The document discusses the limitations of monitoring and evaluation (M&E) in enforcing commitments related to HIV/AIDS and emphasizes accountability as a more effective approach. It highlights the African Peer Review Mechanism (APRM) as a potential tool for fostering ownership, understanding, and governance of the epidemic, while addressing implementation gaps in HIV/AIDS commitments. The case study of South Africa illustrates both the challenges and the positive responses prompted by APRM's recommendations, necessitating political commitment and collaboration among stakeholders to enhance accountability and accelerate progress.

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Monitoring and evaluation are inherently incapable
of forcing action on commitments that have been
implemented or on the programmes or projects that
have not begun in the first place..
M& E can also neither encourage action nor compel
implementation of HIV/AIDS commitments.
Accountability is a better instrument for that.
APRM should be an effective instrument to support
monitoring of effectiveness of HIV/AIDS
programmes and projects and their impact.

3. Generally, for any mechanism to serve as an
accountability instrument with regards to
HIV/AIDS, it must meet three minimum conditions:
 It must push the country to own the epidemic (take
responsibility for the epidemic, acknowledge its
impact and take steps to halt/reverse it.
 It must induce the country to know the epidemic
(nature, behavior, trajectory)
 It must motivate the country to govern the epidemic

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HIV/AIDS, TB and malaria have usually features at
high-level political forum, attracting various
commitments and declarations. Between 1987 and
2007, the international community made about 57
such HIV/AIDS commitments, 23 of them by African
leaders (table annexed), addressing almost every
conceivable aspects of the pandemic.
Therefore, it is important to see how African
countries can address the gaps and improve on
implementation towards desirable outcomes.
Theses gaps are not from a lack of M&E or reporting
but the implementation can be enhanced through a

5. 
APRM deals with the problem of HIV/AIDS both
directly and indirectly in the key documents and
declarations in the conduct or implementation of
the mechanism, in the post-review process and
implementation of the Program of Action
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APRM addresses HIV/AIDS in a fairly
comprehensive manner and in particular the
governance dimension in its structure and process
the process can strength accountability and
governance to fight HIV/AIDS.

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APRM can compel a country to own, know and
govern HIV/AIDS
APRM not only monitors and evaluates the extent to
which commitments are implemented, it also
provides the opportunity for policy makers and
ordinary citizens to hold each other accountable
Need for a Desk review of rule-based indicators (in
APRM documents) and outcome-based indicators
(determining whether APRM can accelerate
implementation of HIV/AIDS commitments).

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Case study of South Africa: Keys findings (ECA)
The APRM CRM shows deeper challenges:
South Africa admits that majority has no access to
quality health care inspite of legal provisions
APRM CRM identified critical areas needing government
attention, especially treatment and protection of women
and children:
APRM CRM found a high rate of rape and other forms of
violent abuse of women
APRM CRM also found a high level of violence against
children, especially girls.
IT worked! South Africa response to the APRM CRM
report
SA has since taken steps to mitigate these
situations, including implementation more vigorously its
existing laws and conventions

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Political commitment at the highest level is needed
for a rigorous and useful review exercise
African countries and their leaders stand
accountable for actions and policies that could lead
to the achievement of the targets
Holding every country accountable, setting up
ambitions targets which reflect the need to
massively scaling up HIV, prevent, treatment, care
and support to move as close as possible to
universal access
It is also important to improve stakeholder
participation in the review process.
( civil society, private sector)

9. There is effectively a need of accelerating the
implementation of HIV/AIDS commitments.
 The review process is costly, there is a need for a
support of the partners to support APRM to really
hold governments and other stakeholders
accountable
 The Abuja call and Maputo indicators, the AU
Roadmap indicators, should serve to monitor the
effectiveness of HIV/AIDS programmes in Africa
 AWA should work together with APRM to
implement and enhance the existent accountability
framework, to advocate for adhesion of all African
countries to the principle of own, know and govern

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THANK
YOU!