A new report from the World Bank has stopped just short of criticizing the National AIDS Control Organisation (NACO) for its lacklustre performance in checking the spread of AIDS in India.

Though it has termed the implementation of globally financed programmes as 'satisfactory', it has noted that lack of proper monitoring mechanisms has made it virtually impossible for the Bank's assessment teams to estimate the results of the five year programme. The report covers the period from 1992 to 1997, which was the first long term AIDS programme financed by the World Bank in India.

"Due to the lack of monitoring and evaluation in this project, including the lack of baseline information, OED was not able to estimate the number of HIV infections averted - the project's broad objective," the report released a couple of weeks ago said, adding that "The impact of later interventions is difficult to gauge due to the lack of baseline, output and outcome data during the life of the project."

In another paragraph, the report observed that "although there are promising signs of behavior change among those engaged in risky behavior, increased awareness of AIDS among the general population has not been sufficiently accompanied by specific knowledge of how HIV is and is not transmitted, and the project did not address sufficiently public attitudes toward people in high-risk groups and those living with HIV/AIDS.

The project greatly overestimated the capacity of NGOs to design and implement HIV/AIDS interventions. Consequently, in most states a smaller percentage of risk groups were reached than might have been expected. There is a continuing need to build implementation capacity among NGOs and all levels of government if the quality of the response and its coverage is to be enhanced.

Finally, aside from the successful implementation of nation-wide epidemiological surveillance of HIV in the last year of the project, monitoring and evaluation was unsatisfactory. The design and ultimate effectiveness of public information campaigns and pilot interventions might have been greatly enhanced had the project invested in collecting the planned baseline data on attitudes, behavior, and HIV levels in the general population and key groups at the start of the project.

The Operations Evaluation Department (OED) said it believed that availability of critical information on nationwide patterns of HIV prevalence and risk behavior earlier in the project's life also would have been helpful in generating stronger political commitment and earlier action, preventing many more infections.

The report known as the Project Performance Assessment Report (PPAR) was prepared after wide ranging consultations with staff of the World Bank country office, current and former staff of the National AIDS Control Organization (NACO) and the Ministry of Health and Family Welfare (MOHFW), U.N. organizations and donor partners, non-governmental organizations (NGOs), persons living with HIV/AIDS, representatives of professional organizations, researchers, and journalists.

The evaluation team also visited six states and union territories to interview staff of State AIDS Control Societies (SACS), NGOs, and other stakeholders: Andhra Pradesh, Delhi, Maharashtra, Tamil Nadu, Uttar Pradesh, and West Bengal. Findings from these areas are highlighted in this report.