New report highlights strengths and weaknesses of major AIDS donors

A new report by HIV/AIDS Monitor and the Center for Global Development has for the first time provided a comparative evaluation of the three major donors of AIDS-related funding: the Global Fund for AIDS, Tuberculosis and Malaria, The World Bank and the US President’s Emergency Fund for AIDS relief.

The report, entitled “Following the funding for HIV/AIDS: a comparative analysis”, focuses specifically on the organisations’ work in Mozambique, Uganda and Zambia. Highlighting the strengths and weakness of each project, it highlights how much developing countries have come to rely on funding provided by the three agencies. In Mozambique for example, government contributions currently make up just 2% of the total sum being spent on AIDS in the country, the rest being derived from PEPFAR, and to a smaller extent, the Global Fund and World Bank.

PEPFAR is by far the largest donor of international funding for AIDS in the three countries, providing 62% of AIDS resources in Zambia, 73% in Uganda and 78% in Mozambique. The programme was praised for its ability to distribute fund quickly and directly. However, much of PEPFAR’s funding is channelled through international (often American) non-governmental organisations, meaning there is little government involvement, and no clear way of handing over responsibility to local stakeholders in the long-term.

The report welcomed the Global Fund’s transparent and flexible funding agreements arranged largely by national governments, but pointed out that a lack of capacity to absorb and process large sums of money meant the distribution and spending of funds was often very slow and involved a great deal of bureaucracy.

Finally, the World Bank, the smallest funder of the three, was praised for its work on strengthening government capacity to cope with AIDS, but as with PEPFAR, doubts were raised about its rigid donor-dictated requirements that mean money is usually allocated according the prerogative of the Bank rather than the country in question.

The paper goes on to recommend greater collaboration between the three agencies, both so funding can be allocated evenly and appropriately, and so each organisation can learn from the others’ successes and failures.

“By learning from each other to fix what is not working and by sharing what is working, PEPFAR, the Global Fund and the World Bank MAP can individually and collectively improve their performance in the fight against AIDS in Africa,” the report states.

Spending on AIDS-related programmes has increased 30-fold since 1996, and last year stood at US$ 8.9 billion. However, this is still far short of the amount that UNAIDS estimates is needed to meet the Millennium Development Goal of reversing the spread of HIV by 2015, and the goal of providing universal access to HIV treatment by 2010.

You can read more about PEPFAR, The Global Fund and other major financing initiatives for AIDS on the AVERT website.