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Billions of dollars have been allocated to fight HIV/AIDS in poor countries over the past decade, yet less than half of those requiring treatment receive it, and for every two people put on treatment, five more become infected. Donors have to do more with available funds
One way to improve the effectiveness of HIV/AIDS programs is to tie funding decisions to performance. Performance-based funding rewards effective programs and gives incentives for poor performers to improve, but only the Global Fund systematically bases funding decisions on past performance,although in practice it is often hampered by poorinformation. Both PEPFAR and the World Bank use assessmentsof past performance to inform decisions, but the dataand decision processes are not shared with stakeholders,and program performance is often treated as a secondarycriterion. Now is the time to link funding decisions to performance.