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Evaluating the International Donor Response to the AIDS Crisis. Moon Yoon Public Health and Social Justice Portland State University December 2, 2008. Source: http://science.nationalgeographic.com. AIDS Epidemic in sub-Saharan Africa. 11% of world population live in sub-Saharan Africa
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Evaluating the International Donor Response to the AIDS Crisis Moon Yoon Public Health and Social Justice Portland State University December 2, 2008
AIDS Epidemic in sub-Saharan Africa • 11% of world population live in sub-Saharan Africa • 67% of worldwide HIV population • 72% of AIDS deaths in 2007 • 90% of HIV infected children Source: 2008 Report on the global AIDS epidemic, July 2008, UNAIDS.
Three AIDS Donors, Three Approaches to the Crisis Source: Oomman N, Bernstein M, Rosenzweig S; Center for Global Development. Following the funding for HIV/AIDS: a comparative analysis of the funding practices of PEPFAR, the Global Fund and World Bank MAP in Mozambique, Uganda and Zambia. October 10, 2007.
President’s Emergency Plan for AIDS Relief (PEPFAR) • Responsible to the US Congress and President • Legislation of very specific targets • Treat 2 million with ARV • Prevent 7 million new infections • Support care for 10 million HIV patients • Allocation of funds also legislated • 55% treatment, 20% prevention, 15% care, 15% orphans
Global Fund to Fight AIDS, Tuberculosis and Malaria • Private foundation based in Geneva, Switzerland • “the Fund is a financial instrument, not an implementing entity” • Provides renewable grants based on proven performance • Governments submit grants by establishing a Country Coordinating Mechanism (CCM) • Challenges in implementation rise most often from capacity of Recipient Organizations
The World Bank Multi-Country AIDS Program for Africa (MAP) • The World Bank exists to “help governments in developing countries reduce poverty by providing them with money and technical expertise they need” • MAP was designed to strengthen a country’s capacity to develop a national response to the AIDS epidemic • Funds given as grants or loans • Bottleneck in the government system • Complex reporting requirements and bureaucracy • Pervasive capacity constraints in public system
Conclusion • Shortage of human resources is a major roadblock • Lack of infrastructure and resources in host country are cited as major reasons for the brain drain • Suggestions to build up infrastructure • Investigate how to develop and retain work force • NGOs should adopt the NGO Code of Conduct for Health Systems Strengthening * • Donors should publicly disclose financial data * http://ngocodeofconduct.org/
References • UNAIDS. 2008 Report on the global AIDS epidemic. (Accessed November 22, 2008, at http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp.) • Oomman N, Bernstein M, Rosenzweig S; Center for Global Development. Following the funding for HIV/AIDS: a comparative analysis of the funding practices of PEPFAR, the Global Fund and World Bank MAP in Mozambique, Uganda and Zambia. October 10, 2007. (Accessed November 22, 2008, at http://www.cgdev.org/content/publications/detail/14569.) • Institute of Medicine. 2005. Healers abroad: Americans responding to the human resource crisis in HIV/AIDS. Washington: DC;The National Academies Press