General Accounting Office Releases Report on USAID’s Efforts to Combat AIDS Epidemic in Africa
The U.S. General Accounting Office on Friday released a report addressed to the Senate Committee on Foreign Relations Subcommittee on African Affairs, titled "Global Health: U.S. Agency for International Development Fights AIDS in Africa, But Better Data Needed to Measure Impact." The report was assembled in response to foreign relations committee Chair Sen. Bill Frist's (R-Tenn.) request for an examination of USAID's efforts in sub-Saharan Africa. The report states that "given the scale" of the HIV/AIDS epidemic, the disease has "grown beyond a public health problem to become a humanitarian and developmental crisis." The report cites the National Intelligence Council, which states that the "persistence" of infectious diseases, such as HIV, threatens to "aggravate and in some cases provoke economic decline, social fragmentation and political destabilization." The GAO report addresses the development and impact of the HIV/AIDS epidemic in sub-Saharan Africa, the "extent" to which USAID's initiatives have aided the fight against the virus in the region and the approach USAID used when it allocated a 53% 2001 fiscal year increase in funding to expand its HIV/AIDS programs in sub-Saharan Africa. The researchers interviewed "key" USAID officials, took written responses from 19 field missions and three regional offices in Africa and visited missions with HIV/AIDS outreach programs in Malawi, Tanzania, Uganda and Zimbabwe.
The report found that HIV/AIDS has had a "significant negative impact" in sub-Saharan Africa, reducing population growth, decreasing life expectancy and "offsetting gains" made from social and economic development efforts. USAID's efforts, while helpful, have been hampered by limited funding, the social stigma attached to the virus, the low socioeconomic status of women, cultural and social customs that make discussion of sex and HIV transmission "difficult," difficulty reaching military personnel with high infection rates, "weak" national health systems and the "slow response" of African leaders in "recogniz[ing] and adress[ing]" HIV/AIDS. USAID has been successful in disseminating information about the virus, promoting condom use and supporting "prevention, diagnosis and treatment" of other STDs. However, according to the report, it is difficult to ascertain an "overall picture" of the agency's effectiveness because missions do not use "consistent indicators" when measuring progress against HIV. USAID's plan for its $174 million budget this year includes new prevention efforts and the "development of a monitoring and evaluation plan." Personnel shortages, "weak" health care systems, "limited" pharmaceutical distribution capabilities and the "unknown capacities" of nongovernmental organizations may hinder the agency's efforts (GAO report, 3/23). To read the full report, go to http://www.gao.gov/new.items/d01449.pdf.