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

Michael Bernstein
October 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.

Event: What Are Donors Doing with AIDS Money?

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The authors then offer recommendations for how each donor can improve its program to increase the effectiveness of aid:

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


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