With much of the global economy facing slowing growth and uncertain prospects, especially in developed countries, a new World Bank report urges African governments and their development aid donors to do significantly more to prevent new HIV infections. Without a dramatic reduction in infections the World Bank says that existing national treatment programs for people living with HIV/AIDS could become unsustainable over the coming years.

After decades of relentless expansion, during which HIV/AIDS claimed the lives of more than 30-million people worldwide and infected more than 60-million, HIV prevalence rates are stabilizing globally and in Africa. More than 6-million people are now on life-saving treatment worldwide, and global financing for HIV/AIDS has substantially increased, rising from US$260-million in 1996 to US$15.9-billion by 2009. However, the report warns that treatments costs are spiraling and the result is further pressure on already strapped public finances, especially in southern Africa, where the epidemic is most intense.

According to the new report―The Fiscal Dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda―an increasingly volatile global economy is causing anxiety about maintaining and expanding AIDS treatment programs in low-income countries such as Uganda, where HIV prevalence rates may be lower than in southern Africa, but with the heavy reliance on external financing contributing to 85 percent of total spending on HIV/AIDS programs, the viability of these hangs in the balance.