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Evaluating the International Donor Response to the AIDS Crisis

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

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  1. Evaluating the International Donor Response to the AIDS Crisis Moon Yoon Public Health and Social Justice Portland State University December 2, 2008

  2. Source: http://science.nationalgeographic.com

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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/

  9. 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

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