title: A decade of investments in monitoring the HIV epidemic: how far have we come? A descriptive analysis.
abstract: BACKGROUND
  The 2001 Declaration of Commitment (DoC) adopted by the General Assembly Special Session on HIV/AIDS (UNGASS) included a call to monitor national responses to the HIV epidemic. Since the DoC, efforts and investments have been made globally to strengthen countries' HIV monitoring and evaluation (M&E) capacity. This analysis aims to quantify HIV M&E investments, commitments, capacity, and performance during the last decade in order to assess the success and challenges of national and global HIV M&E systems.
  
  
  METHODS
  M&E spending and performance was assessed using data from UNGASS country progress reports. The National Composite Policy Index (NCPI) was used to measure government commitment, government engagement, partner/civil society engagement, and data generation, as well as to generate a composite HIV M&E System Capacity Index (MESCI) score. Analyses were restricted to low and middle income countries (LMICs) who submitted NCPI reports in 2006, 2008, and 2010 (n = 78).
  
  
  RESULTS
  Government commitment to HIV M&E increased considerably between 2006 and 2008 but decreased between 2008 and 2010. The percentage of total AIDS spending allocated to HIV M&E increased from 1.1% to 1.4%, between 2007 and 2010, in high-burden LMICs. Partner/civil society engagement and data generation capacity improved between 2006 and 2010 in the high-burden countries. The HIV MESCI increased from 2006 to 2008 in high-burden countries (78% to 94%), as well as in other LMICs (70% to 77%), and remained relatively stable in 2010 (91% in high-burden countries, 79% in other LMICs). Among high-burden countries, M&E system performance increased from 52% in 2006 to 89% in 2010.
  
  
  CONCLUSIONS
  The last decade has seen increased commitments and spending on HIV M&E, as well as improved M&E capacity and more available data on the HIV epidemic in both high-burden and other LMICs. However, challenges remain in the global M&E of the AIDS epidemic as we approach the 2015 Millennium Development Goal targets.
authors.affiliation: Strategic Information and Monitoring Division, UNAIDS, 20 Avenue Appia, 1211 Geneva, Switzerland. alfvent@unaids.org.
authors.forename: Tobias
authors.initials: T
authors.lastname: Alfven
authors.forename: Lotus
authors.initials: L
authors.lastname: McDougal
authors.forename: Luisa
authors.initials: L
authors.lastname: Frescura
authors.forename: Christian
authors.initials: C
authors.lastname: Aran
authors.forename: Paul
authors.initials: P
authors.lastname: Amler
authors.forename: Wayne
authors.initials: W
authors.lastname: Gill
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D057191:Capacity Building; D003906:Developing Countries; D058872:Epidemics; D014943:Global Health; D015658:HIV Infections / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D007449:Investments; D009313:National Health Programs; D015397:Program Evaluation; D011634:Public Health