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World Bank HIV/AIDS Interventions: Ex-ante and Ex-post Evaluation

World Bank Discussion Paper No. 389

The World Bank
June, 1998

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Abstract

This paper evaluates World Bank activities to prevent and mitigate the effects of AIDS in all regions of the developing world during fiscal years 1986 to 1996. It first prioritizes HIV-prevention and treatment interventions using the principles of public economics. Based on this framework, it assesses the appropriateness of Bank lending and grants, Bank Country Assistance Strategies, and country economic and sector work. While the Bank provided extensive assistance for efforts to collect information (surveillance and behavioral studies), support was less extensive for interventions that focus on reducing risky behaviors of those at highest risk for contracting and transmitting HIV. Few of the projects reviewed in the paper relied on strong economic analysis in ex-ante or ex-post evaluation. These findings suggest two primary challenges for the World Bank: (i) to focus its support for HIV prevention interventions that reach groups at highest risk to contract and spread HIV; and (ii) to improve the economic analysis used in preparing Bank HIV-related projects and in evaluating their effectiveness.

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The World Bank Development Economics Development Research Group

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