Working Group on HIV Allocative Efficiency and Effectiveness


Background and Rationale

The newly configured global HIV Economics Reference Group (ERG) will bring together senior health economists and other HIV experts to identify the most important research gaps related to HIV economics, to endorse appropriate tools and methods with which to address them, and to peer review and comment on research efforts that have aimed to address such a purpose.  The goal of the ERG is to improve the efficiency, effectiveness, and sustainability of HIV programs in low and middle-income countries by generating economic knowledge and insights that improve decision-making for those programs globally and locally. During its first two years of existence, it has been agreed that the ERG will operate primarily through three Working Groups to produce technical deliverables and research results in three specific areas:

  • costing, technical efficiency and expenditure tracking;
  • HIV allocative efficiency and effectiveness; and
  • sustainable financing.

These TORs are intended to guide the ERG Working Group on HIV Allocative Efficiency and Effectiveness. In an era of less certainty about future AIDS financing levels, improving the allocative efficiency (better prioritization), the technical and implementation efficiency (better service delivery) and the cost-effectiveness of AIDS responses have become, by necessity, the mantra of Governments with high HIV disease burdens. Better data, research and methods are needed to help governments make better informed decisions to improve their AIDS response results at lower cost.

Since this working group is not addressing an area closely related to allocative efficiency and effectiveness – namely technical efficiency – will work closely with the costing, technical efficiency and expenditure tracking WG in matters relating to technical efficiency.


As guided by the ERG, this Working Group will focus on the following areas of work:

  • Map allocative efficiency studies and HIV effectiveness studies undertaken or planned, and the tools used to conduct them
  • Develop/align, based on a set of agreed principles, methods (including mathematical models) for allocative efficiency, including options for optimization approaches in generalized and concentrated epidemics
  • Develop principles for econometric modelling as part of HIV-related mathematical modelling efforts
  • Technically review guidance for HIV-related impact evaluations with biological and economic end points, and in relation to advisable econometric analyses
  • Technically advise on the design of a series of impact evaluations to (a) evaluate efficiency gains through HIV service integrations, (b) demand creation strategies for HIV prevention interventions, and (c)  other areas as identified by the ERG


The following are an illustrative list of deliverables that it is expected this group will produce, based on the scope of work defined above:

  • Methods for allocative efficiency studies
  • Technical review comments on HIV impact evaluation guidelines, the investment case analytical framework, and other documents presented to the WG for comments
  • Principles for HIV-related econometric modelling

Reporting Lines and Expected Interactions

For the first two years of its existence, the Working Group on HIV Efficiency and Effectiveness is a standing working group of the newly-formed ERG. As such, the chair of the Working Group (World Bank) will provide periodic updates to ERG members, and prepare specific items for ERG consideration within one month before ERG meetings.

Membership and Meetings

The Working Group will be no more than 20 persons, and will consist of the following representatives:

  • Two academia (economists) with a related publication record and who are not directly contracted to the World Bank, GF, USG, or UNAIDS to provide HIV efficiency and effectiveness services or technical support for the duration of the Working Group’s existence
  • Two HIV program implementers from non-governmental organisations
  • One representative of each of the key USG agencies involved in HIV service delivery and economic analyses, as well as OGAC
  • Two representatives of the Global Fund (including the Head of Performance Evaluation)
  • Two representatives from client governments that have undertaken (or are in the process of undertaking) HIV efficiency and effectiveness studies
  • Two representatives from the World Bank who work on the World Bank’s HIV efficiency and effectiveness analytical work program
  • One lead or senior World Bank Health Economist
  • Two representatives from UNAIDS – one in Geneva and one at country level – with economic expertise in the areas of HIV efficiency and effectiveness
  • Two other representatives, as jointly agreed by the WG chair and ERG co-chairs, as the scope of work may warrant
  • Chairperson of the MERG and other such organisations
  • Other persons may be invited as observers or to present at specific working group meetings

The Working Group will meet four times a year in Washington DC, and it will be linked to existing events as much as possible so as to minimize travel costs. Persons unable to attend in person, will be connected via videoconference to the meeting.