Mozambique

HIV/AIDS Response Project: Implementation Completion and Results Report

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Evaluation and Lessons Learned
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Ratings for the HIV/AIDS Response Project for Mozambique were as follows: outcomes were moderately satisfactory, the risk to development outcome was substantial, the Bank performance was moderately satisfactory, and the Borrower performance was also moderately satisfactory. Some lessons learned included: while a strictly technical public health approach would direct resources from the start towards targeting interventions to geographic areas and population groups with the highest HIV prevalence, that direction may from a longer term perspective not always be the right one. Money came to the Mozambican communities because of AIDS. As a result, communities organized themselves. They were empowered to begin to take control of their lives. The income generating activities assisted vulnerable groups to better cope with their vulnerability, and demonstrated that a small amount of money could go a long way. They focused on the enormous and immediate needs of orphans and vulnerable children. These impact mitigation efforts opened the door for an open dialogue in the communities on the risks for HIV infection and laid the foundation for a community-based approach to prevention. Active involvement of civil society means that one must be prepared to finance its priorities, even if these are not immediately and evidently perceived as the most cost-effective to curb the epidemic. The Bank responded swiftly and appropriately to addressing the HIV/AIDS situation in Mozambique when there were few development partners on the ground and limited financing. The fact that the basic design of the project could be maintained through five amendments to the Development Grant Agreement (DGA) proves that the Multi-country AIDS Program (MAP) instrument was used in a flexible way and could respond to the country's evolving needs as the national strategy developed and new partners came on board.