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HIV/AIDS epidemic in the country continues to pose serious public health challenges. However, the M&E systems that would help track the progress are not fully functional and coordinated. This, coupled with the demand for results, increased funding to HIV/AIDS and multiplicity of partners, calls for a robust M&E system especially at the district level where implementation of HIV/AIDS programs takes place. In order to address the challenges, UNAIDS in a collaborative support arrangement with the Ministry of Local government, Uganda AIDS Commission and Management Sciences for Health/STAR-E LQAS, piloted the establishment of two district HIV/AIDS M&E centers of excellence in Kasese and Kiruhura to demonstrate a functional M&E system for learning and replication. The implementation adopted the ten-step World Bank Model of designing, building and sustaining a result based M&E system. This model provides extensive details on how to build, maintain and sustain a result based system. Overall the model highlights the political, participatory and partnership processes involved in building and sustaining M&E systems.