Guest Post: The crisis at the Global Fund to Fight AIDS, TB and Malaria
In 2002, with the future of the fight against AIDS, TB and Malaria looking bleak, the world came together to form a unique partnership: the Global Fund to Fight AIDS TB and Malaria. This kicked off one of the most extraordinary decades in the history of public health, massively increasing funding for the fight against the three diseases. The Fund now supports programmes that save an estimated 100,000 lives every month, and 7.7m. The Fund has helped detect and treat 8.6 million cases of TB, more than 3 million more people are now on life saving ARV treatment and deaths from malaria have reduced by 25% globally in the last 10 years, halving in some African countries.
The funding crisis
In 2011, just as the news was breaking that we know how to end AIDS within a generation, the Global Fund Secretariat reported that they faced a funding crisis. The main cause of the crisis was donor governments failing to deliver money they had promised to the Fund. There are a few reasons behind this:
The financial crisis: To a large degree, The Global Fund’s financial headaches are a consequence of the 2008 financial crisis and the European sovereign debt crisis. The Global Fund gets 95% of its money from governments, most of them in Europe, and given the financial downturn donations to the Global Fund began to slip. In 2008 the Global Fund received 100% of pledges, at the end of 2011 it had only received 70% and at the middle of 2012 it stands at 40%.
Global Fund Corruption: In January last year, the Associated Press ran several stories claiming that they had uncovered massive corruption in Global Fund grants in several countries. The sensational stories were inaccurate – there was fraud in the programmes, but it was discovered and made public by the Global Fund’s own internal watchdog. It had already taken steps to reclaim the money, and the level of funding affected was far lower than claimed by the AP. Corruption is never acceptable, but the Global Fund is one of the best organisations in the world at uncovering and challenging it, and was in effect being punished for being transparent. Following the press coverage, Germany, Ireland, the European Commission and Sweden announced they were withholding funding they had already pledged until investigations were carried out.
Implications of the funding crisis
The Global Fund is the biggest funder of programmes against the three diseases in the world, and its importance for our ability to stop the preventable deaths of millions of people really can’t be overstated. It has between $9.5 and $10 billion to spend in 2011-13, but this is all already committed to existing programmes. The consequence is that the Fund has had to cancel its ‘Round 11’ funding, which was due to be the next opportunity for countries to apply for more money. Many countries were already far advanced in preparing their applications to Round 11 and were counting on that funding stream to run their AIDS, TB and Malaria programmes. In the place of Round 11 the Global Fund has established a bare-bones ‘Transitional Funding Mechanism’ (TFM) which is designed to ensure continuation of ‘essential’ services but not the scale up we need to be able to deliver an AIDS-free generation and to beat TB and Malaria.
The response to the crisis
The Global Fund has responded to the allegations of corruption by launching a ‘High Level Panel’, which investigated its processes for grant monitoring and evaluation and released a report with recommendations for reform, which are now being implemented. The vast majority of donors to the Fund are satisfied that excellent progress is being made to implement the report’s recommendations – all the countries that froze their contributions in response to the AP’s stories have now unfrozen them and expressed confidence in the Fund.
What is needed to get the Fund back on track
There are two ways in which donors can contribute to revitalising the Global Fund. Firstly, several donors have brought forward pledges that had been made for later dates, so that they can fill the cash crisis now. In November 2011 Germany brought forward €100 Million ($131 million); in January 2012, the Gates Foundation issued a $750 million ‘promissory note’ against an earlier pledge – a legally-binding IOU; and President Barack Obama used a discretionary spending fund to top up the US contribution to $1.3 billion in order to meet the US pledge made in 2010. Secondly, donors need to pledge new money so that the Global Fund can start to finance new programmes. In January Saudi Arabia made its first ever pledge - $25 million -and Japan made its biggest contribution to the Global Fund in 10 years, committing $340 million despite the challenges it faces due to last year’s tsunami.
The UK and the Global Fund
The UK Government say that they are strongly in support of the Global Fund. In 2007 the Labour government promised to give the Fund £1 billion between 2008 and 2015, and we have so far delivered around £650 million. In December the current Government brought forward £128 million, due at a later date, of this commitment in order to fight the cash crisis. Under the Multilateral Aid Review, completed in March 2011, the Global Fund was given the top score, representing ‘Very Good’ value for money. It was found to be highly focused on results, accountable, well run and to deliver critical improvements to poor people’s lives. Last month at a specially convened hearing of the International Development Select Committee Andrew Mitchell MP, Secretary of State for International Development, reiterated that the UK intends to make a further commitment, but did not say when, and added that this announcement would be subject to seeing the results of the reform process.
RESULTS UK and the Global Fund
RESULTS UK has been campaigning on the Global Fund for several years, supporting it through replenishment processes and now strongly advocating for new money to be invested and to scale up and develop its ambition. Our groups of grassroots volunteers have made a huge impact on the Fund, teasing out important information from decision makers about the future of the Fund. For instance, in April this year a group of our volunteers met with Simon Bland who is the chair of the Global Fund board to grill him over the future of the organisation. In that meeting he spoke honestly about the need to replace the round based funding system, something we hadn’t heard at any point previously. We work with advocates from across the global south to develop strong messages and recommendation on the future of the Global Fund, using their voices to increase our impact.
To read more on some of our recent actions on the Global Fund, click here. http://results.org.uk/our-actions
We are always looking for more people to help us campaign on the future of this vital global health initiative. If you are interested in becoming involved with RESULTS then please email us in the office.