Examine individual changes

'{{About||Global Fund for Children|The Global Fund for Children}} {{Infobox Non-profit | Non-profit_name = The Global Fund to Fight AIDS, Tuberculosis and Malaria | Non-profit_logo = [[Image:The global fund.JPG|centre|200px]] | founded_date = 2002, [[Genoa]], [[Italy]] | focus = | method = | homepage = [http://www.theglobalfund.org/ www.theglobalfund.org] }} '''The Global Fund to Fight AIDS, Tuberculosis and Malaria''' (often commonly called "The Global Fund" or "GFATM") was established in January 2002 to dramatically increase global financing for interventions against the two [[pandemic]]s ([[malaria]] is actually [[endemism|endemic]]). It is the largest international funding agency (it is neither global nor a fund) to combat malaria and [[tuberculosis]], providing two-thirds of all financing, and provides 20% of all international funding to combat [[HIV]]/[[AIDS]]. The Global Fund Secretariat asserts that as of June 2007, 1.9 million lives have been saved thanks to efforts in 136 countries supported by the Global Fund.<ref name="TheGF">{{cite web |title=The Global Fund Saves Lives |work=The Global Fund web site |accessdate=2007-04-24 |url=http://www.theglobalfund.org/en/terg/evaluations/sa1/}}</ref> Currently the Global Fund is almost completely funded by contributions from the largest developed nations governments <ref>http://www.theglobalfund.org/documents/publications/annualreports/2008/AnnualReport2008.pdf GFATM 2008 Annual Report (audited data)</ref>. In 2005 the Global Fund has stopped reporting results of projects - it changed the wording to influenced and programs supported by the GFATM. The Global Fund was created as a project funding agency is still funded as such by yearly contributions of its donors and a 2-3 years time horizon within the grants, but has recently started to expand its scope by Health System Strengthening, simplified renewal of grants and funding beyond the 3 pandemics into a more general program funding agency. ==Founding== The genesis of the Global Fund emerged during discussions between donor and multilateral agencies toward the end of 1999, leading up to the July 2000 G8 Summit in Okinawa, Japan. At the Summit, G8 nations for the first time established measurable global targets for addressing AIDS, TB and malaria.<ref name="Okinawa">[http://www.g8.utoronto.ca/summit/2000okinawa/finalcom.htm 2000 G8 Okinawa targets for AIDS, TB & Malaria]</ref> That same year, under the leadership of World Health Organization (WHO) Director-General Gro Harlem Brundtland and WHO Deputy Director General David Nabarro, discussions were initiated with donors concerning the creation of a new global health fund to help achieve these targets. In October 2000, WHO and the City of Winterthur, Switzerland convened a Massive Effort Advocacy Forum to engage over 200 public agencies, private sector and civil society organization in a process of buidling ownership and support to massively scale up donor funding to fight diseases of poverty. Speakers included Dr. Brundtland and Swiss President Ruth Driefus, in addition to Prof. Jeffrey Sachs via satellite.<ref name="Winterthur">[http://www.afronets.org/archive/200010/msg00038.php WHO Director-General's address at Winterthur]</ref> This subsequently led to WHO, Credit Suisse/Winterthur Insurance. and the Swiss/Kenyan NGO Double Income Project (DIP) establishing and funding the Massive Effort Campaign, for the purposes of building global support for the fight against AIDS, TB and malaria.<ref name="Massive Effort Campaign">[http://www.unssc.org/web1/programmes/glnp/Knowledge_Sharing/case_studies/Massive_Effort_against_Diseases_of_Poverty_Case_Study.pdf Massive Effort Campaign as a catalyst for the Global Fund</ref> During the final months of 2000 and early 2001, political jockeying over who might host the Global Fund intensified. Many initially assumed hosting the Global Fund was WHO's end game. On August 19, 2000, ''The Washington Post'' reported that "Clinton Signs Bill Establishing Global Fund to Fight AIDS," effectively intending to locate it inside the World Bank. According to ''The Washington Post'', "President Clinton signed a bill today that sets up a global trust fund for AIDS patients that has been likened to a kind of Marshall Plan against the infectious disease." Soon thereafter, UNICEF's Carol Bellamy suggested that UNICEF was better equipped to know "How to Distribute AIDS Drugs," in her March 2001 ''The New York Times'' op-ed. An article published in the British medical journal ''[[The Lancet]]'' by [[Harvard]] academics [[Amir Attaran]] and [[Jeffrey Sachs]] in January 2001 called for an order of magnitude increase in foreign aid budgets for HIV/AIDS, over those the researchers documented in the 1990s. Attaran and Sachs proposed a new funding stream of $7.5 billion or more to fund projects proposed and desired by the affected countries themselves, and that a panel of independent scientific experts validates as having epidemiological merit against the pandemic.