A decade ago, the founding executive director of The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Sir Richard Feachem, adopted the slogan “Raise It, Spend It, Prove It,” to underscore the non-profit organization’s role in dispersing life-saving drugs and interventions against these three major killers. But after the global economic downturn blew holes in the budgets of many of its major donors, and an internal review found evidence of misuse of donor dollars, the Fund, which provides about a quarter of all the money spent on international HIV/AIDS efforts and most of the malaria and tuberculosis (TB) spending in developing countries, is facing some major battles in upholding this slogan.
The Global Fund was created in 2001 after appeals by the G8 nations and the United Nations. A permanent Secretariat was established in Geneva in 2002. The idea behind the Fund was that the world was losing the battle against AIDS, TB, and malaria, and that to reverse course there was a need to dramatically increase resources and direct those resources to the areas of greatest need. The Global Fund worked hard at remaining true to that goal. Feachem, who presided over the non-profit public-private partnership from 2002 to 2007, says the agency resisted pressure to adopt other global health priorities and stuck to its role of raising large amounts of money and spending it as effectively as possible.
And raise money it did. Between 2001 and 2010, The Global Fund’s top 20 government donors contributed US$18 billion, led by the US with a $5.4 billion contribution. For the period from 2002 to 2015, governments have pledged $28.3 billion to the Fund, $20.7 billion of which has actually materialized. The money spent by the Global Fund since 2001 has put 3.3 million people on antiretroviral therapy, helped detect and treat 8.6 million cases of TB, and has been used to distribute 230 million insecticide-treated bed nets to households across sub-Saharan Africa.
But after years of steady growth in both the number of donors and the amount of their contributions, The Global Fund now faces a $2 billion shortfall that Feachem says will carry devastating consequences for developing countries unless the fund is replenished. “A decade of massive investment produced spectacular progress,” says Feachem, who now directs the Global Health Group at the University of California-San Francisco. “It would be unthinkable to let that progress be reversed. That is now a real possibility unless we can urgently mobilize additional resources.”
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