Paper short abstract:

An analysis of how omissions of sub-populations and political realities from HIV infectious disease models may discursively shape global health finance priorities.

Paper long abstract:

As funding for the global HIV response steadily shrinks, the political landscape has grown more contentious. Multilateral

and bilateral donors are under pressure to demonstrate impact of investments, and increasingly press national health

programs to shift spending to proven cost-effective interventions. The growing use of these metrics represent an effort

to move health aid from the realm of the political into the realm of economics, in a context of a shift to the "model of the market" (Adams 2016, Brown 2015). But mathematical models on which these algorithms are based include significant gaps in their assumptions and data (Davis 2007, Davis

Kingsbury and Merry 2012, Davis 2015, Fioramonti 2014, Gruskin and Ferguson 2009, Jerven 2013, Merry Davis and

Kingsbury 2015, Satterthwaite and Rosga 2008). They not quantify corruption, criminalization, stigma, weak health

systems and more that impede access to HIV programmes (Atre 2017, Davis 2016, O'Neil 2016), and amplify the

discrimination caused by missing data on hidden and marginalized key populations. Analysis of costing tools promoted by UN agencies and used in HIV resource allocation will explore the market-driven assumptions behind them, analyzing how uncounted populations and realities discursively shape priorities.