<ref name="Popline">[http://www.popline.org/docs/154856 Defining and refining international donor support for combating the AIDS pandemic]</ref> Attaran and Sachs also recommended that the new funding stream "must be based on grants, not loans, for the poorest countries",<ref name="Popline"/> unlike the [[World Bank]], which was the largest multilateral HIV/AIDS funder then existing. On April 26, 2001, in Abuja, Nigeria, at the urging of WHO, Prof. Sachs and others, UN Secretary General Kofi Annan made the first explicit public call by a highly visible global leader for this new funding mechanism, proposing "the creation of a Global Fund, dedicated to the battle against HIV/AIDS and other infectious diseases."<ref name="Kofi Annan">[http://www.un.org/News/ossg/sg/stories/statments_search_full.asp?statID=8 Annan's call for a global AIDS war chest]</ref> The decision to create the new funding stream was taken by heads of state at the 2001 [[G8 Summit]] in [[Genoa]] (Italy), at the urging of [[United Nations Secretary General]] [[Kofi Annan]], and largely along the lines WHO, Attaran and Sachs described. Indeed, the United Nations system had been considered ill conceived to implement a major increase in development funding. Multiple organisations were converging with small-scale projects on countries with limited institutional capacities, which exacerbated a series of problems, including poor coordination, duplication, high transaction costs, limited country ownership and lack of alignment with country systems. Established in 2002, the Global Fund was intended to introduce a new aid paradigm based on partner country leadership, donor alignment with partner countries' development strategies, harmonization of donor actions, managing for results, and donor and partner being mutually accountable for results. This was subsequently conceptualized by the [[OECD]] in its 2004 Paris Declaration on 'aid effectiveness'.{{citation needed|date=October 2010}} The first Secretariat was established in January 2002, and [[Richard Feachem]] was appointed as its first Executive Director in July of that year and served until March 31, 2007. Dr. Feachem announced he would not seek another term following a probe into the involvement of his wife in the Global Fund's business. Today, the Global Fund is headed by [[Michel Kazatchkine]], a public health expert with over 20 years of experience in the field. The September 2005 conference in [[London]] mobilized 3 billion euro, just over half the pledges at the [[Gleneagles, Scotland|Gleneagles]] G8 summit. In December 2002, the fund made its first disbursement to grantees. The [[United States]] is contributing $700 million to the fund, but has decided to divert the bulk of its AIDS funding to the President's Emergency Plan for Aids Relief, [[PEPFAR]], to more closely control allocation. The Global Fund is the first organization of its kind, incorporated as a Foundation under Swiss law.<ref>[http://www.theglobalfund.org/documents/HQ_agreement_en.pdf Agreement between the Swiss Federal Council and the Global Fund]</ref> It is a new kind of [[public-private partnership]] but is often confused as being part of the [[United Nations System|United Nations family]]. This may be because until January 1, 2009 Global Fund staff were officially [[World Health Organization]] (WHO) staff members and besides this the [[World Health Organization]] (WHO) provided many administrative services to the Global Fund secretariat and is also based in [[Geneva]], [[Switzerland]]. Effective January 1, 2009, the Global Fund became an administratively autonomous organization, terminating its administrative services agreement with the World Health Organization (WHO).<ref>[http://www.theglobalfund.org/en/ifi/?lang=en The Global Fund becomes a fully autonomous international financing institution]</ref> In March 2009, the head of the Fund criticized statements made by Pope [[Benedict XVI]], according to whom AIDS "cannot be overcome through the distribution of condoms, which even aggravates the problems."