U.S. AIDS funding disbursement gap

Jennifer Kates of the Kaiser Family Foundation and her collaborators found that in 2006, the U.S. promised much more for global AIDS funding than it disbursed for the second year in a row. In fact, the U.S. only disbursed 56% of bilateral funds that were promised. In 2006, the U.S. committed $2,362.8mn but only disbursed $1,320.9mn. In 2005, the U.S. committed $1,918mn but disbursed only $1,095mn.

The U.S. was still the largest donor, contributing more than 44% of bilateral donations in that year, but it does raise questions. Is the gap a problem with U.S. overpromising or insufficient absorptive capacity in recipient countries? Would disbursement be higher if the U.S. delivered more funds through the Global Fund than through bilateral channels? (In 2006, the U.S. committed about $464mn to the Global Fund, only 58% (abou $269mn) of which went to AIDS.)

Anybody know?

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One Response to “U.S. AIDS funding disbursement gap”

  1. Kim Yi Dionne from UCLA e-mailed me this comment about disbursement, “in reading a footnote in Helen Epstein’s book, I followed a lead to “PEPFAR Watch” from the Center for Health and Gender Equity page. PEPFAR Watch has PDF posts of the Inspector General’s audits of progress in implementing PEPFAR. Here’s a link:

    I’ve only managed to read through the Tanzania report, so my thoughts will be limited to what I saw there. In TZ in 2005, there were significant funding delays which impeded program implementation. The Inspector General found the causes of the delays to be (1) the Global AIDS Coordinator – he wanted the TZ proposal to have “more clarity” because it was somewhat vague; (2) bureaucratic timeframes – something about the SOAG not being sent to the government until the funds were ready and then having to navigate through Min of Health then Min of Finance; and (3) USAID bureacratic/logistical hurdle – the regional contracting officer wasn’t in TZ once the funds were finally available, but was instead in Kenya.

    However, this would only explain the delay in 2005. The report stated that all of the aforementioned hurdles were expected to not be a problem in 2006 (but as we know, 2006 also saw a disbursement gap).

    I guess the short of it is, I don’t have a good answer, but I have a muddled one for 2005. I imagine there were similar hang-ups in 2006. Essentially, it’s a bureaucratic politics problem.