UNAIDS has Boosted Global Coordination on Disease, But Less Successful on Country Level, GAO Finds
In response to a request by Sen. Bill Frist (R-Tenn.) to examine UNAIDS' progress in addressing global AIDS issues, the General Accounting Office on Monday issued a 68-page report (GAO-01-625) that found that the agency has "helped shift the global community's response to HIV/AIDS from an exclusively health-oriented perspective to a multisectoral approach that addresses the various ramifications of high rates of HIV/AIDS on a country's development." However, the agency's successes have been "partly offset by the inability of UNAIDS' cosponsors to fully integrate HIV/AIDS into their programs and activities and by UNAIDS' weak efforts at the country level," the report states. Since 1998, UNAIDS has given "financial and technical support" to about 50 HIV/AIDS "technical networks," which "link local communities and regions to HIV/AIDS-related resources from universities, health organizations and private consultants." The study's authors interviewed "key" members of the UNAIDS Secretariat, as well as officials from cosponsor nations and the United States. They also conducted an "extensive" review of agency documents and surveyed USAID missions to "obtain perspectives on UNAIDS' HIV/AIDS efforts at the country level."
UNAIDS has "made progress in increasing U.N. coordination" and has "successfully developed" a series of "authoritative, high quality and comprehensive" best practices regarding blood product safety, care of those with HIV/AIDS and tuberculosis and improved access to medicines. However, the agency has not been "as successful" in monitoring the funding and actions taken by nations to address the epidemic at the country level and "has yet to implement a monitoring and evaluation plan that would enable [it] to determine the important results of its overall efforts and measure progress toward achieving its objectives," according to the report. The report says that the agency's success has been hampered by a lack of funding control, as other U.N. agencies and donors have "marshall[ed]" the funds and resources UNAIDS was expected to control. The agency's efforts have also been negatively affected by a "weak political mandate" from the U.N. and the international community, leaving its influence "dependent on how effectively it can advocate AIDS causes to others." In addition, UNAIDS has not always been "consistent" in its response to the HIV/AIDS epidemic, nor has it "followed through sufficiently" on some efforts, such as regional initiatives, the report states. The report recommends that UNAIDS implement strategies to "hold ... cosponsor representatives more accountable at the country level" and to improve its monitoring and evaluation practices. The report also includes a review of UNAIDS' International Partnership Against AIDS in Africa (GAO report, 5/25). To view the report, click here.