India Intelligence Report

 

 

   Is US Global AIDS Program Effective?

  Investigators say that US President George Bush's ambitious USD 15 billion AIDS-fighting program in poor countries was pushed too hard that has ended up in unintentional misrepresentation of patient data to a point where it is unusable.
 

 

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Investigators say that US President George Bush's ambitious USD 15 billion AIDS-fighting program in poor countries was pushed too hard that has ended up in unintentional misrepresentation of patient data to a point where it is unusable. The system has also broken down to a point where decision makers are unable to verify claims of success by local groups that received aid money to stop the spread of the disease or care for AIDS victims and their children. Critics say that the focus has been on results that there was no process setup to account for and verify the recorded data.

Officials of the Bush Administration acknowledge the lapses but say that they have fixed most of the issues identified in multiple countries by several audits by imposing tighter reporting systems and improving the accuracy of information. They blame the shoddy record-keeping to over-eagerness to get the money to AIDS patients but say that waiting for three years to get a fool-proof system in place before dispatching the money is good accounting practice but would have resulted in the death and hardship to many.

The lack of process and record-keeping has encouraged unscrupulous practices where undeserving individuals have received aid money or numbers have been exaggerated to siphon money off the system. For example, in Guyana the aid package was supposed to have gone to 5200 people but only 300 actually received any aid money and many of them were not even affected by AIDS. Conversely, in South Africa, local laws do not allow reporting of AIDS cases which caused under-reporting of actual recipients. Similarly, some programs that promoted mass-media based promotion of sexual abstinence and safety was also dropped from monitoring because it was impossible to verify the veracity of information about listeners and its effectiveness. Orphan care programs recording were also modified to ensure that food handouts was recorded as providing care-instead an orphan has to receive three services before being counted as having received care.

At the same time, there was also criticism of the auditors themselves of force fitting criticisms on hard to measure parameters such as care and prevention and not highlighting easy to record successes such as drug treatment.

Bush had aggressive goals and targets set for his pet project. He wanted to treat 2 million infected people by 2008, prevent 7 million new infections, and provide support and care for 10 million HIV/AIDS patients and orphans.

The high road of discussion on practices and processes of the AIDS programs and adaptive changes made to the program is something that Indian Health Ministry can learn from.