Financing Agreement for Credit 4607-MN Conformed
Serrano,Martin M.
Ratings for the Regional HIV/AIDS Treatment Acceleration Program Project for Africa Region were as follows: outcomes were moderately satisfactory, the risk to development outcome was high, the Bank performance was moderately unsatisfactory, and the Borrower performance was also moderately satisfactory. Some lessons learned included: sub-regional HIV/AIDS projects require a project design that clearly defines the roles and responsibilities of the multiple participating national and regional institutions. Multiple stakeholders generate diverse views, approaches and understandings that need to be addressed during project preparation or immediately after the project becomes effective. Government ownership and leadership is a core requirement for successful institutional arrangements and therefore establishing the institutional framework for program implementation is an essential step during the preparation phase. Regional projects take more time to reach agreements on institutional arrangements, including funds allocation. Public-private approaches and partnerships with non-state actors have shown to be useful to quickly scale-up anti-retroviral treatment programs. Long term partnerships however are only viable with assurances of continued financing whether domestic or external. Sharing information is important to the success of regional programs as it fosters regional learning. The regional advisory (RAP's) panels proved to be an important mechanism for those purposes and could be relevant for other programs in health in Africa and beyond. RAPs facilitated learning and served a useful forum for exchanging knowledge and experience and especially fostering a south-south exchange. Fiduciary processes and reporting for United Nation (UN) agencies need to be clarified during project preparation.
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