Well, the Global Fund has had a big week. It’s been ten years since the creation of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and the recent news about the fund has not been great: internal divisions, questions about improper funding allocations, missing money, and financial shortfalls. On the other hand, the Global Fund has been key, along with PEPFAR, to incredible gains against HIV/AIDS, TB, and malaria in the last decade. In November of last year, the Global Fund stated that it was canceling its latest round of funding and would not disburse funds for new programs and projects until 2014. The global health community was understandably alarmed, especially in the climate of the global economic recession. As of last week, however, the fortunes of the Global Fund may be turning around.
First, the Global Fund announced that Executive Director Michel Kazatchkine would step down in March. He cited the recent executive-level re-organization for his decision. A General Manager, Gabriel Jaramillo, has been appointed to manage day-to-day operations for the fund. Following reports of financial mismanagement and alleged fraud last year, some donor countries canceled or suspended funding.
The re-organization and other internal changes have restored confidence, and coupled with the fund’s impact over the last ten years, it remains key to rolling back the deleterious effects of malaria, TB, and HIV. In an opinion piece for Reuters, Natasha Billmoria of the Friends of the Global Fight Against Aids, Tuberculosis, and Malaria argued that more must be done to bolster the Global Fund’s coffers, writing: “We’re in a tough global economy, to be sure, but we’re also primed to beat back AIDS, tuberculosis, and malaria.” She cited the success of the Global Fund, which has put 3.3 million people living with HIV on antiretroviral treatment, provided PMTCT services to more than one million pregnant women living with HIV, detected and treated 8.6 million cases of tuberculosis, and distributed 230 million bed nets to prevent malaria. The fund itself estimates that it has saved 7.7 million lives in ten years. The International HIV/AIDS Alliance released a report last week discussing the potential impact of the Global Fund’s cancellation of its funding round in November, studying the effects this lack of funding would have in five countries. The report called for donors to provide an estimated $2 billion to fill the funding gap.
“The internal checks and balances have worked in every case…but if you’re going to do business in Africa, you’re going to have some losses.” -Bill Gates
Ask and ye shall receive, it seems. At the World Economic Forum, Bill Gates announced that his foundation had pledged a $750 million “promissory note” to the Global Fund. Mr. Gates said that the economic recession was “no excuse for cutting aid to the world’s poorest.” This announcement marks a bit of a shift for the Gates Foundation, which in the past has disbursed $650 million to the Global Fund for vaccines and innovations, rather than ARV distribution and day-to-day operations. In his annual letter on behalf of the foundation, Mr. Gates supported the Global Fund’s efforts and pointed out that despite some reports, the fund had had less than five percent of its funding misused and had instituted further internal reforms that will decrease those problems. Mr. Gates also argued that some financial mismanagement was a cost of working in the developing world. He was quoted by AP as saying: “The internal checks and balances have worked in every case [at the Global Fund]…but if you’re going to do business in Africa, you’re going to have some losses.”
Although $750 million is not a trifling sum, it is not the $2 billion or more needed to finance grants at the Global Fund. With his announcement, Mr. Gates has demonstrated his confidence in the Global Fund, which might inspire bilateral donors to honor their pledges and/or restore interrupted funding. Recent internal changes at the Global Fund may also prompt donors to donate. We are certainly witnessing a turning point in the fight against some major diseases, such as HIVand malaria, and it is a shame that these partial successes have arrived in tandem with a global recession that shows few signs of turning around soon. With a strong, well-financed Global Fund, we may, with hope, see an HIV-free generation and the further curbing of malaria and TB. Mr. Gates’ support of the Global Fund should give it the much-needed shot in the arm that will help us achieve these goals.
Header photo available here, via USACE Europe District, CC BY 2.0.