Foreign Assistance:

Combating HIV/AIDS in Developing Countries

NSIAD-92-244: Published: Jun 19, 1992. Publicly Released: Jun 24, 1992.

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Joseph E. Kelley
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Pursuant to a congressional request, GAO reviewed the Agency for International Development's (AID) response in developing countries to the human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS), to assess: (1) the priority AID places on AIDS prevention; (2) the AID implementation strategy; (3) whether AID has evaluated the disease's impact on its other development programs; and (4) the management, implementation, and oversight of the AIDS Technical Support Project.

GAO found that: (1) in 1987, AID issued AIDS policy guidance that stated that missions should not mount large AIDS-specific programs because the disease is a sensitive subject and funds and staff are needed for other priorities; (2) the AID policy has evolved substantially since 1987, but AID has not formulated an agencywide strategy which links its policy with bureau and mission operations; (3) AID has not considered the impact of AIDS on its economic development programs; and (4) AID has not developed an agencywide strategy for carrying out AIDS prevention policies or emphasized AIDS issues in programming and budgeting decisions.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Assistant Director of the HIV/AIDS program stated the AID-funded studies by ABT Associates on the socioeconomic impact of HIV/AIDS on Kenya and Thailand have been completed. Additionally, AID has completed other studies such as the study that reviewed the socioeconomic impact of HIV/AIDS on households in Tanzania.

    Recommendation: The Administrator, AID, should expedite the completion of the planned study to examine the effects of HIV/AIDS on overall development.

    Agency Affected: United States Agency for International Development

  2. Status: Closed - Implemented

    Comments: The Policy Directorate is responsible for drafting this document. The HIV/AIDS division continues to work with the Directorate. The policy was rewritten by the AID policy offices and is expected to be released in October 1994.

    Recommendation: The Administrator, AID, should update the 1987 policy, develop an agencywide strategy for implementing this policy, and formally incorporate HIV/AIDS issues into program and budget planning processes.

    Agency Affected: United States Agency for International Development

  3. Status: Closed - Implemented

    Comments: AID is developing systems to meet the requirements of the recommendations. AIDSCAP has identified 12 priority countries with the concurrence of the regional bureaus. AID continues to work with WHO/GPA on the final stages of field testing indicators. The agency is accessing the increased demand for condoms and ways to meet projected increases in condom demand. AID developed a list of priority countries and developed standard indicators. AID HIV/AIDS program condom needs are being met. HIV/AIDS programs have matured and missions are ordering condoms and contraceptives. AID purchased $40 million worth of condoms for the program and WHO/GPA provided another $1 million worth of condoms to meet emergency needs. AID is keeping up with the demand for condoms. AID no longer supplies condoms to Bangledesh and Pakistan for political reasons. Since half of AID condoms went to those two countries, AID now has more condoms for the HIV/AIDS program.

    Recommendation: The Administrator, AID, should: (1) confirm a list of priority countries for HIV/AIDS prevention assistance under AIDS Control and Prevention (AIDSCAP); (2) develop a standardized set of indicators for use in evaluating program impact; and (3) seek ways for satisfying the increased demand for condoms expected to be generated by the AIDSCAP project.

    Agency Affected: United States Agency for International Development


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