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Donors spend billions of dollars to fight HIV/AIDS in developing countries, but poor integration between donors and host country health systems risks undermining international efforts to prevent and treat AIDS. In this analysis, CGD’s HIV/AIDS Monitor argues that donors need to pay more attention to their overall effect on health systems.

They find that 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 AIDS Program for Africa have helped establish AIDS-specific systems and processes distinct from those of other health programs. At the same time, these AIDS-specific processes use many of the same resources as a country’s broader health system.

Because stronger and robust health systems are essential to ensure a long-term, expanded AIDS response, the authors urge the donors to take advantage of specific opportunities to strengthen both AIDS programs and larger country health systems. They recommend pursuing the following goals and taking the following actions to strengthen both national health systems and their own AIDS programs.

Improve health information systems:

  • Coordinate government and donor information needs and flows through national health management information systems and other systems—to reduce information fragmentation, to minimize duplicative and burdensome reporting, and to improve data quality;

  • With governments and other stakeholders, jointly design and invest in information technology solutions for data capture, management and analysis in health ministries, districts, and facilities;

  • Capture investments and their results in building information systems management capacity more systematically; and,

  • Create data collection and reporting incentives through information feedback systems.

Improve supply chain systems:

  • Pursue strategies that will let antiretroviral drugs and essential medicines be distributed jointly and managed using the same logistics management information system.

Strengthen human resources for health:

  • Provide more support to train new health workers;

  • Give priority to financing for new health worker hires—as opposed to top-ups for current health workers; and,

  • Work with governments to improve public-sector human resource policies.