Donor voice donor commitment study_2011 executive summary_final2
Evaluating the International Donor Response to the AIDS Crisis
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Evaluating the International Donor
Response to the AIDS Crisis
Moon YoonPublic Health and Social Justice
Portland State UniversityDecember 2, 2008
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Source: http://science.nationalgeographic.com
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AIDS Epidemic in sub-Saharan Africa
11% of world population live in sub-Saharan Africa67% of worldwide HIV population72% of AIDS deaths in 200790% of HIV infected children
Source: 2008 Report on the global AIDS epidemic, July 2008, UNAIDS.
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Three AIDS Donors, Three Approaches to the Crisis
Source: Oomman N, Bernstein M, Rosenzweig S; Center for Global Development. 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. October 10, 2007.
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President’s Emergency Plan for AIDS Relief (PEPFAR)Responsible to the US Congress and PresidentLegislation of very specific targets
Treat 2 million with ARVPrevent 7 million new infectionsSupport care for 10 million HIV patients
Allocation of funds also legislated55% treatment, 20% prevention, 15% care, 15%
orphans
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Global Fund to Fight AIDS, Tuberculosis and MalariaPrivate foundation based in Geneva, Switzerland“the Fund is a financial instrument, not an
implementing entity”Provides renewable grants based on proven
performanceGovernments submit grants by establishing a
Country Coordinating Mechanism (CCM)Challenges in implementation rise most often from
capacity of Recipient Organizations
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The World Bank Multi-Country AIDS Program for Africa (MAP)The World Bank exists to “help governments in
developing countries reduce poverty by providing them with money and technical expertise they need”
MAP was designed to strengthen a country’s capacity to develop a national response to the AIDS epidemic
Funds given as grants or loansBottleneck in the government system
Complex reporting requirements and bureaucracyPervasive capacity constraints in public system
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ConclusionShortage of human resources is a major roadblockLack of infrastructure and resources in host
country are cited as major reasons for the brain drain
Suggestions to build up infrastructure Investigate how to develop and retain work forceNGOs should adopt the NGO Code of Conduct for
Health Systems Strengthening *Donors should publicly disclose financial data
* http://ngocodeofconduct.org/
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References UNAIDS. 2008 Report on the global AIDS epidemic. (Accessed
November 22, 2008, at http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp.)
Oomman N, Bernstein M, Rosenzweig S; Center for Global Development. 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. October 10, 2007. (Accessed November 22, 2008, at http://www.cgdev.org/content/publications/detail/14569.)
Institute of Medicine. 2005. Healers abroad: Americans responding to the human resource crisis in HIV/AIDS. Washington: DC; The National Academies Press