<ref>[http://www.google.com/hostednews/afp/article/ALeqM5gvwcxvyzgtHGu3TFaSOVQtkVoyGw AIDS activists blast pope's rejection of condoms]</ref> ===Replenishment phase=== As of 2010, the Global Fund has entered its 'replenishment phase', i.e. it needs funders to commit themselves to continued financing. Alarms have been raised prior to the 2010 October meeting about a looming deficit in funding, which would lead to people currently undergoing ARV treatment losing access to this - increasing the chance of them becoming resistant to treatment. [[UNAIDS]] Executive Director [[Michel Sidibé]] has dubbed the scenario of a funding deficit an "HIV Nightmare".<ref>Hellevik, Siri Bjerkrem: [http://blog.nibrinternational.no/#post20 "Is an HIV Nightmare on the Way?"] at ''the NIBR International Blog, August 23, 2010''</ref> The Global Fund has stated that it needed at least 20 billion dollars in 2011-13, and 13 billion just to "allow for the continuation of funding of existing programs".<ref>Hellevik, Siri Bjerkreim: ''HIV Nightmare Averted - For Now'', [http://blog.nibrinternational.no/#post22 NIBR International Blog, October 14, 2020]</ref> Its 2001-2010 budget includes 19,4 billion dollars, with 600 interventions in 145 countries and 5.7 lives saved.<ref name=rep>{{it}}[http://www.repubblica.it/solidarieta/emergenza/2010/10/03/news/fondo_globale_anti_aids-7672987/ La Repubblica], 4 October 2010</ref> Italy, founding member of the Fund seating in its administrative committee, announced at the [[35th G8 summit|Aquila 2009 G8 Summit]] a ''una tantum'' contribution of 30 million €. Both the ''una tantum'' and the 2009 and 2010 contributions (130 million € each) have not been disboursed (in fall 2010), for a total debt of 290 million €.<ref name=rep/> At the October 2010 replenishing meeting $11,8 billion USD was mobilized, with the USA being the largest contributor - followed by France, Germany and Japan. The Global Fund has said that the $1,2 billion USD lack in funding will "lead to difficult decisions in the next three years that could slow down the effort to beat the three diseases".<ref>Hellevik, Siri Bjerkreim: H''IV Nightmare Averted - For Now'', [http://blog.nibrinternational.no/#post22 NIBR International Blog, October 14, 2020]</ref> ==Operation== A characteristic of the Global Fund that has drawn much praise is the transparency of the organization. Information on the Global Fund's processes, including quite sensitive decision making processes, is available from their official website. Importantly, the Global Fund is a financing mechanism rather than an implementing agency. This means that monitoring of programs is supported by a Secretariat of approximately 600 staff (as of 2011) in Geneva. Implementation is done by [[Country Coordinating Mechanism]]s, which are committees consisting of local stakeholder organizations in-country that include some or all of government, NGO, UN, faith-based and private sector actors. This has kept the organization smaller than other international bureaucracies, but also given rise to concern over its capacity to ensure appropriate use of its funds. (See Corruption and Misuse of Funds section, below.) It has also raised concerns about conflict of interest, as some of the bodies who sit on the CCMs also receive money from them. The Global Fund provides initial grant funding solely on the basis of the technical quality of applications, as evaluated by its independent [[Technical Review Panel]]. The Fund has no means of assessing the implementation capacity of the applicants. Grants are signed for an initial period of two years. It provides continued funding to programs based solely on the basis of performance, which is generally defined as disbursement and purchases. The Fund makes no attempt to confirm whether services were delivered or whether its grants had any effect on health status or outcomes. The objective of the Global Fund — to provide funding to countries on the basis of performance — was supposed to make it different from other international agencies that concerned themselves primarily with recording what money has been spent on, rather than what targets have been achieved. These organizations have hundreds or thousands of staff that assist with implementation of grants. However, the Global Fund's five-year evaluation concluded that without a standing body of technical staff, the Global Fund is not able to ascertain the actual results of its projects. It has therefore tended to look at disbursements or the purchase of inputs as performance. It also became apparent shortly after the Global Fund opened that a pure funding mechanism could not work on its own, and it began relying on other agencies (notably WHO) to support countries in designing and drafting their proposals and in supporting implementation. UNDP, in particular, bears responsibility for supporting Global Fund-financed projects in dozens of countries. As a result, the Fund is most accurately described as a financial supplement to the existing global health architecture rather than as a separate approach. Bilateral donors immediately pledged millions (in some cases billions) of [[US dollar]]s in support of Global Fund programs. The innovative approach to its financing principles is obviously considered key to its success. Since its inception, the Global Fund has committed US $11.4 billion to more than 550 grants in 136 countries (as of December 2008).