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Global Fund for AIDS, TB, Malaria “Not in Crisis”

WASHINGTON, Apr 26 2012 (IPS) - Although coming off a rocky year in 2011, the Global Fund to Fight AIDS, Tuberculosis and Malaria is “not in crisis”, according to the organisation’s deputy general manager, Debrework Zewdie.

At a roundtable organised on Wednesday by the Council on Foreign Relations here, Zewdie stated that after being forced to weather a scandal last year and the ongoing international economic downturn, the Global Fund is once again receiving substantial commitments from bilateral donors.

A day after the news was officially disclosed to the Global Fund’s governing board, Zewdie announced new or renewed multi-year funding promises from Germany, Japan, Spain and the UK. The Global Fund’s most significant donor, the United States, has maintained its backing throughout the difficulties of the past year.

“Dr. Zewdie delivered a clear message that the Global Fund’s transformation is well underway, with a strong new focus on impeccable grant management,” Mark Isaac, interim president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, told IPS.

“She also underscored how critical ongoing U.S. leadership is to ensuring support from other nations and to reaching those most in need around the world with lifesaving services.”

The Global Fund began operating in 2002 with the expressed aim of operating differently from other such multilateral funders. It was to be a simple, straightforward organisation with a simple, straightforward mandate: to disburse funding with the aim of treating and preventing HIV/AIDS, tuberculosis and malaria.

Quickly attracting some of the biggest names in international philanthropy and celebrity, the impact and example of the Global Fund on global health over the past decade would be difficult to overstate. As of last year, the organisation had approved funding of some 23 billion dollars. Today, it is operating in 150 countries, with a particular focus on sub-Saharan Africa.

Further, the Global Fund’s activities have been on the increase. Around 80 percent of its funding dispersal has taken place within the last five years.

Today, it is the world’s largest grant-making body working on the three diseases under its remit.

Alongside this massive ramping up, however, the Global Fund has inevitably become a complex behemoth. “When the Global Fund was created, it was supposed to be simple,” Zewdie said in Washington. “It’s nothing like that now.”

The Global Fund’s complexity appears to have led to an inability to adequately oversee its massive operations.

In January 2011, the Associated Press news agency, utilising data from the Global Fund’s own inspector general, published allegations that the Global Fund was losing tens of millions of dollars due to mismanagement and corruption. According to that data, up to two- thirds of grant monies for certain projects was being lost to various types of fraud.

Additional allegations of poor oversight and shoddy management came to light following the initial publication.

The news led the European Commission and several European countries to announce that they would be withholding nearly 450 million dollars, pending investigation.

The results quickly amassed, with the most dramatic ramification coming in November 2011. At that time, because some 2.2 billion dollars in pledged donor contributions had not materialised, the Global Fund’s governing board announced that it would be cancelling the next scheduled round of grant dispersal.

Since then, many have begun warning that the significant strides that have been made in recent years against each of these diseases were in danger of being rolled back. Zewdie’s comments on Wednesday coincided with the marking of World Malaria Day, the theme of which this year is “Sustain Gains, Save Lives”, clearly underlining the building anxiety.

The Global Fund has been adamant that, although the mid-term future of its efforts has been in danger during the contribution slowdown, the multi-year structuring of its programmes means that on-the-ground services have not experienced negative impacts.

According to a new report funded in part by the Clinton Health Access Initiative, however, 91 percent of cases of malaria resurgence over the past eight decades have been due to weakened control programmes, typically due to funding cuts.

The recent turnaround in donor sentiment is undoubtedly motivated at least in part by significant restructuring plans being implemented within the Global Fund.

The agency is currently halfway through a twofold plan aimed at dealing with issues of complexity and mismanagement. Zewdie reported that while the Global Fund’s grant-making monies used to be evenly split between administrative and programmatic costs, an expedited 60- day overhaul resulted in administrative costs being cut down to a quarter of the total.

In addition, the agency has moved to shift its focus to what those areas deemed “high impact”, following a realisation that resources were not going only to those countries most in need. The total number of staff – previously around 600 – will also be reduced.

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