Increasing funding for Global Mental Health by drawing lessons from the case of HIV/AIDS

Abstract

Objective: Global Mental Health (GMH) is the field of global health dealing with the spectrum of mental, neurological and substance use disorders (MNS disorders), often with a focus on low- and middle-income countries (LMICs). While MNS disorders constitute a consider-able burden of disease, investments in the field lag behind, creating a severe funding gap. In contrast, the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) epidemic has seen unprecedented commitment, especially in terms of funding. Consequently, this paper examines the research question: “How can the increase in global funding for HIV/AIDS over the past three decades serve as an example to draw lessons for increasing GMH funding in LMICs?”.
Methods: Based on the ‘Theory of Lesson-drawing’ by Rose (1991) two programs, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), were analyzed, and a conceptual model cre-ated for each program. The conceptual model, in addition to a comprehensive literature review were the base to draw learnings from the fight against the HIV/AIDS epidemic and its funding. Learnings from HIV/AIDS were applied to GMH by giving a prospective evalua-tion of the transferability and desirability of the analyzed programs and their outcomes.
Results: A concrete next step that should be taken in order to increase funding and imple-mentation of high-quality mental health care in LMICs includes the establishment of a GMH partnership which represents diverse constituencies and expertise. Among other things, emphasis should be put on promoting strong civil-society and community involvement. Ad-ditionally, a multi-facetted advocacy and awareness campaign to increase traditional donor contributions, innovative financing mechanisms and domestic resources for GMH should be launched.
Conclusion: Lessons from the increase in global funding for HIV/AIDS and how it was achieved can be drawn in the areas of funding generation, raising political and social com-mitment and multi-stakeholder collaboration. Yet, the analysis has also shown the potential pitfalls when overall health system strengthening efforts and primary health-care integration are not sufficiently addressed.
Acknowledgments: This paper was produced as a final thesis to acquire the academic de-gree BSc International Health Sciences at Fulda University of Applied Sciences. I would like to extend my gratitude to Prof. Dr. Dr. Jens Holst for his support throughout my studies and this thesis supervision, together with Prof. Dr. Kai Michelsen. Moreover, I would like to thank Eric Daniel Sander for his invaluable thoughts and input during the writing process, as well as those who supported me with corrections and proof-reading.