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The Global Fund: Too Important to Fail

Posted by: FSG Global Health on 1/10/2012
By Owen Ryan, Deputy Director for Public Policy at the Foundation for AIDS Research (amfAR)

Ten years ago, the world’s wealthiest nations made an unprecedented commitment to save the lives of the world’s poor by creating The Global Fund to Fight AIDS, Tuberculosis and Malaria. Today, political skittishness and financial turmoil threaten to undo all of this progress. We must not allow that to happen.

In just a decade the Global Fund has disbursed over $14 billion in grants to 150 countries, received contributions from more than 50 nations, private businesses, and philanthropies, and listed the likes of Bono, Bill Gates, and Carla Bruni-Sarkozy among its champions. It is credited with saving more than 6 million lives.

But, let’s put aside the numbers and celebrities for a moment and talk about what this really means. From 2000 to 2002, I lived in a small village in Malawi that was decimated by these diseases. In less than a year, my classroom went from approximately 40 students to over 120 simply because my fellow teachers kept dying. The rural clinic where I spent most of my time went months without a doctor or any kind of medicine on its shelves. Now, nine years later, almost 1 in 4 HIV-positive Malawians are receiving treatment and more than 1 million bed nets to prevent malaria infection have been distributed. Each of these pills, or tests, or nets translates to lives on the ground – teachers in classrooms and doctors in clinics. These investments don’t just create hope. Hope is too vague a word. These investments lead to tangible, countable lives saved.

Pictured: Owen with secondary school student in Malawi, 2001

Yet, the Global Fund has not had a great year. Last January, news reports of fiscal mismanagement in recipient countries led some donors to suspend future contributions (despite the fact that these discoveries were made by the Global Fund’s own investigation system and were already being prosecuted). Those decisions, along with several nations reneging on their annual pledge, resulted in the Global Fund canceling new funding rounds until 2014. Though aid will continue to flow to the most essential programs (an additional $10 billion between 2011 and 2013), no new programs or expanded projects will receive funding for the next two years at least.

Donor countries are right to question misappropriation, but to punish millions of the poor for the actions of a few is heartless. Furthermore, to hide these decisions behind masks of economic uncertainty is cowardly. The Global Fund must not be allowed to fail.

The good news is this is a tragedy that can be reversed. The G20 must come together immediately to commit additional funds towards the goal of having filled the gap before the International AIDS Conference in July. Without these resources, we will simply be handing these diseases to the generations that come after us.

About Owen Ryan: Owen Ryan is the Deputy Director for Public Policy at amfAR, the Foundation for AIDS Research. Prior to his current role, Owen was a Program Officer for HIV Policy and Advocacy at the Bill & Melinda Gates Foundation. He also serves as the Vice Chair for the Board of Directors of Funders Concerned about AIDS. He has more than 15 years in global health policy and programming experience including work in Malawi, South Africa, and Zimbabwe. Owen earned his Masters of Public Health and of International Affairs from Columbia University.

 



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David
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Thanks for sharing your unique grassroots and global perspective Owen. You make it a compelling moral imperative to maintain resources for global health. Now from your position in Washington, DC, how do you see US leaders responding to these arguments for investment in global health - in light of shrinking domestic budgets and questions about global institutions like the Global Fund and MF Global?
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Owen Ryan
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David - Before I get to the heart of your question, let's separate out some terms. MF Global and the Global Fund have nothing in common beyond a half-shared title. The former was a financial derivatives broker that went bankrupt in October after bad investment choices and "losing" clients’ money - in essence, it was a place that people put money to make money and in the end, that didn't happen.
The Global Fund is a place where governments have put money to save lives and since its start a decade ago, that's exactly what has happened. Fraud is being identified by its own systems, criminals prosecuted and money returned. This is a working system.
I think the US has asked the right questions about management and reform. The Fund took these seriously and made a slate of changes in November. As Secretary Clinton has said, you can't push the Fund for transparency and then punish it for finding faults. The US sees the Fund is working, and, as a result, continues to commit to it.
Laura Herman
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Owen, thanks so much for the insights shared. How can we do more to shift the world's reaction to this fraud. We all cry for greater transparency and I agree with Secretary Clinton - we cannot then punish for the discoveries. Is there an opportunity for the Global Fund to adopt the principles of a learning organization and show greater transparency regarding the lessons that come from its work - internally and externally? Learning is no excuse for fraud, but it does form the basis of taking corrective action based on discoveries - something that I think the Global Fund does, but could be more systematic about.
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