Organizations working in the field of global health, such as the Commission on Smart Global Health Policy at the Center for Strategic and International Studies, have called for increased accountability and transparency and a focus on results within the PEPFAR program. The commission has called for publicly stated outcome targets; sound measurement frameworks in PEPFAR’s Partnership Frameworks; comprehensive agreements with host governments that clearly define measures of success; and partner commitments to sustainability and accountability. This approach would provide increased accountability and transparency, which would ultimately lead to a more effective and efficient program that saves more lives and spends public dollars more wisely.
Measurement frameworks and increased transparency can be important tools in ensuring that radical antigay and inappropriate religious-based prevention “campaigns” are not funded through PEPFAR’s prime and subpartner methodology. The Office of the Global AIDS Coordinator should therefore publish more information on prime and subpartner organizations and activities in which those organizations are engaged.
It is very difficult to track the flow of funds from U.S. government agencies through the various layers of funded organizations, although the government collects extensive data on disbursements. Even individuals working for O/GAC in Washington and PEPFAR focus countries have trouble accessing information on distribution of funds. O/GAC and relevant government agencies should openly and voluntarily disclose information on amounts of grants, background of recipients, and program specific information. This information is vital to justifying the continuation of programs that are working and the elimination of those that are underperforming. Enhanced transparency can only improve outcomes, and if necessary, O/GAC and relevant agencies should be encouraged to provide robust data on prevention programs to the public and their own staffs through requests from members of Congress.
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