In 2000, before significant resources were devoted to address the global AIDS epidemic, information about key HIV indicators was sparse. A few countries had sentinel surveillance for some populations, but most did not. There were no national surveys of HIV prevalence. National programs did not collect and report on key indicators. There were no global reports monitoring progress. Planning was based on vague notions of what should be done, with little understanding of where programs were most needed and what their effects would be.
Today the situation is entirely different. UNAIDS releases an annual global report that contains official estimates of the epidemic status for all countries. Most countries have surveillance systems and many conduct national surveys every five years. Service statistics are collected routinely and national programs report annually on standardized indicators through the Global AIDS Response Program Reporting system. Programs use modeling to prepare annual estimates of key indicators that are reviewed and reported to UNAIDS. Targets are set on the basis of estimated need and used to mobilize funding from national governments, the Global Fund, PEPFAR and other funding sources. Many programs today prepare estimates for sub-national areas and use them to guide the geographic allocation of resources. In some programs, analysis of facility-level data has increased understanding of where services are most efficient.
The current system works well because it is locally implemented. National programs collect data and analyze it to prepare estimates that are reviewed by key stakeholders before being adopted as ‘official’. These official estimates are used to prepare national strategic plans, Global Fund applications and PEPFAR Country Operational Plans. Detailed and reliable service statistics, coupled with estimates of the population in need, allow programs to monitor performance towards national and global goals. This information allows for the identification of activities that are working well and those that need improvement.
Today almost all national HIV programs have one or more M&E officers that focus on the collection and analysis of high quality data. In many countries these officers are supported by M&E officers at UNAIDS and PEPFAR as well as M&E personnel within implementing partner organizations.
This M&E effort has been crucial to global progress. It allows programs to set meaningful service targets in order to achieve goals, to monitor progress, and to estimate the funding required to meet those goals. These data are key to mobilizing funds from the Global Fund and to PEPFAR’s efforts to maximize efficient use of available resources. In the last few years these data have been used to develop national Investment Cases for HIV. These analyses have been important in mobilizing additional domestic resources for HIV as donor funding has plateaued.
The family planning field is 5-10 years behind in developing strong data systems, but it is catching up quickly. The field has benefitted from the long history of national surveys (DHS, MICS, national surveys) but service statistics have been more or less ignored until recently. Now through FP2020, Track20 and PMA2020 data are being collected on a routine basis and presented in standardized indicators that are reviewed and approved by national programs. As these systems gradually improve and expand to more countries better information will become available to support more effective planning and resource allocation.