World Bank MAPS its Future in AIDS in Africa

On Wednesday, I had the pleasure of attending one of the many World AIDS Day celebrations at the World Bank. The vice president for Africa, Obiageli Ezekwesili launched the new AIDS Agenda for Action, 2007-2011. At this luncheon gathering of several African Ambassadors to the U.S., the World Bank's vice president for Africa, Obiageli Ezekwesili, said a new 5-year action plan for fighting the HIV/AIDS pandemic in Africa sought to ratchet up the Bank's role as an adviser to governments and its power to bring together donors to ensure AIDS funding is properly used. In addition, the World Bank would increase its work among high-risk groups such as prostitutes and commercial sex workers or in other areas where donors were absent, such as countries emerging from conflict. "The landscape has changed since the bank first took the leadership on HIV/AIDS in 1999 so we have needed to go back to reflect on our future role," Ezekwesili told Reuters.

Indeed the landscape has changed with PEPFAR and the Global Fund on the scene and here to stay. Given that the Bank's total commitments are about 1/10th that of the Global Fund's and even less than that of PEPFAR's, the Bank can flex its financial biceps with limited bravado. Yet, the Bank's long-standing development partnerships with its client country governments makes it necessary for the Bank to think strategically about the most effective use of its HIV/AIDS investments and this is laid out in the Agenda for Action structured around 4 strategic pillars. The HIV/AIDS Monitor at CGD interacted closely with the ActAfrica Team and senior management at the World Bank to review an earlier draft of the Agenda. While we disagree with the Bank's strategy to scale-up its programs (with its limited resources) in strategic Pillar 2 , we applaud the senior management of the World Bank for acting on our recommendations and those of others to: 1) focus the response, through evidence based and prioritized HIV/AIDS strategies; 3) deliver more effective results through increased country M & E capacity including increased knowledge generation and sharing and cross country learning; and 4) harmonize donor collaboration.

The Agenda for Action lists the anticipated results from implementing it, but this is a tall order for the Bank and the HIV/AIDS Monitor will be watching closely to determine the Bank’s success in implementing these strategies. For example, by strengthening the M & E in every country we look forward to learning more about community-based interventions supported by the Bank and the measurable results of these programs in fighting AIDS. With this solid road MAP laid out the Bank can speed ahead to make a difference, learning and sharing information with fellow drivers along the way.