Committing to Results

"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."

Acknowledgments

vii

Foreword

ix

Executive Summary

xiii

Acronyms and Abbreviations

xix

Introduction

3

(8)

The Rationale for World Bank Involvement

3

(1)

Objectives of the Evaluation

4

(2)

Analytic Framework and Methodology

6

(5)

The Evolution of the World Bank's Response to HIV/AIDS

11

(14)

Two Phases of the World Bank Response

11

(8)

The Portfolio of World Bank Project Assistance

19

(6)

Findings from the First Generation of Bank HIV/AIDS Assistance

25

(18)

Findings and Lessons from the Bank's Country-Level HIV/AIDS Assistance

25

(14)

The Reach, Perceived Quality, and Relevance of the Bank's Analytic Work on HIV/AIDS

39

(4)

An Assessment of Ongoing Assistance The Africa MAP

43

(18)

The Objectives, Design, and Risks of the Africa MAP

43

(3)

Were the Assumptions Valid?

46

(2)

Evidence on Implementation to Date

48

(3)

Did the Unanticipated Risks Materialize?

51

(10)

Conclusions

61

(6)

Recommendations

67

(4)

Appendixes

71

(2)

A: Conceptual Framework for the Evaluation

73

(4)

B1: Timeline of Project Approvals and HIV/AIDS Strategies

77

(4)

B2: An Annotated Timeline of the World Bank HIV/AIDS Response

81

(16)

B3: Timeline of Global AIDS Events

97

(12)

C1: HIV/AIDS Portfolio Data

109

(10)

C2: Performance Ratings for Completed AIDS Projects

119

(2)

D: Coverage of HIV/AIDS in Country Assistance Strategies and Poverty Reduction Strategy Papers

121

(6)

E: Inventory of World Bank Analytic Work on AIDS

127

(4)

F: The Reach, Quality, and Utility of the Bank's Analytic Work in HIV/AIDS

131

(12)

G: Case Study Summaries

143

(12)

H: Results from the MAP Self-Administered Questionnaire

155

(14)

I: Survey of Task Team Leaders---Summary of Results

169

(24)

J: Survey of World Bank Country Directors for African Countries Participating in the Multi-Country AIDS Program

193

(10)

K: Statement of the External Advisory Panel

203

(4)

L: Management Response

207

(20)

M: Chairman's Summary: Committee on Development Effectiveness (CODE)

227

(4)

Endnotes

231

(12)

References

243

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