Global Health:

Joint U.N. Programme on HIV/AIDS Needs to Strengthen Country-Level Efforts and Measure Results

GAO-01-625: Published: May 25, 2001. Publicly Released: Jun 8, 2001.

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Despite efforts by the international community to reduce the spread of the human immunodeficiency virus, AIDS is now the fourth leading cause of death in the world and the primary cause of death in sub-Saharan Africa. The Joint United Nations Programme on HIV/AIDS (UNAIDS), funded in part by the United States, is one important international effort against the disease. UNAIDS was established by the United Nations (U.N.) in 1996 to provide coordinated U.N. action and to lead and promote an expanded global response to the worldwide epidemic. This report (1) assesses UNAIDS' progress, especially at the country level, toward increasing the coordination and commitment of the U.N. and global community; (2) assesses UNAIDS' progress in providing technical assistance and information and in developing a monitoring and evaluation plan to measure results; and (3) identifies factors that may have affected UNAIDS' progress. GAO found that UNAIDS has made progress in increasing U.N. coordination and enhancing the global response to the worldwide HIV/AIDS epidemic, but its country-level efforts need to be strengthened. UNAIDS has provided financial and technical support to about 50 HIV/AIDS technical networks worldwide, but has not been as successful in tracking the funding and actions host governments and others have taken to address the AIDS problem. UNAIDS has also been unable to follow its intended model of U.N. reform, whereby a single Secretariat together with several U.N. agencies would marshal the U.N. and global community's resources to address the AIDS epidemic.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: UNAIDS' Unified Budget and Workplan (UBW) now requires coordination among cosponsors and contributes to transparency on roles and resources. UNAIDS agreed to jointly appoint the Theme Group chair with its Country Resident Coordinators in some countries. In addition, the Program Coordinating Board (PCB) will seek the endorsement of the Secretary General to request a written annual progress report on implementation of the United Nations Country Team Implementation Support Plans to the National Response (UNISP) from the UN Theme Groups on HIV/AIDS.

    Recommendation: To help UNAIDS achieve progress toward its mission and to help demonstrate this progress, the Secretary of State should direct US representatives on the cosponsors' executive boards to propose initiatives to accelerate the cosponsors' efforts to integrate HIV/AIDS into the work of their agencies.

    Agency Affected: Department of State

  2. Status: Closed - Implemented

    Comments: UNAIDS' Unified Budget and Workplan (UBW) now requires coordination among cosponsors and contributes to transparency on roles and resources. UNAIDS agreed to jointly appoint the Theme Group chair with its Country Resident Coordinators in some countries. In addition, the Program Coordinating Board (PCB) will seek the endorsement of the Secretary General to request a written annual progress report on implementation of the United Nations Country Team Implementation Support Plans to the National Response (UNISP) from the UN Theme Groups on HIV/AIDS.

    Recommendation: To help UNAIDS achieve progress toward its mission and to help demonstrate this progress, the Secretary of State should direct US representatives on the cosponsors' executive boards to propose initiatives to hold cosponsors' country-level staff accountable for (1) participation in theme groups and (2) the results of theme groups' efforts to help host countries combat HIV/AIDS.

    Agency Affected: Department of State

  3. Status: Closed - Implemented

    Comments: UNAIDS, representing 10 cosponsors, WHO, World Bank, UNICEF, USAID, Department of State, DHHS, CDC, and the Global Fund to Fight AIDS, TB and Malaria jointly developed and published the standard monitoring and evaluation plan, known as the M&E Toolkit for HIV/AIDS, Tuberculosis and Malaria, in June 2004. The purpose of this framework is to establish a selection of standard indicators and best practices for monitoring and evaluating disease mitigation activities at the country level. The Toolkit is now the excepted framework for developing and implementing monitoring and evaluation workplans for UNAIDS and all the cosponsors.

    Recommendation: To help UNAIDS achieve progress toward its mission and to help demonstrate this progress, the Secretary of State and the Administrator, USAID, should request that the UNAIDS Secretariat and cosponsors complete a monitoring and evaluation plan that will allow UNAIDS to determine the results of its overall efforts and progress, especially at the country level.

    Agency Affected: United States Agency for International Development

  4. Status: Closed - Implemented

    Comments: UNAIDS, representing 10 cosponsors, WHO, World Bank, UNICEF, USAID, Department of State, DHHS, CDC, and the Global Fund to Fight AIDS, TB and Malaria jointly developed and published the standard monitoring and evaluation plan, known as the M&E Toolkit for HIV/AIDS, Tuberculosis and Malaria, in June 2004. The purpose of this framework is to establish a selection of standard indicators and best practices for monitoring and evaluating disease mitigation activities at the country level. The Toolkit is now the excepted framework for developing and implementing monitoring and evaluation workplans for UNAIDS and all the cosponsors.

    Recommendation: To help UNAIDS achieve progress toward its mission and to help demonstrate this progress, the Secretary of State and the Administrator, USAID, should request that the UNAIDS Secretariat and cosponsors complete a monitoring and evaluation plan that will allow UNAIDS to determine the results of its overall efforts and progress, especially at the country level.

    Agency Affected: Department of State

 

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