UNAIDS: The First 10 Years

UNAIDS The First 10 Years184UNAIDS coined the phrase ‘making the money work’. This was the major challenge. Therewas the perception that only a brief window in time existed in which to do this – to convincepoliticians, for example, of the sustainability of the response – and thus the urgency.But ‘making the money work’ was no easy task for most countries. Many of those applying foror receiving funds did not have what some economists call the ‘absorptive capacity’ to usethem. They lacked the personnel to process funds and ensure their distribution, the plannersand policy makers to make the necessary proposals based on the right technical know-howand, in particular, they suffered from extreme shortages of staff on the ground – doctors,nurses, community workers, programme managers and others. The lack of capacity of somecountries to absorb aid assistance was not a new problem, but it had never been satisfactorilyresolved. The increased funds for AIDS made the countries’ absorptive capacity problemeven more obvious.If the availablefunding failed toproduce soundresults in scalingup prevention andtreatment, it wouldnot be easy toconvince donors ofthe need to continueinvesting.Donors could not professignorance of such problems,and in fact, in some instances,they have exacerbated themby requiring these hardpressedcountries to executeprogrammes according totheir own rules and to reportregularly – again according todonor-specific standards – onthe programmes or projectsthey were funding. For instance,some countries might have 10donors, and so would have toproduce 10 different reports.Every year donors would visit countries and, yet again, require specific work to be done. Inone year, for example, Tanzania might receive 2,000 donor delegations and aid missions, allof whom would expect to be met by top officials, and the Minister of Finance would have tosupply 10 000 reports 5 . Donors would impose reporting requirements that were overwhelmingfor small countries. For example, the island of Saint Vincent (population 117,000) was askedto monitor 191 indicators, and Guyana, 169 indicators. Time and money was wasted in duplicatingtasks to meet the demands of a multiplicity of public and private agencies. The sametime and money could have been spent on extending prevention programmes, supportand treatment for people living with HIV and on eradicating serious gaps in many nationalresponses to AIDS, such as surveillance to identify people most at risk.Despite the great hike inAIDS funding, family careis still essential in all affectedcountriesUNAIDS/W.Phillips5United Nations Millennium Campaign website, 2007. Harmonization of Aid: Why Does Harmonization MatterSo Much?