HIV/AIDS

Despite the continued spread of HIV/AIDS in many countries, the U.S. Agency for International Development (USAID) has made important contributions to the fight against the disease. USAID-supported research helped to identify interventions proven to curb the spread of the virus that have become the basic tools for the international response to the epidemic. Applying these interventions, USAID projects have increased awareness of the disease; changed risky behaviors; and increased access to the treatment of sexually transmitted diseases and to condoms, which have helped to slow the spread of the disease in target groups. USAID managers are expected to closely monitor projects, but the major responsibility for internal financial management and control rests with recipient organizations. In its first two years of operation, the Joint United Nations Programme on HIV/AIDS (UNAIDS) has made limited progress in achieving its goal of leading a broad-based, expanded global effort against HIV/AIDS. However, GAO did observe innovative activities that were implemented by cosponsor agencies.

GAO noted that: (1) AID has made important contributions to the fight against HIV/AIDS; (2) AID-supported research helped to identify interventions proven to curb the spread of HIV/AIDS that have become the basic tools for the international response to the epidemic; (3) applying these interventions, AID projects have increased awareness of the disease; changed risky behaviors; and increased access to treatment of sexually transmitted diseases and to condoms, which have helped slow the spread of the disease in the target groups; (4) under the terms of cooperative agreements with private implementing organizations, AID managers are expected to closely monitor projects, but the major responsibility for internal financial management and control rests with recipient organizations; (5) AID's financial oversight primarily consists of conducting preaward evaluations of prospective funding recipients, reviewing quarterly expenditure reports, and requiring audits; (6) officials from AID's Office of Inspector General said that there were no indications of systemic problems from audits conducted; (7) in its first 2 years of operation, the U.N. has made limited progress in achieving its goal of leading a broad-based, expanded global effort against HIV/AIDS; (8) while data indicate that spending by the cosponsors has not increased, data are not yet available to measure the U.N.'s progress in increasing spending by donor countries, the private sector, or affected countries; (9) moreover, theme groups, the forum for coordinating U.N. efforts in the field, have had a difficult start and, in some countries, cosponsor agencies are just beginning to work together; (10) the UNAIDS Secretariat has not been successful in providing technical assistance and other support to facilitate theme group activities and performance measures for the U.N.'s HIV/AIDS programs; and (11) despite the U.N.'s limited progress in meeting its objectives, GAO observed innovative and low-cost activities that were implemented by cosponsor agencies.