In Bangkok there was frequent discussion of monitoring and evaluation programs, particularly with respect to the "three ones" -- one plan, one coordination mechanism, one m&e framework. Despite the great importance of m&e, there isn't a lot of obvious activity in this area. The UNAIDS site has the most comprehensive M&E section of any organization -- but it hasn't been updated for two years. The best (only?) recent resource on M&E, the "Monitoring and Evaluation Toolkit" compiled by the Global Fund and others, has, according to AltaVista, only four organizations linking to the Global Fund's document download area: The Global Fund, WHO, USAID (co-authors of the document) and AIDS Matters. (As a point of contrast, the UNAIDS 2004 Report on the Global AIDS Epidemic has about 150 organizations linking to it.) The Global Fund is, at the least, ramping up m&e efforts (including advertising two job openings for M&E officers), and I know that donors continue to try to coordinate on M&E issues. The next twelve months are pivotal in persuading donors that initial investments in combating AIDS are sound -- which is very little time for enhancing efforts.

Yahoo Groups is the largest community site online, with tens of millions of users each month.  What is being said in Yahoo Groups about global AIDS?  A search returns 105 groups, 15 of which have more than 100 members.  The majority of the communities are used for organizing AIDS programs, although the largest communities are information-focused.  The 15 largest Yahoo Groups addressing global AIDS are:

stopglobalAIDS (1207 members)
This list is the national newsletter and forum for the Student Global AIDS Campaign.

art4development (1078 members)
Art4Development.Net(Arts For Global Development Network) is an online initiative that forms a worldwide network of individuals and organizations who use or advocate the use of arts to address social, economic and educational development issues collaboratively. You may find more information about this initiative at www.art4development.net. The Art4Development.Net E-Community became active in May 2003 and since then the forum provides digests with news, discussion topics, and announcements on arts ... more

Aids-Africa (647 members)
Aids-Africa brings together a multisectoral community of Africans and other countries to raise and jointly address health-related issues, particularly HIV/AIDS in Africa. When 2,500,000 people in Africa will die of Aids this year, we are not talking about a “cause” — we are talking about an emergency, a global humanitarian emergency. The facts about Aids blow your mind. They also break your heart. Imagine if a third of the kids at your local primary school were Aids orphans. That's a reality in ... more

We have complimented the Global Fund in the past on efforts at transparency. Two new offerings provide further examples of these efforts.

First, the Global Fund has instituted a "Price Reporting Mechanism" in which grant recipients post purchase prices of various products (including drug purchase prices). The Aidspan site offers a nice summary of this new offering. We're not aware of other donor agencies providing this sort of data.

Second, Aidspan reports that the Global Fund will be launching an "early warning system" describing grants that are unlikely to be renewed without corrective action. The hope is that publicizing difficulties will provide motivation to correct problems. Again, we're not aware of any other donor agency providing this sort of information (the more common approach is to hide problem grants).

What do NPR, CARE and Medscape have in common? They care enough about the AIDS debate to advertise their information on Overture or Google, the two leading "pay for keyword" services online. Unfortunately, not many groups share their passion. Only 24 groups advertise on Overture for the word "AIDS". This compares to 68 for "diabetes" or 89 for "acne". The top "bid" for "aids" is $.50, compared to $2.79 for "diabetes" or $3.00 for "acne". Without pushing this analysis too far, it is fair to say that there are relatively few organizations trying to increase their influence in the global AIDS debate with any sort of aggression -- or else we'd see more advertising. It's perplexing given that global AIDS is in great part an "information problem" (policy formulation, education, prevention efforts, monitoring & evaluation, etc.), yet organizations aren't turning to the web as actively as we would hope.

The world's greatest problem is AIDS, and the most effective organization to date to combat AIDS is the Global Fund. Unfortunately, the Global Fund depends on donations, principally from governments, and governments have short attention spans. With this comes Friends of the Global Fight, a DC-based advocacy group with the mission of increasing donations to the Global Fund. It will do this through working with legislators and also raising the Fund's profile with the general public. The organization is new and still getting the kinks out (low profile, early generation Web site -- and a somewhat peculiar name), but it has three potent things going for it: star power (Jack Valenti, the new President, is well-connected in both DC and Hollywood), competent leadership (Anil Soni was Richard Feachem's well-regarded deputy at the Fund), and a narrow mission that is clear to measure and vital to achieve. They are bound to play an important role.

There currently are three main sources of funds for global AIDS. Two of these are well-known (and frequently discussed on this site): the US Government (principally PEPFAR), and the Global Fund. The third, the World Bank, is less-well understood. Through 2003 the Bank has provided more than two billion dollars in loans and grants to developing countries to combat AIDS. The largest program, the "Multi-Country HIV-AIDS Program" (MAP), has provided over one billion dollars in grants to 28 African countries. There is quite a bit of information about the programs online, including a commendable level of detail about individual projects (although it is all admittedly difficult to decipher if you are not highly familiar with the Bank). As is the case with both US Government and Global Fund funding, World Bank financing for global AIDS is expected to ramp up with time and continue to be a major source of global AIDS finance.

