In the current economic climate where donor countries see their budgets shrink, there is a bigger emphasis than ever on aid effectiveness and value for money, to make sure that with limited financial resources greater results can be achieved.
One of the key principles of the aid effectiveness agenda is country ownership. New aid modalities, such as budget support, donor coordination and pooled funding to strengthen health systems as well as integration of HIV in broader global health and development programmes are reflected in both EU and U.S policies and strategies, and in the EU U.S Dialogue on Health and the implications of this for the targeted response to HIV and key populations needs to be closely monitored. The Global Fund, the GAVI Alliance and the World Bank recently established the Health Systems Funding Platform which intends to coordinate, mobilize, streamline and channel the flow of existing and new international resources to support national health strategies to promote national ownership. Important questions to look at is how civil society will be involved in the formation and implementation of the HSS Funding Platform and how community systems strengthening and HIV is being addressed.
In addition, many international agencies have started to focus strongly on ensuring value for money. For example the Global Fund has emphasised the importance it places on value for money and UNAIDS has produced technical guidance on how to ensure value for money in Global Fund proposals. The new coalition government in the UK has stressed that given the current difficult economic times, the country's focus will be on ensuring value for money. The U.S is also moving in this direction. The International HIV/AIDS Alliance has undertaken a number of different studies to assess the value of its work and of community based HIV interventions which are important to feed into relevant policy processes, such as the development of the UNAIDS Investment Framework.