On May 14, 2008 the World Bank released a report, The World Bank’s commitment to HIV/AIDS in Africa: Our Agenda for Action, 2007-2011, which lays out a new four year strategy to fight the HIV/AIDS epidemic on the continent. In 2000 the World Bank made a three- phase, 15- year programmatic commitment to addressing HIV/AIDS in Africa. The first phase was “emergency response” in which essential programs and structures were put in place to begin treatment and care. The World Bank is now moving into the second phase with the Agenda for Action. The Agenda for Action will create the infrastructure needed for individual nationstates to manage HIV/AIDS programs and will put the World Bank in a consultative role in advising the nationstates on their care and treatment services.

 

The Agenda for Action is set up in four “pillars,” each focusing on different areas needed to give individual nationstates the freedom and responsibility of running their own HIV/AIDS programs. The first pillar is “focus the response through evidence-based and prioritized HIV/AIDS strategies, integrated into national development planning.”[1] This strategy is to incorporate HIV/AIDS programs into the national development plan, including business plans; integrate HIV/AIDS treatment and prevention in other health programs like reproductive health and nutrition; and assist with technical and analytical support, in addition to funding.[2] The second pillar is “scale up targeted multisectoral and civil society responses.”[3] This will integrate HIV/AIDS policies in key sectors of civil society, so everyone can become an active participant in prevention and care. It will also work to address gender inequality issues as women are more vulnerable to HIV/AIDS, and to provide programs for youth and orphans and vulnerable children.[4] The third pillar is “deliver more effective results through increased country Monitoring and Evaluation (M&E) capacity.”[5] This focuses on accountability of programs and teaching states how to monitor and evaluate programs, how to manage the financial aspects of the programs, and how to share knowledge throughout the African region.[6] The last pillar is “improve donor harmonization and coordination.”[7] It gives individual countries the infrastructural capacity to build and maintain programs but still work with partner organizations like UNAIDS in joint planning. It also maintains the World Bank’s responsibility by including a call for institutional assessments.[8]

 

In the report, the World Bank acknowledges the particular vulnerability of women, calling it the “feminization” of the epidemic and noting that approximately 61% of those with HIV are women.[9] The report acknowledges the importance of improved sexual and reproductive health and gender equality, which is included in the Agenda for Action’s second pillar focusing on civil society. This acknowledgement shows that the World Bank sees that women have an important place in society and their needs should not be neglected.

 

The overall purpose of the Agenda for Action is widespread. From reducing the number of new HIV infections and improving life expectancy of those already infected to placing more responsibility and more knowledge in the hands of individual states as well, the World Bank aims to drastically change the face of the AIDS epidemic in Africa. It expects that within five years individual countries will have more knowledge about the epidemic, be able to allocate resources more effectively and accountably, and that financial and health systems will be more advanced.[10] In order for the epidemic to truly be combated, individual countries must be empowered to take control of all aspects of the programs.

 

“After 25 years, it is time to apply the lessons of experience and scale up what is working,” says Peter Piot, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).“With this Agenda for Action, the World Bank reaffirms its long-term commitment to assist partner countries achieve…universal access…to HIV prevention, treatment, care, and support by integrating AIDS into their national development agendas, scaling up… responses, and strengthening national systems.”[11]

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