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The Bank's Contribution to Results

In Kenya, one of the first countries to benefit from the World Bank’s Multi-Country AIDS Program (MAP) for Africa (launched in 2000),

  • AIDS-related deaths in Kenya have fallen by 29 percent since 2002
  • HIV prevalence among adults aged 15 to 49 years in urban areas decreased from 10 percent in 2003 to 8.7 percent in 2007.

Uganda, Malawi, and Zambia are other MAP countries where HIV/AIDS prevalence has fallen.

In Botswana, the Bank has assisted in increasing the coverage, efficiency, and sustainability of targeted HIV/AIDS interventions. By focusing on institutional capacity building, prevention and mitigation, Botswana has:

  • Increased Voluntary Counseling & Testing: Among countries for which testing utilization data are available for 2008, the highest number of tests per 1000 population was reported in Botswana (210) (WHO, UNICEF, UNAIDS 2009)
  • Reduced AIDS mortality & fewer OVCs: The estimated annual AIDS-related deaths fell by more than half—from 15,500 in 2003 to 7400 in 2007—while the estimated number of children newly orphaned by AIDS has fallen by 40% (Stover et al., 2008)
  • PMTCT reduced fivefold: the annual number of new HIV infections among children has declined fivefold in Botswana, from 4600 in 1999 to 890 in 2007 (Stover et al., 2008)

Senegal was among the first group of countries to benefit from the Multi-Country AIDS Program (MAP) for Africa covering prevention, care and treatment. The project, which started in 2002, had strong civil society and national support. Over the course of the effort:

  • 600,000 people were tested for HIV
  • Over 360,000 pregnant women utilized prenatal HIV-related services to prevent mother-to-child transmission
  • 70% of the Senegalese people believe their country is effectively responding to the HIV/AIDS challenge (UNAIDS, 2010)

In Rwanda, the Government recognized early on the interface between strengthening the health system and scaling up the response to HIV/AIDS and used MAP funds to support the scale up of AIDS treatment and to strengthen more broadly the health system through the roll out of performance based financing for HIV/AIDS services and the provision of annual grants to facilities to improve their overall functioning. As a result:

  • Life saving AIDS treatment was provided to over 9200 patients of which the majority were females, who are disproportionately affected. With the support of multiple partners Rwanda reached a coverage rate of about 70 percent in comparison to the regional average of 30 percent (2007).
  • HIV/AIDS related mortality declined steeply following the introduction of AIDS treatment and HIV/AIDS patients had lower levels of reported sexual activity and higher rates of condom use than non-patients.
  • Providers reported a high degree of satisfaction with the empowering effects of hospital grants which allowed them to decide on the number, profile and payment levels of additional personnel recruited. Providers also reported satisfaction with the upgraded laboratories which enhanced their capacity to serve all patients.
  • Performance based financing provinces supported by IDA experienced higher rates of increases in HIV testing (before/after comparisons) than non PBF provinces.
  • Community health insurance (mutuelle) was subsidized for over 52,000 households, reaching about a quarter million people who had improved access to general health services.

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