Last year, PEPFAR submitted guidelines which encouraged country staff to submit a proposal to conduct an “impact evaluation” (IE) as part of their annual Country Operation Plan (COP). Subsequently, they received four submissions, of which three were funded. But they also learned that many PEPFAR staff – who are mostly program implementers, or the managers of program implementers – didn’t fully understand what they were being asked to do; what does PEPFAR mean by “impact evaluations”?
CGD Policy Blogs
Earlier this month, Ambassador Goosby officially announced that he was stepping down from his role as Global AIDS Coordinator where he led the President’s Emergency Plan for AIDS Relief for the past four years. As my colleague Amanda blogged in anticipation of Dr. Goosby’s departure, his service will be remembered for strengthening the evidence base behind PEPFAR’s work.
It’s one thing to measure the quality of AIDS care; it’s another to understand how to improve it. Our last blog showed how the metaphor of the “treatment cascade” can be a useful way to conceptualize and measure the quality of AIDS care and that PEPFAR supported care has room for improvement on this measure (see more on the treatment cascade here). In order to achieve the health benefits that would result from reducing patient attrition over the course of the treatment cascade, PEPFAR and its partners need to learn why some facilities do better than others and what factors contributors to treatment success.
Counting the number of patients on treatment is no longer enough. For years even the friendliest critics of the global struggle against AIDS have pointed out that this metric unfairly neglects the people who are not put on treatment and then die, largely because their deaths are uncounted except in so far as they increase the treatment “coverage rate.” This diverts attention from the challenge of assuring that patients are retained on treatment and remain alive and healthy, rather than failing treatment and dying, sometimes after only a few months.
This is a joint post with Mead Over.
The new World Bank Group Strategy posted this week for discussion by the Development Committee, the ministerial-level forum that oversees the World Bank and the IMF, provides a solid analytical foundation for what has so far been a messy and disjointed re-organization effort. The release of the paper coincided with a speech by bank president Jim Kim that covered much of the same ground, but the strategy paper digs deeper. For those of us who believe that the World Bank has a crucial role to play in addressing the problems of the 21st Century, there is much to applaud.
This is a joint post with Alan Gelb.
In response to our August 5 blog criticizing the World Bank’s current reorganization plans, a few readers wrote to ask us if we could come up with a better idea. This is a daunting challenge. We’ve heard that the Bank has spent millions over more than a year to generate more than 40 ideas about how to tweak the Bank’s organization and has intensively discussed three overarching ideas, for none of which we have actually seen a background paper – or even a PowerPoint. So with brains unfettered by facts, uncluttered by concept papers, bereft of briefings and emboldened by ignorance, here goes…
This is a joint post with Mead Over.
The World Bank is reorganizing. Bloomberg reports that president Jim Yong Kim has written staff about a shake-up at the bank’s highest levels in preparation for implementing an as-yet-to-be-announced new institutional strategy. Such can be unsettling for bank employees, some of whom will find their jobs on the line and others who may get new bosses. Is there any reason for the rest of the world to care?
The Institute of Medicine, the prestigious health arm of the National Academy of Sciences, has weighed in with a massive report on the President’s Emergency Plan for AIDS Relief (PEPFAR), the multibillion dollar US effort to confront the epidemic in the developing world. The evaluation validates PEPFAR’s enormous reach during its first 10 years and identifies concrete actions that Congress and PEPFAR should take for the program to become more sustainable moving forward.
This is a joint post with Mead Over and Denizhan Duran.
In mid-2011, one of the biggest developments in HIV/AIDS research took place. The HPTN 052 study found that early antiretroviral therapy treatment could reduce HIV transmission by 96% in couples where one partner is HIV positive and the other is HIV negative. The study was heralded as the breakthrough of 2011 by Science, and was hailed as a game changer by many others, including UNAIDS, The Economist and The Lancet. The World Health Organization wrote a comprehensive guideline for TasP, or treatment as prevention, in June 2012, asserting that “TasP needs to be considered as a key element of combination HIV prevention and as a major part of the solution to ending the HIV epidemic.”
One popular statistical software package in academia is Stata. CGD has always used it, and thus so have I. As my colleague Mead Over pointed out, Stata's business model is an interesting mix of private and public goods provision. The private corporation profits by cultivating a public free-software community on top of its core product. Stata sells you the main program, which includes commands to perform all sorts of analyses.