The first directors have now been appointed to the Global Fund to fight AIDS, TB and Malaria, which has just finished its first meeting in Geneva, Switzerland. Funding criteria have been announced, which clearly follow the ideas developed by the Global Fund's Transitional Working Group. The first round of grants is promised for April when the Global Fund will be meeting again, in New York.
The basic principle of the Global Fund is to support priority-setting within and by the people most directly affected by the three diseases, and not to impose those priorities on them. This has been strongly supported by the Stop AIDS Campaign in the UK but goes against calls from some activists for a minimum proportion of the funding to be reserved for antiretrovirals to treat HIV.
The Global Fund is set up as a "public-private partnership" whose board reflects a range of different interests. There are seven governmental donors, seven governments representing countries likely to draw on the Fund, two non-governmental organisations (one from the North, one from the South), two private sector organisations (representing Foundations and business), and non-voting memberships reserved for a person living with AIDS (or, in theory, TB or malaria), WHO and UNAIDS.
“The Fund is an unprecedented cooperative effort to combat the world’s
deadliest epidemics,” said Paul Ehmer, Team Leader of the Secretariat, in the Global Fund's news release announcing the outcome of its first meeting.
“Today, we are taking a major step forward, moving rapidly to get these
resources to the people that need them most. This is not just a matter of
caring and compassion -- it is economically wise as well. The diseases we
are addressing have a terrible impact both on human lives and on economic
development."
"A report (Macroeconomics and health: investing in health for economic development) released recently by leading economists and health experts reaffirms that healthy people are essential to a nation’s economic prosperity."
"The Fund will finance plans developed through country partnerships in
severely affected countries as well as in areas with growing epidemics. It
will also support plans in countries that have demonstrated the highest
level political commitment to eradicating these diseases. Its approach
will be integrated and balanced, covering prevention, treatment, and care
and support in dealing with the three diseases.
"Proposals will be funded rapidly, with minimum red tape, but with enough
safeguards to make sure funds are used responsibly and effectively. Also,
the Fund will finance projects that are most likely to clearly demonstrate
measurable success.
President George W Bush yesterday pledged US $200 million for the Global Fund in 2003, disappointing many activists who had been led to expect that US contributions would rise above the $200 million committed for this year. To date, including this announcement, industrialised and developing countries, corporations, foundations and individuals have pledged some US$1.9 billion to the Fund, of which up to US$700 million are expected to be granted in 2002.
The Fund says that while this is an important start, far more resources are needed. The Fund’s aim is to attract significant additional resources that will increase the pool of money already available to fight AIDS, tuberculosis and malaria.
“To be able to responsibly spend millions of dollars in a way that will
make a measurable difference takes time,” said Mr Ehmer. “We must get it
right.”
How the Global Fund is Administered
A unique feature of the Global Fund is its composition, which includes Non-Governmental Organisations (NGOs) and private sector interests as of right.
Donor countries represented on the Board are France, Italy, Japan, Sweden,
the UK, the US and the European Commission. Some of these seats have
alternates and will rotate among countries.
Similarly, the seven developing countries on the Board include China, Brazil, Nigeria, Pakistan, Thailand, Uganda, Ukraine.
The private sector is represented by the Gates Foundation (on behalf of Foundations) and Anglo-American, the mining company with extensive business interests in southern Africa, which has recently committed itself to health benefits including access to antiretroviral treatment for its HIV positive employees. Contrary to some published statements, this position was not awarded to a pharmaceutical company although senior pharmaceutical company representatives did offer to serve.
The NGO representatives, with full voting rights, are Millie Katana, a woman living with HIV, representing the Health Rights Action Group of Uganda, and Dr Christoph Benn who is Head of the Department for Health Policy and Studies with the German Institute for Medical Mission.
There are two alternate NGO representatives, namely Fidon R Mwombeki who is the General Secretary of the Northwestern Diocese Evangelical Lutheran Church in Tanzania, and Dr Peter Poore, a health adviser associated with Save the Children in the UK.
In addition to regular Board members, the Joint United Nations Programme
on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), along with
the World Bank, which handles the Global Fund’s finances, hold ex-officio
non-voting seats on the Board. The Board’s composition includes a person
living with or affected by HIV/AIDS, TB or malaria, also in a non-voting
seat. This is occupied by Philippa Lawson, an active member of the International Community of Women with HIV (ICW), based in the USA (Charles Roy, the Executive Director of the AIDS Committee of Toronto is an alternate representative).
A small Secretariat located in Geneva manages the Global
Fund’s work and recruitment of the permanent executive head and staff is
beginning. Meantime, an interim Secretariat is being staffed by
secondments from UN organizations and governments.
Mobilizing additional public and private resources will be a key goal for
the Fund. The Fund’s second board meeting will take place towards the end
of April in New York.