New UNDP report highlights the role that cash transfers can play in preventing HIV

Oct 17, 2014

New York City, USA - 17 October 2014 - Today, on the International Day for the Eradication of Poverty, UNDP has released a new report on cash transfers and HIV prevention. Cash transfers are a major tool in the fight against poverty in its many forms. Since their introduction in Brazil, Mexico and Bangladesh in the early 1990s, cash transfers have grown in popularity worldwide. Recent evidence points convincingly to a new benefit of cash transfers: HIV prevention. UNDP believes that cash transfers are just one example of how development approaches can be brought to bear on the HIV epidemic, highlighting a path toward ending poverty and ending AIDS in our lifetime.

“We’ve known for years that cash transfers can reduce poverty, improve access to education and health services, and tackle other broader development objectives. That cash transfers are now showing serious potential to prevent HIV at the same time is a huge ‘win-win’, with possible implications for how sectors of government design and finance mutually beneficial programmes,” says Dr. Mandeep Dhaliwal, Director of UNDP’s HIV, Health and Development Group, which produced the report.

UNDP’s report emphasizes that it is precisely cash transfers’ impacts on underlying drivers of the epidemic that make them so effective for reducing HIV risk. The report recognizes HIV as an issue of inequalities, one propagated in particular by overlapping gender and economic inequalities. Cash transfers can most usefully prevent HIV where they help reduce these inequalities.
That addressing inequality is central to this story makes the work immediately relevant to UNDP’s new Strategic Plan, 2014-2017.

“Our new Strategic Plan prioritizes reducing poverty and addressing inequalities, including economic and gender inequalities. It emphasizes inclusive social protection and the importance of co-benefit analysis and planning. All of these areas can serve as possible entry points for cash transfers work. Not surprisingly, effective cash transfer programmes will also play an important role in the fight against Ebola,” adds Dr. Dhaliwal.

UNDP’s report offers a comprehensive set of strategies for moving forward in terms of policy and programmes as well as research. These recommendations are anchored in an important fact: that cash transfers already reach over one billion people in the developing world.

“Given the scope and popularity of cash transfer programmes, which are and will continue to be implemented for broader development objectives, the greatest opportunities may not be in scaling up pilot studies focused exclusively on HIV prevention,” comments Brian Lutz, UNDP Policy Specialist and one of the report’s co-authors. “Rather, the immediate opportunity is in making cash transfers and other forms of social protection HIV-sensitive – in other words, maximizing the positive impacts on HIV while minimizing the negative ones.”

According to the report, making cash transfers HIV-sensitive can be accomplished by first considering key contextual factors that drive the epidemic in a given area, and then adjusting various programme elements to ensure coverage and access by those most vulnerable. Much of the available evidence on cash transfers and HIV prevention centres on girls and young women, who bear significant HIV burdens, particularly in sub-Saharan Africa, and often have less control over their sexual choices than do men. UNDP’s report recommends that cash transfers also be explored for their potential to prevent HIV among key populations, such as men who have sex with men, transgender people, sex workers, and people who inject drugs.

Investment approaches to AIDS and the Global Fund’s new funding model have placed a premium on interventions that are high-impact, cost-effective and sustainable. UNDP’s report notes that cash transfers’ potential to impact HIV alongside poverty and other development objectives makes them a particularly appealing investment opportunity. Previous work by UNDP and the STRIVE consortium at the London School of Hygiene & Tropical Medicine shows how cross-sectoral financing of cash transfers can make them cost-effective investments of scarce resources. The report suggests that, where relevant, cash transfers could be integrated into Global Fund concept notes, which are anchored in comprehensive national plans.

“Comprehensive national strategic plans create opportunities to identify links across sectors of government, such as those embodied by cash transfers for HIV prevention. At the same time, HIV-sensitive cash transfers might qualify for extra resources, beyond regular country allocations, that the Global Fund has set aside to finance evidence-based, high-impact innovations,” says Mr. Lutz.

UNDP cautions that specific attention must be paid to ethical and human rights considerations. It advises against making receipt of cash transfers contingent on HIV status or maintenance of HIV status. Nor should cash transfers be linked to irreversible or invasive procedures, such as medical male circumcision or microbicide use, regardless of the potential for efficacy in these areas. Instead, the report recommends that efforts be made to reduce financial and non-financial demand-side barriers, such as user fees and transport costs, to help people who wish to access these and similar services that are critical components of comprehensive HIV responses.

UNDP’s report on cash transfers and HIV prevention builds upon the HIV, Health and Development Group’s ongoing work, particularly its work helping countries to embed HIV and health into action on gender, poverty and broader efforts to accelerate and sustain progress on the Millennium Development Goals (MDGs). Fighting poverty and HIV are at the core of the MDGs and are expected to remain central within the post-2015 development agenda.

UNDP’s Discussion Paper on Cash Transfers and HIV Prevention is available here.

About UNDP’s HIV, Health and Development Group

UNDP is a founding cosponsor of the Joint UN Programme on HIV/AIDS (UNAIDS), a partner of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and a cosponsor of several other international health partnerships. UNDP’s work on HIV, health and development leverages the organization’s core strengths and mandates in human development, governance and capacity development to complement the efforts of specialist health agencies of the United Nations system.


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