Financial management is the Achilles heel for rapidly scaling up civil society's role in mitigating the HIV/AIDS pandemic, especially when the donor community is caught between the "rock" of getting the money out there and the "hard place" of timely and accurate financial reporting to keep the funds flowing.

The challenge is to develop innovative agreements and management mechanisms that will get the money out into the community where it can do the most good, without putting an undue administrative burden on either the giver or the recipient. Furthermore, where lives are at stake, there is a moral imperative to ensure that funds earmarked for prevention, care, and treatment of HIV/AIDS patients and orphans and vulnerable children are disbursed as quickly as possible to organizations providing services.

As the money available for HIV/AIDS programs grows, NGOs are hard pressed to absorb these funds and report on their use while dealing with programmatic demands. Management Sciences for Health (MSH) works with program managers to improve financial planning and accounting to maximize return on donor investments. MSH helps organizations secure funding and make informed long-term financial decisions by building sound financial systems into their business models, using proven tools to diagnose and resolve financial issues.

In Uganda, MSH assisted the Inter-Religious Council of Uganda (IRCU) to develop an efficient grant-making process and improved reporting structure for Ugandan NGOs receiving HIV/AIDS grants. The IRCU has distributed $2.1 million from the President's Emergency Plan for AIDS Relief to 70 faith-based organizations in Uganda, which have provided care and support to approximately 7,900 orphans and vulnerable children and 33,500 people living with HIV/AIDS. The IRCU has also trained 32,700 providers and community members in HIV/AIDS-related services.

Read more from MSH's recent publication,"Expediting the Transfer of Funds for HIV/AIDS Services," from the Occasional Papers series.

Based on feedback that MSH has received in its work from the local to the national level, as well as observations made in the field, we offer this paper to serve as an aid for finding approaches that balance the need for accountability with the imperative for keeping funds flowing through the pipeline.