Every Dollar Counts: How Global AIDS Donors Can Better Link Funding Decisions to Performance

Billions of dollars have been allocated to fight HIV/AIDS in poor countries over the past decade, yet less than half of those requiring treatment receive it, and for every two people put on treatment, five more become infected. This situation, in combination with the global economic crisis and the growing pressure to respond to broader global health objectives, is forcing donors to consider how to do more with their available funds. One way to improve the effectiveness of HIV/AIDS programs is to tie funding decisions to performance. Performance-based funding rewards effective programs and gives incentives for poor performers to improve. Donors have experimented with this approach, but they should do much more to ensure that funding decisions reflect and respond to how well funding recipients meet the objectives of their programs