"The World Bank did its first AIDS strategy report in 1988. The report said the crisis was urgent. It presciently detected "an environment highly conducive to the spread of HIV" in many African countries. It noted that the epidemic was far from reaching its full potential and that "the AIDS epidemic in Africa is an emergency situation and appropriate action must be undertaken now." The World Bank gave $1 million to WHO to fight AIDS/HIV 1988/9.
Then saying in 1992 that the 1988 "Strategy Paper has been reasonably well implemented." ...
The World Bank's 1993 World Development Report, whose theme was health, notes that "At present, most national AIDS programs are inadequate, despite international attention and the significant effort by WHO to help design and implement plans for controlling AIDS." Translation: it's the WHO's fault...
Part of the problem was probably that aid agencies didn't know what to do to address the crisis, but the above examples show little evidence that they were searching for answers. Only after a truly massive number of people were infected with HIV did AIDS gain the sufficient level of visibility for action...
Ironically for aid agencies that often are trying to do everything, 'everything' sometimes leaves out some high priorities...
The World Bank did produce a Monitoring and Evaluation Operations Manual, prepared jointly by UNAIDS and the World Bank. The manual sensibly warns that "the more complex an M&E system, the more likely it is to fail." It then spends 52 pages laying out its extremely complex M&E system."
Excerpts from William Easterly's "White Man's Burden"
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