Second Independent Evaluation of UNAIDS

1. Second Independent Evaluation of UNAIDS Evaluation Team: Derek Poate, Kathy Attawell, Paul Balogun

2. Purpose • To assess the efficacy, effectiveness and outcomes of UNAIDS (including UNAIDS Secretariat, the PCB and cosponsors) at the global, regional and country levels

3. Questions in the TOR • The evolving role of UNAIDS within a changing environment • Governance of UNAIDS • The response to the Five Year Evaluation of UNAIDS • The Division of Labour between the Secretariat, Cosponsors, Agencies and Countries • Strengthening Health systems • The administration of the Joint Programme • Delivering as One • Involving and working with civil society • Gender dimensions of the epidemic • Technical support to national AIDS responses • Human rights • The greater and meaningful involvement of People living with HIV

4. Conceptual organisation of the evaluation questions Overarching issue c) The way in which UNAIDS has responded to the recommendations of the first 5 year evaluation From 5-year evaluation How UNAIDS is responding to the changing context a) The evolving role of UNAIDS within a changing environment e) Strengthening health systems g) Delivering as One How UNAIDS is fulfilling its Mandate ECOSOC mandate and core objectives d) The Division of Labour between the Secretariat, Cosponsors, Agencies and Countries (global coordination role) h) Involving and working with civil society i) Gender dimensions of the epidemic j) Technical support to national AIDS responses k) Human rights l) The greater and meaningful involvement of people living with HIV How UNAIDS works b) Governance of UNAIDS d) The Division of Labour between the Secretariat, Cosponsors, Agencies and Countries (operational relationships) f) The administration of the Joint Programme Looking forward How has past performance prepared and enabled UNAIDS to deal with future Challenges? To thefuture

5. UNAIDS has responded well to some aspects of the changing context UNAIDS remains highly relevant and has been effective in some key areas of its mandate UNAIDS is less successful at managing changes in governance and management UNAIDS has a low level of efficiency for accountability and management of performance Main conclusions

6. UNAIDS has responded to context • The Five-year Evaluation stimulated UNAIDS towards country-level support, but did not bring about reforms in governance that improve the way the cosponsors work together and with the secretariat. • The diversity of the epidemic at country level is bringing greater recognition that country responses and support from development partners have to be tailored to specific national circumstances. • Greater efforts are needed to provide effective leadership and support for HIV prevention policies and programmes. • Lack of a clear joint programme position on HIV and health system strengthening and of clarity of roles between the secretariat, WHO and World Bank has limited UNAIDS’ influence.

7. Governance • Formal arrangements between the PCB and cosponsor governing bodies remain weak and have undermined progress with accountability. • The emergence of global coordinators has established an effective working link between the cosponsors and the secretariat. The CCO fails to perform its executive role. • The PCB could do more to direct its attention to performance of the joint programme and improve accountability structures. • Strategic frameworks have changed too often to be useful and have never provided a satisfactory framework to monitor performance.

8. Division of labour & joint working • Progress has been made in joint programming at global level. The global coordinators have been the most significant factor. • The division of labour has not led to a rationalisation of staff across the programme as a whole. • The combined initiatives of joint teams and division of labour have led to better team working and perceived improvements in UN effectiveness and efficiency at country level. The influence of joint teams has been greater than that of the division of labour. • At country level, lead agency, single point of entry and coordination of technical support have not yet been effectively implemented. • Accountability for joint team working is a contentious area at country level. • Funding arrangements lead to fragmentation and competition between the cosponsors and the secretariat country office. Neither the joint team nor the division of labour tackle financial incentives.

9. Civil society and people living with HIV 1 • Engagement with civil society and PLHIV organisations has been a cornerstone of the UNAIDS approach and has contributed to their increased involvement in policy, programming and M&E at global, regional and country levels. • Whilst there is good evidence of influence on policy-making at global level and to a lesser extent at regional level, the picture with regard to influence at country level is more mixed and barriers to meaningful involvement remain. • Work with civil society and PLHIV is supported by cosponsors, but there is no common vision across UNAIDS or coherent engagement across joint teams. At country level the secretariat is seen as leading in this area, reinforced by a significant investment in Social Mobilisation and Partnership Officers.

10. Civil society and people living with HIV 2 • Support for resource mobilisation and capacity building has focused on national networks and umbrella organisations. Technical support from the secretariat and cosponsors has been fragmented and piecemeal. • There are no agreed objectives for civil society or PLHIV involvement; without clear and measurable objectives it is difficult to assess impact of involvement. • More attention needs to be given to engagement with the private sector.

11. Technical support to national AIDS responses • Technical support is the key interface between the UN and national HIV programmes • Some improvements have been made in coordination at global level; there is a need for better coordination of technical support providers and of technical support provided by joint teams; there are few examples of UN technical support plans. • UN technical support is valued by country partners but remains largely driven by agency mandates, rather than national priorities, and the division of labour has had little impact. Technical support concentrates on short-term issues; capacity and systems development are less well supported. • UNAIDS support for M&E has been critical but there is a need to rationalise World Bank GAMET and UNAIDS Secretariat support for M&E. • Reviews of technical support providers have been conducted but there has been poor tracking and evaluation of technical support at country level.

12. Human rights & Gender 1 • UNAIDS Secretariat has provided good and diverse leadership on HIV and human rights and to tackle stigma and discrimination. • A lack of consensus has impeded leadership in many areas, including harm reduction and the rights of sex workers. UNAIDS is criticised for not being bold enough to confront policies driven by ideology nor to tackle national responses that fail to address controversial issues. • Work at country level suffers from uneven and often weak capacity in the UN, and a lack of consensus. • The role and commitment of UNDP as lead agency for human rights needs to be reassessed. • Resources devoted to human rights issues are inadequate. There is a general failure to reach people with the highest risk behaviour and prevention services are inadequate for IDU, MSM and SW groups.

13. Human rights & Gender 2 • Governments respect technical guidance by the UN and NGOs look to UNAIDS leadership to raise controversial issues, yet there is a perceived decline in UNAIDS adopting a proactive stance. • Leadership by UNAIDS on gender has seen strong rhetoric but less action. The joint programme has found it difficult to reconcile differing perspectives • UNDP was slow to respond to its lead role in gender and effectiveness is undermined by a lack of clarity about the respective roles of the secretariat, UNDP, UNIFEM and the GCWA. • Support for gender work at country level is fragmented and unstrategic. • MSM and sexual minorities have received less attention until recently; UNDP has started to take the agenda forward.

14. UNAIDS has been • successful in working towards its original ECOSOC objectives of global leadership • mostly successful in advocating greater political commitment at global and country level and broad-based political and social mobilisation • partly successful in promoting and achieving global consensus in policy and programmes and in strengthening capacity at country level

15. Recommendations • 24 recommendations seek to make UNAIDS • more focused, • more strategic, • more flexible and responsive, • more accountable and • more efficient.

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