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

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Nandini Oomman, Michael Bernstein, Steven Rosenzweig

10/10/2007

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Donor funding for HIV/AIDS has skyrocketed in the last decade: from US$ 300 million in 1996 to US$ 8.9 billion in 2006. Yet, little is understood about how these resources are being spent. This second major output from CGD's HIV/AIDS Monitor team analyzes the policies and practices of the world's largest AIDS donors -- the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank's Multi-Country HIV/AIDS Program for Africa (MAP) -- as they are applied in Mozambique, Uganda and Zambia, and compares these systems against six key funding practices that can help donors support the national AIDS response in a manner consistent with the aid effectiveness principles of the Paris Declaration. These best practices are: working with the government; building local capacity; keeping funding flexible; selecting appropriate recipients; making the money move; and collecting and sharing data. PEPFAR scores well on making its money move and on collecting data; the Global Fund ranks high on tailoring programs and sharing data; and the World Bank stands out for its long-term commitment to working with the government, strengthening systems and building local recipients' capacity.

1) Recommendations to all three donors

• Jointly coordinate and plan activities to support the National AIDS Plan
• Assist the government in tracking total national AIDS funds
• Focus on building and measuring capacity
• Develop strategies with host governments and other donors to ensure financial sustainability
• Strengthen financial data collection and disclosure

2) Recommendations to PEPFAR

• Make the government a true partner in PEPFAR programs
• Increase flexibility of programming and funding
• Strengthen capacity-building activities in host country
• Adopt two-year cycles for Country Operational Plans
• Publicly disclose data

3) Recommendations to the Global Fund

• Keep the focus on funding gaps
• Re-examine strategies to build local capacity
• Simplify procedures for good performers
• Publicly disclose data

4) Recommendations to the World Bank MAP

• Focus resources on building government capacity
• Become a knowledge bank, with a focus on prevention
• Transition to use of existing government systems
• Increase individual disbursement amounts
• Publicly disclose data

Download event materials

  

Initiatives

• HIV/AIDS Monitor: Tracking Aid Effectiveness

Research Topics

• Global Health Policy
• Regions

CGD Experts

• Nandini Oomman

Articles

• AIDS: The Politics of Prevention (America Abroad Media)
• The PEPFAR Paradox (Newsweek)
• Experts Want African Aid Funds Channelled Away from HIV (Guardian UK)
• Can HIV/AIDS Donors be the Lead "Gender Bender" of Global Development? (Huffington Post)
• AIDS Billions and Health Systems: Q&A with Nandini Oomman
• AIDS Funding Binds Longevity of Millions to U.S. (Washington Post)
• A Trickle or a Flood: Commitments and Disbursement for HIV/AIDS - Q&A with Michael Bernstein
• Making Sense of the 2006 AIDS Epidemic Update: Q&A with Mead Over
• What's Next for the Global Fund?
• HIV/AIDS Monitor: Q&A with Nandini Oomman

Multimedia

• HIV/AIDS Research in Zambia (Interview)
• What Are Donors Doing with AIDS Money? (Event)