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.

Abstract

Donor funding for HIV/AIDS has reached levels unprecedented in the history of global health: annual funding for AIDS in low- and middle-income countries increased 30-fold from 1996 to 2006 from US$ 300 million to US$ 8.9 billion. While funding remains far short of the estimated need international donor commitments for HIV/AIDS are significant and likely to be so well into the future. The resources for AIDS are a topic of considerable interest and debate internationally yet little is understood about how these resources are actually being spent and whether they are being made available as efficiently and effectively as possible for the fight against AIDS. Through the lens of what is happening in several countries in sub-Saharan Africa this paper examines the flow of resources from three of the worlds largest AIDS donors: the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR) the Global Fund to Fight AIDS Tuberculosis and Malaria (Global Fund) and the World Banks Multi-Country HIV/AIDS Program for Africa (MAP). Drawing on country-level research undertaken by collaborating local research organizations we describe the levels and types of funding from these donors and highlight the procedures through which funds are committed released and accounted for in three countries in which all of the programs are active: Mozambique Uganda and Zambia. Through this close look at how money moves from donor to specific purposes we describe bottlenecks and other difficulties in the disbursement of funds document the way their disbursement systems attempt to build national capacity to fight AIDS and identify specific ways in which the donor agencies could make the resources move more efficiently. (excerpt)

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