OBJECTIVES: Development Assistance for Health (DAH) is one of the main pillars of health financing in Sub-Saharan Africa. This research focuses on the cost-effectiveness of DAH-derived interventions for HIV, Malaria and Tuberculosis by country, in order to identify and prioritize alternative uses of these funding resources.

METHODS: Data were drawn from the Institute for Health Metrics and Evaluation’s databases (Global Burden of Disease and DAH) and from the World Bank (World Development Indicators) for the period 1995-2018. Simple linear regression analysis was used to estimate the effect of DAH on DALYs averted and Deaths averted in the three diseases, while the Sub-Saharan countries were classified in the Human Development Index (HDI) categories. To perform the economic evaluation of DAH on DALYs averted and Deaths averted in order to prioritize funding by country and by disease, Generalized Cost - Effectiveness Analysis was performed, based on the WHO’s GDP per capita thresholds.

RESULTS: The positive impact of DAH on HIV treatment seems to be mainly reflected in the case of countries belonging to the middle HDI category, while the channeling of DAH for Malaria and TB treatment is estimated to be statistically significant for countries in the low HDI category. DAH was found to be very cost-effective in 13 countries, cost-effective in 9 countries and non-cost-effective in 2 countries, while in 21 countries the DAH was found to be dominated.

CONCLUSIONS: The Sub-Saharan African countries vary considerably in terms of their Health Systems infrastructures and organization, and are still remarkably undersupported from their own national resources, resulting in low efficiency of the funds invested. This requires the development of a cost-effective allocation and priority-setting policy to orient funds towards specific countries and diseases in order to achieve the expected positive results in the near future.