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Evaluating the World Bank's Assistance for Fighting the HIV/AIDS Epidemic

Committing to Results: Improving the Effectiveness of HIV/AIDS Assistance

HIV/Aids Evaluation Report Cover This evaluation assesses the development effectiveness of the World Bank's country-level HIV/AIDS assistance defined as policy dialogue, analytic work, and lending with the explicit objective of reducing the scope or impact of the AIDS epidemic. The evaluation identifies findings from this experience and makes recommendations to improve the relevance, efficiency and efficacy of ongoing and future activities. This is the first comprehensive evaluation of the World Bank's HIV/AIDS support to countries, from the beginning of the epidemic through mid-2004. Because the Bank's assistance is for implementation of government programs by government, it provides important insights on how national AIDS programs can be made more effective.

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Statement of the External Advisory Panel

World Bank Management Response

Chairman's Summary: Committee on Development Effectiveness

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Findings:
	The World Bank's assistance has induced governments to act earlier or in a more focused and cost-effective way.
	It has helped raise political commitment, create or strengthen AIDS institutions, enlist NGOs, and prioritize activities.
	Political commitment and capacity have been overestimated and need to be addressed continuously, as appropriate in the country context.
	Failure to reach people with the highest risk behaviors likely has reduced the efficiency and impact of assistance.
	Weak monitoring and evaluation and the failure to ensure that country-based research is focused on programmatic priorities are missed opportunities for improving the effectiveness of the national response.

Recommendations : In the next phase of its response, the Bank should help governments use human and financial resources more efficiently and effectively to have an impact on the epidemic.
	Help governments to be more strategic and selective, and to prioritize activities that will have the greatest impact.
	Strengthen national institutions for managing and implementing the long-run response, particularly in the health sector.
	Improve the local evidence base for decision-making and create incentives to ensure that programmatic decisions are guided by relevant local evidence and rigorous analytic work.

Evaluation Building Blocks

Country Case Studies:
	Brazil
	Ethiopia
	Indonesia
	Russia

Projects Performance Assessment Reports (PPAR):
	Brazil: AIDS and STD Control Project I and II, in English or Portuguese
	Cambodia: Disease Control and Health Development Project
	Chad: Population/AIDS Control Project, in English or French
	India: National AIDS Control Project
	Indonesia: HIV/AIDS and STDs Prevention and Management Project
	Kenya: Sexually Transmitted Infections Project
	Uganda: Sexually Transmitted Infections Project

Other Background Documents:
	Timelines
	HIV/AIDS project portfolio
	Coverage of HIV/AIDS in Country Assistance Strategies and Poverty Reduction Strategy Papers
	Review of World Bank analytic work
	Africa Multi-Country AIDS Program: Selected background materials for assessing the assumptions, design, and implementation to date

The Independent Evaluation Group (IEG)is an independent unit within the World Bank; it reports directly to the Bank's Board of Executive Directors. The goals of IEG 's evaluations are to draw lessons from Bank experience, and to provide an objective basis for assessing the results of the Bank's work.

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