The Global Fund to Fight
AIDS, Tuberculosis and Malaria

Reviewed by Emma Thomas

What is the problem?

AIDS, TB and Malaria cause 300 million illnesses and 5 million deaths every year. AIDS and TB have formed a 'deadly partnership': TB is responsible for the deaths of 15% of HIV patients. Malaria continues to develop resistance to antibiotics and one of the most widely used anti-malarial drugs is now almost useless in southern and eastern Africa.

The immediate human tragedy is appalling: the long-term consequences are potentially devastating to wider objectives to combat poverty. Every aspect of society is affected, particularly as the AIDS virus tends to affect the most productive members of society, in the prime of their working lives. Productivity is affected and skills are depleted: families fall deeper into poverty and businesses struggle with higher costs. On a macroeconomic level, it has been estimated that in countries with an HIV/AIDS prevalence of 20% or more, GDP has dropped by 2.6 points annually. The Global Fund has been established in response to this crisis.

What is the Global Fund?

"…a comprehensive world response to diseases of poverty"
Richard Feachem, Executive Director of the fund.

Kofi Annan established the Global Fund to Fight AIDS, Tuberculosis and Malaria, in April 2001. Its purpose is to serve as a funding source to fight these three diseases, it will not operate any of its own projects. Funding is awarded for proposals that cover all areas of disease control: prevention, treatment and care. Organizations who wish to receive funding must work together to develop a proposal, via the Country Coordinating Mechanisms (CCMs). CCMs are a partnerships mechanism that will include representation from governments, NGOs, civil society, multilateral and bilateral agencies. The CCM is responsible for "national multi-partner and multi-sectoral development planning", in other words, the Fund is promoting an integrated approach that unifies efforts to combat the epidemics in a particular country.

How much money does it have?

The fund currently stands at just over $2bn, mostly in pledges from governments. This level of funding has been severely criticized as inadequate and falls far short of the $7-10bn that UNAIDS estimates to be the cost of combating AIDS alone. Determined fundraising efforts are continuing, however, the Fund stresses that it is a complementary source of funding, to help fill in gaps in existing country initiatives.

How is it using Public-Private Partnerships?

The Fund is a unified funding entity that brings together donors from public and private sectors. At the first private sector consultation meeting of the Fund, it was agreed that the Fund would not succeed "unless the private sector is fully recognized as a partner - not just as a potential donor." So its not simply a question of the private sector donating money: public and private sector organizations are represented on the Fund's Board of Directors and the private sector have offered to establish permanent advisors to the Fund. Private sector skills have been brought in to assist in fast tracking the release of the initial funds.

Partnerships are also being promoted in the initiatives that receive funding. When selecting proposals, the Fund favors projects and initiatives that have a cross-sector approach, coordinated through the CCMs. Proposals are encouraged that draw on resources from the public sector, the private sector and civil society. This recognizes that attempts to combat a crisis on this scale cannot succeed if resources are fragmented and do not involve all the parties that make up society.

Impact so far….

The first round of grants have just been awarded, totaling a contribution of $616m across 28 countries. The most immediate impact is likely to be derived from the fact that the Fund makes it possible over the next five years for twice as many people in developing countries to receive anti-retroviral (ARV) treatment, and represent a six-fold increase over the current provision of ARVs in Africa. It is hoped that the structure of the fund in encouraging a public-private partnerships approach will have a lasting legacy in getting organizations to work together and build on mutual strengths. The Fund has the potential to make a dramatic impact in not only the fight against HIV/AID, TB, and Malaria, but in improving the overall quality of healthcare in emerging economies. Public-Private Partnerships such as this have tremendous capacity to leverage private capital to serve a public good. What is now needed are more PPP's in the health sector that focus on preventing and treating infectious diseases and the development of the health care infrastructure to deliver those services to at risk populations.

For further information: Visit the Fund's website at:
www.theglobalfund.org