously difficult to collect and to analyse. Manufacturers,
financiers and country programme managers simply do not collate
their information in a way that makes interpretation easy. UNFPA
provides the best available data at the global level. UNFPA's
1998 report shows that expenditure trend for condoms between 1992
and 1998 was as follows:
| |
1992 | 1993
| 1994 | 1995
| 1996 | 1997
| 1998 | Total
| Per cent of all contraceptives
|
Condoms
$ million | 20.8
| 40.1 | 39.9
| 60.6 | 73.3
| 50.9 | 51.4
| 337 | 37
|
As the data is patchy, we cannot comment on the apparent
drop in value of supplies after 1996. The overall increase in
condom provision between 1992 and 1998 is, however, far greater
than for any other contraceptive commodity. UNFPA notes in its
1998 report that AIDS is the major reason for this increase.
Illustrations of country performances include the following:
— condoms sold through social marketing increased
by over 100 per cent between 1996 and 1996 in Kenya, Madagascar,
Mozambique and Zimbabwe (social marketing is the provision of
goods by organisations such as Population Services International
and Marie Stopes International, with a subsidy reflecting the
public benefit derived from their use);
— in Nigeria, surveys show the increase in condom
use by certain risk-behaviour groups: 14 per cent of dock workers
used one in their most recent sexual encounter with a non-regular
partner in 1996, increasing to 45 per cent in 1997; the figures
for long-distance truck drivers was 21 per cent in 1993 and 45
per cent in 1997;
— Uganda's social marketing programme increased
sales from 1.2 million in 1992 to nearly 10 million in 1997;
— Kenya's social marketing programme (run by Population
Services International) sold over 12 million condoms in 1999,
about 20 per cent higher than in 1998. This was the fourth year
in succession showing an annual growth of 20 per cent or higher.
The attached charts show the trends in socially marketed
condom provision during the last decade. For many years condom
use (and contraception in general) was much further advanced in
south Asia, mainly Bangladesh and India. The charts show that
not only has the provision of socially-marketed condoms increased
dramatically in sub-Saharan Africa, it is now at about the same
level per head of population as in south Asia. Population Services
International provided these charts to DFID. They combine data
from all the major social marketing organisations.
GROWTH IN CONDOM SOCIAL MARKETING, 1990-99
NUMBER OF
COUNTRIES WITH
CONDOM SOCIAL
MARKETING PROGRAMMES,
BY REGION,
1990-99
| | 1990
| 1991 | 1992
| 1993 | 1994
| 1995 | 1996
| 1997 | 1998
| 1999 |
| S Asia | 3 |
4 | 4
| 4 | 4
| 4 | 4
| 4 | 4
| 2 |
| Other Asia | 2
| 4 | 5
| 6 | 7
| 7 | 10
| 9 | 9
| 3 |
| Latin America/Caribbean | 8
| 11 | 11
| 12 | 12
| 13 | 13
| 12 | 15
| 6 |
| E Europe | 0
| 0 | 0
| 0 | 0
| 1 | 2
| 2 | 3
| 3 |
| N Africa | 1
| 1 | 2
| 2 | 2
| 2 | 1
| 1 | 1
| 0 |
| Sub-Saharan Africa | 8
| 13 | 16
| 20 | 22
| 25 | 28
| 29 | 30
| 31 |
| TOTAL | 22 |
33 | 38
| 44 | 47
| 52 | 58
| 57 | 62
| 45 |
Note. 1999 data complete for Africa only.
SOCIAL MARKETING
CONDOM SALES,
BY REGION,
1990-99 (MILLIONS)
| | 1990
| 1991 | 1992
| 1993 | 1994
| 1995 | 1996
| 1997 | 1998
| 1999 |
| S Asia | 423
| 534 | 464
| 520 | 412
| 457 | 509
| 587 | 609
| 417 |
| Other Asia | 6
| 10 | 13
| 22 | 31
| 59 | 85
| 110 | 128
| 21 |
| Latin America/Caribbean | 19
| 33 | 28
| 42 | 38
| 49 | 57
| 65 | 78
| 57 |
| E Europe | 0
| 0 | 0
| 0 | 0
| 0 | 2
| 2 | 2
| 4 |
| N Africa | 17
| 15 | 14
| 3 | 16
| 13 | 2
| 2 | 2
| 0 |
| Sub-Saharan Africa | 18
| 41 | 51
| 75 | 124
| 171 | 160
| 203 | 236
| 276 |
| TOTAL | 482 |
632 | 571
| 662 | 620
| 749 | 815
| 968 | 1,056
| 775 |
Note. 1999 sales data incomplete (PSI only).
SOCIAL MARKETING
CONDOM SALES
PER 100 POPULATION,
1990 AND 1998
Countries with condom social marketing programmes in 1998
| | 1990
| 1991 | 1992
| 1993 | 1994
| 1995 | 1996
| 1997 | 1998
| 1999 |
| S Asia | 36.0
| |
| |
| |
| | 44.7
| |
| Other Asia | 0.4
| |
| |
| |
| | 7.6
| |
| Latin America/Caribbean | 3.8
| |
| |
| |
| | 14.1
| |
| E Europe | 0.0
| |
| |
| |
| | 1.4
| |
| N Africa | 20.6
| |
| |
| |
| | 2.6
| |
| Sub-Saharan Africa | 3.7
| |
| |
| |
| | 43.4
| |
Note. 1990 data considers population of those
countries that had programmes in 1998, whether or not they had
programmes in 1990.
4. DFID INPUTS TO
COPENHAGEN +5 CONFERENCE
ON HIV/AIDS
DFID objectives on HIV/AIDS at the UN Special Session for
Copenhagen +5 have been to ensure recognition of its importance
as a challenge to development and to poverty eradication, and
to support commitments made, and maintain language agreed, at
ICPD +5.
In the draft outcomes document, within the context of comprehensive
national strategies on poverty eradication (Commitment 2), there
is a recommendation to use health policy as an instrument for
poverty eradication along the lines of the WHO strategy on poverty
and health. We are also supporting specific references to HIV/AIDS
under Commitment 6 on access to education and health care, and
Commitment 7 on Africa and least Developed Countries. These references
include acknowledgement of the increased poverty and inequality
resulting from the epidemic, and recommendations for measures
to enable people to protect themselves from HIV/AIDS and to improve
the quality of life of those already infected.
Many of the references to HIV/AIDS remain to be finally agreed.
However we anticipate that agreement will be reached on the basis
of language already accepted at ICPD +5.
Dr Julian Lob-Levyt
Chief Health and Population Adviser
Department for International Development
June 2000
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