Press Release - Department for International Development:
Responding to HIV/AIDS
18 June 2004
The Department for International Development responds to the
international HIV/AIDS epidemic on a wide number of fronts, and has
increased its expenditure in this area in recent years. It has also
recently announced an intensified effort to address the epidemic,
one of the major threats to international development goals. A
National Audit Office report has identified DFID’s broad-based
approach, its flexibility of response in-country, and its role in
supporting research as strengths. Difficulties remain, however, in
adequately embedding HIV/AIDS across DFID’s planning systems; in
securing information both to plan and monitor effective
interventions; and in making best use of HIV/AIDS expertise and
knowledge.
The epidemic, particularly devastating for poor countries,
jeopardises achievement of the Millennium Development Goals which
have the overall aim of halving by 2015 the proportion of the
world’s population living in extreme poverty. The United Nations
Development Programme estimates that in Burkina Faso, Rwanda and
Uganda, the proportion of people living in absolute poverty will,
as a result of HIV/AIDS, increase from 45 per cent today to 51 per
cent in 2015.
Today’s report to Parliament by head of the National Audit
Office Sir John Bourn points out that DFID’s HIV/AIDS strategy
compares well with HIV/AIDS strategies developed by like-minded
donors. It provides a starting point for country staff to develop
programmes suited to local circumstances. But it could have
provided further guidance on the relative merits of different
approaches, responding to demand from country teams for guidance on
the most difficult issues – such as the merits of funding
anti-retroviral drug treatments. DFID plans to produce a new
strategy in July this year which it intends will address these and
other issues.
The broad-based and multi-sectoral nature of DFID’s HIV/AIDS
response makes associated expenditure difficult to isolate. DFID
estimates, on the basis of projects which targeted HIV/AIDS to any
degree (including reproductive health programmes), that it spent
£274 million in 2002-03. When reproductive health is excluded, DFID
estimates that its bilateral HIV/AIDS expenditure in 2002-03 was
between £103 million and £169 million, depending on the estimation
method used. And a new system to estimate the proportion of DFID’s
funding of multilateral institutions relevant to HIV/AIDS has
produced an estimate of £57 million for 2002-03. In addition, a
proportion of DFID’s general support to a nation’s budget can be
channelled to HIV/AIDS programmes but, in common with other donors,
DFID has had difficulty in identifying how much and is developing a
system to address this issue.
Effective development interventions require good analysis of the
context and potential responses prior to project implementation.
The autonomy afforded to country teams has enabled DFID to adopt a
flexible approach to HIV/AIDS programming. Today’s report found
that assistance plans for countries targeted for HIV/AIDS action
provided coverage of HIV/AIDS issues, particularly those relating
to Africa, where the proportion of the population affected by
HIV/AIDS is higher. But plans often did not link the approach
proposed with resourcing and expected impacts. At project level,
country teams often took key decisions on areas for intervention at
an early stage in the design process, based on their judgement and
experience – followed up later by more formal technical, social,
institutional and risk appraisals.
The extent to which HIV/AIDS features in planning documents
gives an indication of the perceived importance of the disease.
However, eight of 14 Institutional Strategy Papers which set out
DFID’s relationship with multilateral development institutions fail
to mention HIV/AIDS. Furthermore, monitoring of progress against
the objectives set out in these documents has been variable.
The development of a safe, effective vaccine would reduce
significantly the trauma and cost of the disease. DFID led the
donor community in funding innovative research into AIDS vaccines.
DFID has also funded other research which has in some cases helped
to shape global opinion on the disease. Disseminating the results
of this work to partner countries and organizations has made solid
headway in changing the climate of opinion and promoting evidence
based decision making. More could have been done, however, to
disseminate the results to DFID’s country teams – who, as
practitioners, could benefit from it to help craft cost-effective
country responses to the epidemic.
Sir John Bourn said today:
"The HIV/AIDS epidemic has a devastating effect on the
lives of poor people in developing countries. The Department for
International Development has a clear commitment to respond to
HIV/AIDS. The Department should put in place management systems
sufficiently robust to ensure that people affected by HIV/AIDS gain
the greatest possible benefit from the increasing resources
allocated to the epidemic."
Notes for Editors
- The Millennium Development Goals, adopted unanimously in
September 2000 by member states of the United Nations, include the
target to "have halted by 2015 and begun to reverse, the spread of
HIV/AIDS". Further information can be found at http://www.developmentgoals.org/.
- DFID’s Public Service Agreement targets for 2003-06 include the
following HIV/AIDS targets:
- In 16 countries in sub-Saharan Africa, DFID will contribute to
the development and implementation of more effective government-led
health programmes tackling HIV/AIDS, as measured by a reduction in
the proportion of 15-24 year old pregnant women with HIV from 16
per cent.
- In 4 countries in Asia, DFID will contribute to the development
of HIV/AIDS strategies as measured by prevalence rates of HIV
infection in vulnerable groups being below 5 per cent.
Further detail on DFID’s PSA targets can be found at http://www.dfid.gov.uk/.
- Total DFID expenditure in 2002-03 was £3,313 million of which
£1,813 million (55 per cent) was bilateral assistance and £1,409
million (43 per cent) was channelled through multilateral
organisations. The remaining £90 million was spent on
administration.
- Press notices and reports are available from the date of
publication on the NAO website,
which is now at www.nao.org.uk. Hard copies can be
obtained from The Stationery Office
on 0845 702 3474.
- The Comptroller and Auditor General, Sir John Bourn, is the
head of the National Audit Office which employs some 800 staff. He
and the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 46/04
All enquiries to Barry Lester, NAO Press Office:
Tel: 020 7798 7937
Mobile: 07748 181692