We are well-familiar with the impressive AIDS philanthropic work of one high-tech entrepreneur, but there is another entrepreneur less lionized, but worthy of acknowledgement. Ed Scott, co-founder of BEA Systems, is the co-founder and principal funder of the Center for Global Development, a well-regarded policy institute with considerable focus on HIV/AIDS. He also co-funds DATA, a global AIDS advocacy organization, and most recently provided financial support to launch Friends of the Global Fight, which advocates on behalf of the Global Fund. Ed's background is atypical for a software entrepreneur, including 17 years of work for the US government. He apparently keeps a low profile (a quick Google search demonstrates that), but his efforts are impressive and meritorious.

The largest global AIDS program by far, the US "President's Emergency Program for AIDS Relief", represents $15 billion over the next five years, but currently has almost no information online. The best PEPFAR site today -- limited mostly to fact sheets and press releases -- is a subsite at the Department of State.

Presumably the leadership of PEPFAR at the Department of State is creating a new Web presence. (Hint: check the Global Fund site which does a reasonable job.) In addition to the normal fare ("about", "media", "resources"), here are six items that would be highly valuable on a new PEPFAR site:

• Grants to date: bits and pieces of this information are available now online, but there is no comprehensive list. PEPFAR officials in Bangkok frequently cited totals, but could we see breakdowns?


• RFPs and prospective grants: Just today, for example, applications were due for a $150 million "twinning" program which will be funded principally through PEPFAR. These are significant efforts meriting publicity.


• Small grants: Many PEPFAR contractors will run small grant programs of their own -- a comprehensive list would be terrific.


• Contact information: Where and Who is PEPFAR?


• Blog: It would be nice to have a running Web log from an articulate, senior PEPFAR official (such as Mark Dybul -- I'd link to him, but there isn't much online -- here is Google). PEPFAR needs a "voice", and a blog would assist.


• Feedback forum: PEPFAR has a major PR challenge (as anyone in Bangkok will testify). One strategy is to ignore the problem, another is to attack it. Allowing user feedback that can be responded to in a public online forum would help greatly in identifying issues, addressing them, and demonstrating transparency.

I've spent enough time in DC to know that this list is politically difficult -- but if other grantmaking organizations can provide information of this sort, why not PEPFAR?

I've listed in the past core principles for confronting the AIDS crisis. Here is an expanded approach of how a simple mind might consider AIDS:

• AIDS is the biggest problem facing the planet today (or so says the Copenhagen Consensus);


• A vaccine is probably 15 years away at best (or so estimates Paul Farmer and many others), so it won't play a role in the next 100+ million infections;


• Drug treatments will greatly lag behind need for many years. Drugs might lessen the rate of growth of AIDS if tied to prevention, but will increase infection rates if programs are implemented poorly;


• The only hope of containing AIDS is through prevention. Societies need to be "immunized" against AIDS through education.


• While the mass media and training programs can be helpful in prevention education, there is no better way to spread important messages than by word of mouth through family and friends.


• There is no better way to motivate people to tell their friends and family about AIDS than to pay them money to do so.

My conclusion is that the best way to confront the planet's biggest problem is to pay people to tell their friends and families about AIDS

I'm not sure what this means.  I'm not aware of social marketing programs that rely on payments, especially in some sort of "multi-level marketing" format.  I've heard no discussion of payments in AIDS education.  I understand that there are myriad political, financial and social obstacles to paid prevention programs. 

I also know, however, that paid programs are highly effective in many diverse contexts, the amount of money necessary to motivate action is relatively inconsequential (I won't run numbers here -- but think ten cents per referral), and that paid programs can be highly controversial (which isn't necessarily bad in education programs).  I expect the next step in designing smart efforts would be to offer a competition to policymakers around the world to design an effective AIDS education campaign that included payments as incentives -- and see what the most knowledgeable people on the front lines had to say.

The IAEN today published a follow-up interview with Paul Farmer in which he responds to reader questions from around the world. Highlights include his estimates of total costs in Haiti of "good AIDS care" ($500 per patient / year); time to a useful vaccine (15 years); and important "neglected ideas" (complete integration of prevention and care; community-based and supervised care called "DOT-HAART"; and the importance of linking AIDS projects to women's health and TB projects).  He also highlights the new treatment guide published by Partners in Health which is certainly one of the most important AIDS books this year.

Although Technorati now tracks nearly 3.5 million blogs, there is relatively little discussion of global AIDS in "blogspace". Here are five blogs that discuss global AIDS issues:

JID News: covering AIDS policy and treatment issues in Asia;
World Economic Forum: policy updates from the WEF, many involving AIDS;
Keep a Child Alive: a campaign site involving ARV treatments for children
Radio Left: a politically involved site commenting on AIDS policy;
Health Policy Special Interest Group of the System Dynamics Society (name change?): a "best resources" site involving AIDS and other health topics.

This list really should be 50 items long, or 500 (and I hope soon will be). If anyone has additional resources to list, please post comments here.

Much of this Web log relates to technology, and how it can be better used to combat global AIDS. One imporatant resource for professionals interested in AIDS and technology is the AIDS Information Group (AIG), a consulting practice launched by Forum One. The AIG seeks to work with the most important organizations combatting AIDS to improve their technology and information capabilities. AIDS presents immense communications and coordination challenges -- it is global, fast moving, ever changing, and involving many thousands of organizations. It demands a stronger "information infrastructure" than exists now, something the AIG seeks to enhance.