<ref>[http://www.theglobalfund.org/en/about/ About the Global Fund]</ref> In March 2010, [[Dow Jones Indexes]] signed a memorandum with The Global Fund to explore the creation of co-branded indexes that could be licensed as the basis for investment products. The Global Fund aims to strengthen its engagement with the private sector, while the Dow seeks to add to its range of socially-conscious indexes.<ref>[http://press.djindexes.com/index.php/the-global-fund-to-fight-aids-tuberculosis-malaria-dow-jones-indexes-sign-memorandum-to-explore-creation-of-co-branded-indexes/ Dow Jones Indexes developing products with The Global Fund], DJ press release, March 4, 2010</ref> ==Corruption and Misuse of Funds== In January 2011, the [[Associated Press]] reported vast corruption in programs financed by the Global Fund<ref>http://www.google.com/hostednews/ap/article/ALeqM5jBNgIu-Vg-_pAVtF6PcN9eSYPfiA?docId=eccd6da0cec34b489a67dfdf80cb933b</ref>. The article cited findings of the GFATM OIG office that up to 2/3rds of funds in some of the reviewed Global Fund’s grants were lost to fraud and the OIG report showed that systematic fraud patterns have been used across countries. GFATM members have since then posted discrediting comments on people providing additional information on these dealings <ref>http://www.guardian.co.uk/society/sarah-boseley-global-health/2011/jan/28/aids-infectiousdiseases</ref> or tried to make their comments disappear with press releases and marketing write-ups<ref>http://www.npr.org/blogs/health/2011/01/24/133188263/global-health-fund-finds-some-fraud-recoups-losses</ref>. These newly uncovered misuses of funds were investigated and made public by the Global Fund Inspector General's Office (OIG), an auditing unit independent from the Global Fund Secretariat that manages the disbursements of funds to the programs (the selection of new applications for grants is done by the Technical Review panel and the GFATM Board - both independent entities from the GFATM secretariat)<ref>http://www.theglobalfund.org/en/oig/?lang=en</ref>. The GFATM Secretariat has posted a series of press releases on the GFATM website <ref>http://www.theglobalfund.org/en/pressreleases/?pr=pr_101207</ref> to publish their views on these dealings. The Fund's Inspector General's office (OIG) which uncovered the corruption has been newly reinforced after the post was vacant for more than a year and was only created during 2005, years after the GFATM started to disburse US$ billions of funds into grants.<ref>http://www.theglobalfund.org/en/oig/?lang=en</ref>. During these investigation the U.N. Development Program ([[UNDP]]) that manages and supervises a large proportion (12%) <ref>[http://news.yahoo.com/s/ap/20110128/ap_on_re_eu/eu_aids_fund_corruption_corrective Associated Press - Yahoo News], Correction of size of UNDP fund management for the GFATM, last accessed 04 February 2011 </ref> of the fund's spending as Local Fund Agent (LFA) in-country (the Global Fund has no country offices) has claimed diplomatic immunity to block the GFATM inspector general from access to internal audits and books of investigated programs in the more than two dozen nations.<ref name="ap-report"/> The OIG has only examined a small percentage of the grants so far. Previous reviews of grants and the organization have shown substantial misconduct in some programs, lack of adequate risk management and operational efficiency of the Global Fund.<ref>[http://www.theglobalfund.org/documents/terg/TERG_Summary_Paper_on_Synthesis_Report.pdf/ Summary Paper on the Five-Year Evaluation Synthesis Report], 5 year review study paid by the GFATM pp13, 2009</ref> Severe cases of corruption have been found in several African countries such as Mali, Mauritania, Djibouti and Zambia. Global Fund spokesman, Jon Liden, said; "The messenger is being shot to some extent. We would contend that we do not have any corruption problems that are significantly different in scale or nature to any other international financing institution."