The public policy impact of the changing official development assistance programme in financing the HIV/AIDS response in southern Africa

Abstract

With more than 30 million people living with HIV/AIDS and about 2.5 million people infected in 2006 alone, the HIV/AIDS epidemic has become one of the highest priorities on the global development agenda. About 65% of the world population living with HIV/AIDS live in sub-Saharan Africa. Sub-Saharan Africa also lags behind in achieving international development goals and the burden of HIV/AIDS further exacerbates the cycle of poverty and inequality. Donor aid is often given on the assumption that the recipient country has adequate capacity in the government to manage all aspects of development: planning, fiscal management, programme design, financial control and budgeting, project implementation, accountability and monitoring and evaluation. The multiplicity of funding modalities in the donor field makes the absorption and spending of aid a challenge. The national capacity influences the ability to absorb donor aid and the role of public administration in the national development programmes cannot be over-emphasised. To attain the Millennium Development Goals (MDG) of the Millennium Declaration of the United Nations, special attention needs to be given to HIV/AIDS. Should the AIDS pandemic not be resolved properly, almost all the MDG might be in jeopardy. The Paris Declaration on aid effectiveness, harmonisation and alignment does not make any provision for safeguarding funds for the mitigation of the impact of HIV/AIDS in recipient countries. The United Nations’ UNAIDS has made it clear that to effectively attain any development goals in the developing world, mainstreaming of HIV/AIDS in all development activities needs to be done. Conceptually, mainstreaming HIV/AIDS means to bring HIV/AIDS to the centre of the development agenda, which requires change at individual, departmental and organisational level. From this overview emerges the research question: ‘Will the changing international official development assistance environment have an influence on financing the response to HIV/AIDS in the developing countries of southern Africa?’ This is a qualitative and descriptive study, based on a literature survey utilising a deductive approach in the fields of public administration, public financial management, development, development administration, HIV/AIDS and official development assistance (ODA). A model for a sector-based approach to financing the AIDS epidemic in the country was developed. The model is based on the many different mechanisms, best practices and lessons learned of many different organisations. It suggest one overarching body with legal status that can manage a country’s HIV and AIDS programme as a cross cutting issue. The Central body will have representation of all sectors, including government, donors and multilaterals. All the role players in the field should be involved in the development, planning and implementation of the programmes.