UNAIDS: The First 10 Years

UNAIDS The First 10 Years172… Looking back, I think there’s little question that without that target the Ministers of Healthwould not have felt pressure to actually deliver on anything. I think it was most importantthat the UN asked Ministers of Health and governments to actually perform and be heldaccountable for outcomes”.This meant that it was several months before the planned new staff could be recruited incountries. ‘While WHO could only support the implementation efforts of its Member States,time was lost in disputes over ownership and the feasibility of achieving the target, rather thanthe action needed’ 33 .Interestingly, at the 15 th PCB meeting in June 2004, although the PCB welcomed the greatlyincreased focus on treatment, as exemplified by the “3 by 5” initiative, it stressed that ‘…prevention must remain a cornerstone of a comprehensive response, not only to prevent newinfections but also to reduce stigma and discrimination’. There was a growing concern, notonly among PCB members, that prevention had been side-lined by the focus on treatment.Monitoring and evaluationMonitoring and evaluation are crucial to determining whether funding is being used effectivelyand whether programmes are reaching target populations and accomplishing theirobjectives. It supports the information needs of partners such as the Global Fund andPEPFAR. However, there was evidence that efforts at monitoring and evaluation were beinghampered by a lack of technical capacity and resources 34 . In September 2003, UNAIDSpublished its first Progress Report in the Global Response to the HIV/AIDS Epidemic, thefollow-up to the 2001 UN General Assembly Special Assembly on AIDS, and it reportedthat 75% of the 103 reporting countries felt they did not have the capacity to report reliablyon indicators such as HIV workplace policies, coverage of antiretroviral therapy and accessto prevention of mother-to-child transmission services. Only 43% of these countries had anational monitoring and evaluation plan.Consequently, UNAIDS has established a Monitoring and Evaluation Unit within theSecretariat as well as in the World Bank (the Global Monitoring and Evaluation Team), aspart of the effort to strengthen countries’ capacity to track the epidemic. This was also theresult of a recommendation from the Five Year Evaluation of UNAIDS.Paul De Lay runs the Secretariat’s Evaluation Department and he explained that it has threefunctions. The first is to help countries develop their monitoring and evaluation systems. Morethan 40 full-time Monitoring and Evaluation Advisers and their teams provide technical assistanceto countries and Regional Support Teams, and support the coordination and capacitybuilding of national monitoring and evaluation systems. The advisers’ role is to work withgovernments, civil society and UN system counterparts to strengthen national capacity inMonitoringand evaluationare crucial todetermining whetherfunding is beingused effectively andwhether programmesare reaching targetpopulations andaccomplishing theirobjectives.33Schwartländer, Grubb, Perriëns (2007).34UNAIDS (2004). Global Report 2004. Geneva, UNAIDS.