{"id":20033,"date":"2012-09-04T14:10:28","date_gmt":"2012-09-04T13:10:28","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=20033"},"modified":"2012-09-04T14:10:30","modified_gmt":"2012-09-04T13:10:30","slug":"daniele-dionisio-overhauling-the-global-fund","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2012\/09\/04\/daniele-dionisio-overhauling-the-global-fund\/","title":{"rendered":"Daniele Dionisio: Overhauling the Global Fund"},"content":{"rendered":"

\"\"<\/a>The Global Fund<\/a> (GF) is a partnership between governments, civil society, the private sector, and relevant communities as an international financing institution for HIV, tuberculosis (TB), and malaria prevention, and treatment programmes. The GF supports national programmes by distributing funds, provided verifiable results are pledged.<\/p>\n

Since its inception in 2002, the GF has become the main funder of initiatives to fight HIV, TB, and malaria. US$ 23 billion of funding has been given out for more than 1,000 programmes in 151 countries, as of mid 2012.<\/p>\n

To date, the programmes backed by the GF<\/a> secure HIV and TB treatment for 3.6 million and 9.3 million people respectively (a 21 per cent increase since the end of 2010), and 270 million insecticide treated nets for the prevention of malaria. Under programmes endorsed by the GF, the number of cases of malaria that have been treated has risen by more than half in the same period to 260 million. At the same time, with GF support<\/a>, TB and HIV services have more than doubled, HIV testing and counselling sessions have risen by 43 per cent to 210 million, and the number of HIV infected pregnant women enjoying full course antiretroviral treatment has increased to 1.5 million.<\/p>\n

Overall, while 8.7 million lives have been saved to date thanks to programmes supported by the GF, the institution wishes to earmark up to US$8 billion in grants<\/a> to fight HIV, TB, and malaria over the coming 20 months, with US$5 billion of earmarked for Africa.<\/p>\n

Drastic redesign<\/strong>
\nThese prospects, however, could be mired in uncertainty now that the GF is experiencing a deep\u00a0 financial shortfall<\/a> as the global economic crisis has slowed down or frozen some donor governments\u2019 commitments.<\/p>\n

Donors are increasing pressure for better management and greater returns on their investments, and new measures are needed to ensure the GF keeps working effectively for years to come.<\/p>\n

On 23 November 2011, the GF\u2019s board decided<\/a> to reject new grant requests until at least 2014. They also decided to make savings in the grant portfolio and only finance services for working programmes coming to an end before 2014, and to further curb funding to some upper middle income countries. The board also appointed a general manager<\/a> to work alongside the executive director and ferry the GF through a drastic shake-up and get a better performance.<\/p>\n

As such, since general manager Gabriel Jaramillo<\/a>‘s appointment in February this year, the GF has been rolling out a process to effectively manage grants, raise donations, and strengthen the fund’s forecasting.<\/p>\n

While changing the way the GF does business <\/a>and disburses money, the redesign includes an improved approach to risk management from country to country, which takes into account recent allegations of fraud among fund recipients and the results of audits<\/a> and investigations by the Office of the Inspector General between 2005 and 2012.<\/p>\n

These revealed that at least 3 per cent of funding had been misspent, misappropriated, or inadequately accounted for.<\/p>\n

Tough changes stand out in the overall GF overhauling:<\/p>\n