<ref name="ap-report">{{cite news |title=AP Enterprise: Fraud plagues global health fund |author= |url=http://www.google.com/hostednews/ap/article/ALeqM5jBNgIu-Vg-_pAVtF6PcN9eSYPfiA?docId=eccd6da0cec34b489a67dfdf80cb933b |agency=Associated Press |date=23 January 2011 |accessdate=23 January 2011}}</ref> This statement triggered a wave of private protests from other agencies who felt the Fund was attempting to divert attention from itself. Subsequent Global Fund statements have omitted any reference to other agencies. In response to the findings, Sweden, the fund's 11th-biggest contributor, has suspended its $85 million annual donation until the corruption problems are resolved.<ref name="ap-report"/> Together with Sweden, Germany, the 3rd biggest contributor to the fund has also blocked any financing until a special investigation has been completed.<ref>[http://www.bmz.de/de/presse/aktuelleMeldungen/2011/januar/20110125_pm_10_globalerfonds/index.html Minister Niebel on Corruption at the GFATM], BMZ message, January 25, 2011 German only</ref> These findings come on top of previously discovered massive abuse of funds, corruption and mismanagement in a series of grants that forced the GFATM to suspend or terminate these grants after such dealings became publicly known with Uganda, Zimbabwe, Philippines, Ukraine being the largest of these grants (more than US$ 100 million each).<ref>[http://www.theglobalfund.org/en/pressreleases/ Global Fund Press releases], various press releases, last accessed January 25, 2011 </ref> The story widened in February 2011 when the Financial Times reported that the fund’s board of directors had failed to act previously on concerns over accountability, including the conclusion of an ex­ternal evaluation in 2009 which criticized the Fund's weak procurement practices. <ref>UN health fund to review practices, Financial Times, Feb. 3, 2011</ref> Warnings of inadequate controls had also been reported periodically.<ref>A spoonful of ingenuity, The Economist, Jan. 7, 2010.</ref> In Feb. 2011 the FT also reported that its own review found that neither Global Fund staff nor the Local Fund Agents (the entities entrusted with ensuring accountability at country level) had noticed the deficiencies reported by the inspector-general. ==Financing, major donations and administration== The GFATM is almost completely funded by contributions from the largest developed nations governments / tax payers. GFATM audited annual returns show that currently more than 96% of its yearly contributions are received from government organizations <ref>http://www.theglobalfund.org/documents/publications/annualreports/2008/AnnualReport2008.pdf GFATM 2008 Annual Report (audited data)</ref>. Its largest private contributor by far is the [[Gates Foundation]] <ref>http://www.theglobalfund.org/documents/pledges_contributions.xls GFATM detailed pledges and contributions (not audited)</ref> *In January 2006, [[Bono]] and [[Bobby Shriver]] announced the launching of the [[Product Red]] campaign, proceeds from which would go to the Global Fund. *In August 2006, the [[Gates Foundation]] contributed $500 million to the Global Fund, calling the fund "one of the most important health initiatives in the world".<ref name="RegisterGates">[http://www.theregister.co.uk/2006/08/10/gates_foundation_health Gates puts $500m into global health fund]</ref> *In March 2006, Executive Director [[Richard Feachem]] announced his intention to step down, as soon as his successor was determined by the Global Fund Board. In April 2007, Dr. [[Michel Kazatchkine]] became the Global Fund's new Executive Director. ==See also== *[[Student Global AIDS Campaign]] *[[Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria]] ==References== {{reflist}} ==External links== * [http://www.theglobalfund.org/ The Global Fund — website in six languages] * [http://www.theglobalfight.org/ Friends of the Global Fight] * [http://www.action.org/ ACTION: Advocacy to Control TB Internationally] * [http://www.schooltbclubs.com/ A Global Fund Project in Pakistan] {{DEFAULTSORT:Global Fund, The}} [[Category:International organizations]] [[Category:International nongovernmental organizations]] [[Category:HIV/AIDS organizations]] [[Category:Tuberculosis]] [[Category:Global health]] [[Category:Malaria organizations]] [[Category:World Health Organization]] [[Category:Organisations based in Geneva]] [[de:Global Fund]] [[fr:Fonds mondial de lutte contre le SIDA, la tuberculose et le paludisme]] [[no:The Global Fund to Fight AIDS, Tuberculosis and Malaria]] [[sq:Fondi Global për HIV/AIDS, Tuberkulozin dhe Malarien]]'