Donor Agendas, Community Priorities and the Democracy of International HIV/AIDS Funding
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Each year, donors channel $7.6 billion into HIV programming in affected countries. With this funding often comes significant control over interventions at country level, though there is considerable skepticism about the value of donor- driven strategies. Locally conceived approaches are believed to be more effective, but it is not always clear that donors are responding accurately or appropriately to the priorities of communities. Concept notes submitted to the Global Fund to Fight AIDS, Tuberculosis and Malaria by eight African countries were systematically measured to determine their responsiveness to community priorities. National Civil Society Priorities Charters were used as a measure of community-identified needs. Malawi’s concept note was by far the most responsive to civil society priorities and Zambia’s was the least. The concept notes were the most responsive to civil society priorities on key populations’ issues, and the least responsible on priorities related to voluntary medical male circumcision. Statistically significant relationships were found between the responsiveness of Global Fund concept notes and Afrobarometer indicators on democracy, participation and civic engagement. There was also a significant relationship found between the voice and accountability rankings from the World Governance Indicators. This makes a compelling case to show that a context of democracy is linked to civil society’s ability to influence HIV/AIDS funding decisions at national level. Understanding the factors which hinder or enable community-led program development is critical for a more effective HIV response.