Parallel Session on Monitoring and Evaluation to Inform Action and Set Direction fro Research Five -Year (5YE) Evaluation of the Global Fund Tuesday, 18 November :00 - Meeting Room Wa Kamissoko 2008 Global Ministerial Forum on Research for Health – Bamako, Mali

Scope and Scale of 5YE in Malawi Overwhelming need for evidence that Global Fund (GF) is contributing towards reducing incidence and prevalence of HIV/AIDS, TB & Malaria Evaluate in the context of SWAps i.e. assess contribution rather than attribution of GF Assess morbidity & mortality trends using primary & secondary data sources in 9/28 districts Sources of data: National records, Household surveys, National Health Accounts, District- specific data, & Research studies Indicators: Burden of HIV/AIDS,ART Scale-up, Smear +ve TB cases, ITN & R_ coverage for malaria

Values of 5YE – Linkages with Research HIV/AIDS prevalence 14.7% (2003) to 12.6%(2007) with 898,888 PLWHA,s(2007) ART Scale-up: 13,183(2004) to 146,856(2007) of which 100,649 are alive HIV/AIDS Research Dissemination conferences held annually show an increase in # of studies TB – operational research has been the cornerstone of informing policy and practice in NTP e.g. DOTS Malaria – 6 million malaria episodes annually Mx:Case management, prophylaxis with ITN & IPTp with SP all led by research

Gaps in Linking Evaluation Outcomes with Research – How to Address Them? Weak mechanisms for synthesizing, packaging, and disseminating research findings so that they may incorporate M&E outcomes Influx of funds into HIV/AIDS research(60/60 gap) & ART scale-up programs has led to diversion of attention from major killer diseases and erosion capacity of health systems to respond to more important challenges e.g. Maternal & Child mortality Lack of expertise (Health Economist) to critically analyze the collected data so as give a picture of the real impact and cost-effectiveness of these interventions

Specific Recommendations – Enhance the Link between M&E and Research Strengthen the capacity within the country so that the health research systems are better able to link M&E outcomes to research e.g. creation of Research Unit within the MoH Equitable and moral funding by donors on priority issues (90% of research funds are from external agencies in African Region) alignment with national health research priorities (EHP) Real Q. is: Who sets the health research agenda and how? African PIs are glorified data collection clerks!