TY - JOUR T1 - Approaches to improving the efficiency of HIV programme investments JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-010127 VL - 7 IS - 9 SP - e010127 AU - Minahil Shahid AU - Ipchita Bharali AU - Robert Hecht AU - Gavin Yamey Y1 - 2022/09/01 UR - http://gh.bmj.com/content/7/9/e010127.abstract N2 - Summary boxCurrent annual funding levels are insufficient to tackle the global burden of HIV and it is unlikely that these levels will increase substantially in the near future.Improving the efficiency of investments in HIV control programmes is, thus, critical to the ongoing HIV response.While there is considerable variation between countries, the most promising areas for efficiency include measures to: (a) reallocate resources to the most effective interventions, including testing and antiretroviral therapy, (b) reduce the unit cost of delivering key services via better targeting, procurement and management practices, (c) use community-based treatment support and target models to deliver interventions to the most affected groups and (d) use cost-effective interventions such as demand creation incentives, HIV self-testing, and integration of services.Improving the efficiency of investments in HIV control programmes is critical to the ongoing HIV response and reaching the target of ending the AIDS epidemic as a public health threat by 2030 (Sustainable Development Goal 3.3). Donor fatigue and the gradual decline in donor disbursements, including the decade-long trend of declining bilateral funding for HIV from donor governments other than the USA,1 present a challenge to sustaining the current level of HIV spending.2 Even with the existing available resources, the global burden of HIV exceeds the funding available to address it.3 In light of the negative economic impacts of COVID-19, donor funding for HIV could be under further threat.4While there is widespread agreement that there is a need for additional resources to adequately address HIV, evidence suggests that new resources raised from international and domestic sources are unlikely to be sufficient in the near future.3 Scaling up HIV services to achieve national and global targets will, therefore, require that countries take steps to get ‘more health for the money’—that is, to get the … ER -