The Level of Effort in the National Response to HIV/AIDS: The AIDS Program Effort Index (API) 2003 Round
USAID, UNAIDS, WHO, and the POLICY Project (December 2003)
Full Document (English)
UNAIDS, USAID, and the POLICY Project developed the AIDS Program Effort Index (API) to measure program effort in the response to the HIV/AIDS epidemic. The index is designed to provide a current profile of national effort and a measure of change over time. The API was applied to 40 countries in 2000; a revised index was applied in 54 countries in early 2003.
The results show that program effort is relatively high in the areas of political support, policies, and planning with average scores above 70 percent of the maximum effort. Prevention programs and the legal and regulatory environment are the next most highly rated components with scores between 60 and 70 percent. The human rights component received the lowest score. Respondents reported that legal structures are in place to protect human rights but that resources and enforcement efforts are lacking. Resource availability and mitigation effort also received low scores. By region, Eastern and Southern Africa has the highest overall scores. West and Central Africa and Asia also scored relatively high, with Latin America and the Caribbean and Eastern Europe somewhat lower. The average score for all countries increased slightly from 56 percent in 2000 to 59 percent in 2003. The largest increases were for political support, resources, and care and treatment.
The API survey shows clearly that all countries have some organized effort to combat the HIV/AIDS epidemic. Most countries have good policies and organizational structures in place. The weakest areas are in the implementation of the policies and plans. Countries with the strongest effort, such as Brazil, Senegal, Thailand, and Uganda, all have strong political commitment and a national consensus that lead to significant effort to implement comprehensive programs.