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, finding that the big international donors often create duplicate AIDS-specific systems that competitively draw on the health resources of developing countries. The report recommends taking specific steps to more broadly improve health information systems, improve supply chain systems, and strengthen the health workforce.
The President's Emergency Plan for AIDS Relief (PEPFAR) is the single largest funder of global AIDS relief programs, but it does not regularly release data on how its money is spent. In this report, CGD's HIV/AIDS Monitor Team analyzes a newly available dataset of PEPFAR funding. They find, among other things, that only 30% of funds in 15 focus countries have gone to local organizations. They urge PEPFAR to regularly publish such funding data to improve transparency and strengthen coordination with host country governments and other stakeholders, and they suggest actions PEPFAR should take to improve the effectiveness and sustainability of its programs.