Global Health:

U.S. Agency for International Development Fights AIDS in Africa, but Better Data Needed to Measure Impact

GAO-01-449: Published: Mar 23, 2001. Publicly Released: Mar 23, 2001.

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The AIDS epidemic in sub-Saharan Africa has grown beyond a public health problem to become a humanitarian and developmental crisis. The Agency for International Development (AID) has contributed to the fight against human immunodeficiency virus (HIV)/AIDS in sub-Saharan Africa by focusing on interventions proven to slow the spread of the disease. However, AID's ability to measure the impact of its activities on reducing transmission of HIV/AIDS is limited by (1) inconsistent use of performance indicators, (2) sporadic data collection, and (3) lack of routine reporting of results to headquarters. As part of its approach for allocating the 53 percent increase in funding for HIV/AIDS prevention activities in sub-Saharan Africa for fiscal year 2001, AID prepared a plan to expand monitoring and evaluation systems in countries designated as in need of significant increases in assistance. However, when implemented, the monitoring and evaluation requirements in the plan will not initially include all countries where AID missions and regional offices in sub-Saharan Africa implement HIV/AIDS programs. Further, the plan does not specify to whom these data will be reported or how the information will be used. Failure to address these issues not only inhibits AID's ability to measure the performance of its HIV/AIDS activities but also hinders the agency's decision-making regarding allocation of resources among missions and regional offices and limits efforts to identify best practices.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: In a letter dated September 5, 2001, USAID agreed with the recommendations for Executive Action in GAO's March 26, 2001, report and cited specific actions it is taking, or planning to take, to implement an improved reporting system to ensure that select information from the field is routinely reported to USAID Washington. In response to the recommendation that it require all missions and regional offices that conduct HIV/AIDS prevention activities--select standard indicators to measure the progress of its HIV/AIDS programs--the agency stated that it (1) has developed the handbook of standard indicators, (2) organized a technical working group to develop a set of standard indicators for new areas; i.e., mother-to-child transmission, orphan support and care, and support for HIV infected people, and (3) conducted a four-day workshop to encourage development of national monitoring and evaluation plans in African countries using standardized indicators for seven African countries.

    Recommendation: To enhance AID's ability to measure its progress in reducing the spread of HIV/AIDS in sub-Saharan Africa and better target its resources, the Administrator, AID, should require that all missions and regional offices that conduct HIV/AIDS prevention activities select standard indicators to measure the progress of their HIV/AIDS programs.

    Agency Affected: United States Agency for International Development

  2. Status: Closed - Not Implemented

    Comments: No action taken.

    Recommendation: To enhance AID's ability to measure its progress in reducing the spread of HIV/AIDS in sub-Saharan Africa and better target its resources, the Administrator, AID, should require that all missions and regional offices that conduct HIV/AIDS prevention activities gather performance data, based on these indicators, for key HIV/AIDS activities on a regular basis.

    Agency Affected: United States Agency for International Development

  3. Status: Closed - Not Implemented

    Comments: No action taken.

    Recommendation: To enhance AID's ability to measure its progress in reducing the spread of HIV/AIDS in sub-Saharan Africa and better target its resources, the Administrator, AID, should require that all missions and regional offices that conduct HIV/AIDS prevention activities report performance data to a unit, designated by the Administrator, for analysis.

    Agency Affected: United States Agency for International Development

 

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