Background

Mozambique is reported to have the sixth highest prevalence of HIV of all countries in the world, with approximately 12.4 percent of the population living with HIV (Statista, 2021). The estimated number of new HIV infections per year decreased from 160,000 in 2010, to about 130,000 by 2019, with 60 percent of people living with HIV accessing antiretroviral therapy (ART) (UNAIDS, 2021a). However, the country has continued to have poor retention in care, resulting in mortality rates higher than would be expected for the size of the epidemic (U.S. Department of State, 2019).
Mozambique is experiencing programmatic challenges in its HIV response and, in addition, remains dependent on development partners. Most funds for the HIV response in 2019 came from external funders (96 percent), with an estimated 4 percent of the funds coming from domestic public expenditures and 0.1 percent coming from domestic private expenditures (UNAIDS, 2021b). The Government of Mozambique has evaluated several financing options, including a cell phone tax, a “sin” tax on tobacco and alcohol consumed in night clubs or bars, and a mandate for formal sector employers to pay for HIV treatment for employees, but none of these are currently being implemented. In addition, the government’s recent fiscal crisis limits its budgetary space for HIV response funding. Urgent action is needed to identify alternative and feasible financing solutions to increase internal resource mobilization and thus help Mozambique achieve its 95-95-95 goals by 2030.
Although Mozambique’s gross domestic product (GDP) is still chiefly generated by smallholder farming, the country’s economic growth has been diversifying, particularly through mining, manufacturing, electricity generation, water resources, and construction (Cruz et al., 2016). In particular, the extractive sector (minerals mining, petroleum, and natural gas) contributed 7.4 percent of GDP in 2018 (EITI, 2020). Although currently a small share, this contribution has been increasing and may offer opportunities for increased private sector engagement in the health sector.
An exploration of options to engage the private sector to support HIV services in the country may help address the reliance on external funders. By investing in employee health schemes, companies can also reduce the direct burden on the public sector. The Health Policy Plus (HP+) project, funded by the U.S. Agency for International Development (USAID), conducted an assessment of private sector companies located in high-HIV burden areas in Mozambique to identify opportunities and challenges to private sector engagement in the HIV response. This brief summarizes current corporate social responsibility (CSR) trends in Mozambique and highlights the individual contributions and perspectives of nine companies. HP+ provides here various policy options and recommendations that may enable Mozambique to increase private sector engagement and investment for HIV. These recommendations are informed by interviews with the companies and a review of the global CSR landscape.