The World Bank Operations Evaluation Department Evaluation of the World Banks Assistance in Responding to the Aids Epidemic : Ethiopia Case Study

By Vaillancourt, Denise

Description
Economics

Excerpt
Summary: The objective of this case study is to evaluate the impact of the World Bank?s assistance ? policy dialogue, analytic work, and lending ? on Ethiopia?s national response to HIV/AIDS, and to derive lessons from that experience. It is one of four country case studies conducted as part of OED?s Evaluation of the Development Effectiveness of World Bank Assistance for Fighting the AIDS Epidemic. This case study is based on a review of published and unpublished documents on HIV/AIDS in Ethiopia; structured interviews with various stakeholders representing the government, civil society, World Bank, donors, and nongovernmental, community-based, and faith-based organizations; field visits to selected regions of Ethiopia in August 2003; and analysis of epidemiological and behavioral data. The current document was finalized as of early 2004 and covers events up to that date. AIDS Epidemic The first cases of HIV infection in Ethiopia were reported in 1984 and the first AIDS cases in 1986. Heterosexual transmission is the major mode of HIV infection. HIV spread rapidly among sex workers and other populations with high rates of sexual partner change. In its second phase, HIV spread to the sexual partners of high-risk populations, including monogamous partners and those with much lower rates of partner exchange. In rural Ethiopia, the epidemic began in the early 1990s. National adult HIV prevalence was estimated at 6.6 percent in 2002 ? 13.7 percent in urban areas (15.6 percent in Addis Ababa) and 3.7 percent in rural areas. About 219,400 Ethiopians were estimated to be living with AIDS. The Ethiopian HIV/AIDS epidemic is now ?generalized,? with average HIV prevalence in the general population of 5 percent or higher. However, there is considerable geographic heterogeneity in the epidemic, with some regions at an earlier stage.