Working Group on HIV Programme Costs and Technical Efficiency


Background and Rationale

The newly configured UNAIDS/World Bank Economics Reference Group (ERG) will bring together senior health economists and other HIV experts to provide strategic analysis and advice related to the economics of AIDS to the UNAIDS family and other stakeholders. 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. The ERG will operate primarily through three Working Groups to produce technical inputs in specific areas:

(i) Costing and technical efficiency;

(ii) HIV allocative efficiency and effectiveness; and

(iii) Sustainable HIV financing.

These terms of reference are intended to guide the Working Group on HIV Programme Costs and Technical Efficiency. Better understanding of HIV intervention and program costs and expenditures and how these vary across facilities and across countries are critical to improving technical efficiency in service delivery and to maximize coverage and health impact. Though more and more information is available on the HIV service costs and expenditures in low- and middle-income countries, significant gaps remain.


Under the auspices of the UNAIDS/World Bank HIV Economics Reference (ERG), the Working Group on Programme Costs and Technical Efficiency will focus on HIV programme costing, and technical efficiency.

The purpose of the Working Group is to:

  • Review and align existing methods, guidelines and tools;
  • Identify gaps in costing and technical efficiency;
  • Map and give guidance to ongoing and planned studies and initiatives;
  • Provide strategic direction on the policy implications of these.


Deliverables will include but not be limited to:

  • Standardized guidelines for costing and technical efficiency;
  • Recommendations on costing and technical efficiency  frameworks and tools;
  • Guidance on routine costing and technical efficiency analyses;
  • Targeted recommendations and policy implications of ongoing studies.

Reporting Lines and Expected Interactions

For the first two years of its existence, the Working Group on Programme Costs and Technical Efficiency is a standing working group of the newly formed ERG. As such, the chairs of the Working Group (Bill and Melinda Gates Foundation and Centers for Disease Control) 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 on Program Costs and Technical Efficiency will initially be led by Bill and Melinda Gates Foundation the Centers for Disease Control and will have a membership of a maximum of 20 members to ensure that it is a compact body. Invitation will be based on the technical qualifications of prospective members, and at the same time ensure that there is wide representation from low/middle income governments, multilateral organizations, bilateral agencies, non-governmental organizations, and academia.

Members will maintain membership for a period of two years and will receive no remuneration for participating in Working Group activities (apart from reimbursement of costs related to Working Group meetings).

Members will be expected to participate regularly in the Working Group meetings and conference calls.

Working Group members will not be disqualified from taking on work commissioned by the Working Group, provided that they are not involved in the selection of the persons/institutions contracted on behalf of the Working Group.

Timeframe and management of the Working Group

The Working Group will operate for an initial period of two years and will meet not less than once every six months during this time. UNAIDS will serve as the Working Group’s secretariat working closely with the Bill and Melinda Gates Foundation and the Centers for Disease Control. It will ensure that agendas, key readings and relevant documents are circulated in advance of each meeting. UNAIDS will commission background analysis on behalf of the Working Group. Materials on the Working Group and its activities will be posted on the ERG website to facilitate information sharing among members, and potentially to support public dissemination of key products.