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The Global Fund To Fight Aids Tuberculosis And Malaria

Evidence Of Program Effectiveness

How Does The Global Fund Work?

It is difficult to get an overall sense of the Global Fund’s effectiveness because of the wide range of programs it funds. Some of these programs have strong evidence bases, leading us to believe that they would likely be successful if implemented appropriately. However, large amounts of funds go to other activities whose exact nature is unclear examples we have seen include direct support for orphans and vulnerable children10 education aiming to change behavior,11 policy development, and stigma reduction. We would need a large amount of information about the outcomes of these programs to feel confident in their impact.

Key Malaria Results In 2021 In Countries Where The Global Fund Invests:

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Programmatic results achieved during 2021 by countries and regions where the Global Fund invests.

A child dies of malaria nearly every minute. Great progress has been made in malaria control with a reduction in overall cases and deaths, but that momentum has stalled in recent years. COVID-19 has exacerbated that challenge, knocking us further off track, while resistances to insecticides and treatments show signs of spreading. The Global Fund partnership response has been to innovate, by investing in tools such as dual active ingredient nets and to continue what has worked, such as funding the mass distribution of long-lasting insecticidal nets, seasonal chemoprevention, rapid diagnostic tests and quality-assured treatment supporting regional manufacturing and strengthening national efforts to make testing as widely available as possible. In 2021, Global Fund-supported programs recovered from declines in 2020, with testing and treatment for malaria registering gains.

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In countries where the Global Fund invests, negotiating directly with manufacturers, the cost of a pyrethroid-piperonyl butoxide net, which provides better malaria control in areas of pyrethroid insecticide resistance, is now less than US$2.60. The cost of antimalarial treatment dropped to US$0.58 in 2021, allowing the Global Fund to procure 145 million artemisinin-based combination courses.

Canada’s Support For The Global Fund

Canada has supported the Global Fund since its inception and is its sixth-largest donor. Canada has also been a consistently strong voice on the Global Fund board.

Canada’s support of the Global Fund focuses on the following priorities:

  • Combat HIV/AIDS, tuberculosis and malaria
  • Reduce child mortality
  • Improve the health and rights of women and children
  • Promote human rights in the context of HIV/AIDS, tuberculosis and malaria.

While the impact of the COVID-19 pandemic had a significant impact on the Global Fund’s work, with the support of donors like Canada, the Global Fund is working to get back on track to eliminating the diseases.

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Resilient And Sustainable Systems For Health

Resilient and sustainable systems for health are the foundation for defeating todays infectious diseases and the basis for preventing, preparing for and responding to future pandemics. The Global Fund is the worlds largest multilateral provider of grants for strengthening systems for health. Over the 2021-2023 implementation cycle, we are investing US$4.9 billion, or US$1.5 billion a year, in formal and community health systems through our core grants and through C19RM about one-third of our total investments. Learn more

Coverage Of Treatment And Prevention Interventions

HIV &  AIDS

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Malaria coverage for 38 African countries for which data is available from WHO / Malaria Atlas Project estimates in countries where the Global Fund invests. HIV and TB estimates are based on all countries where the Global Fund invests. Based on published data from WHO and UNAIDS .

We measure our progress against the targets in the global plans for HIV, TB and malaria and in the Sustainable Development Goal 3 of health and well-being for all. Our achievement is the result of efforts by a wide array of actors comprising the Global Fund partnership, including governments, multilateral agencies, bilateral partners, civil society groups, people affected by the diseases and the private sector.

2022 Results Report

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Key Tb Results In 2021 In Countries Where The Global Fund Invests:

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Programmatic results achieved during 2021 by countries and regions where the Global Fund invests.

In 2021, drug-resistant TB and the effect of COVID-19 remained major challenges. The impact of COVID-19 on TB programs has been significant: In 2020, the number of deaths from TB rose for the first time in a decade. But thanks to interventions by the Global Fund partnership, TB programs are starting to recover.

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In the fight against TB, we are recovering from 2020 losses in the following key indicators: finding and treating people with the disease, including those with drug-resistant TB improving access to quality diagnosis, treatment and care and scaling up prevention and supporting catch-up activities to find and treat those who did not access care during the pandemic and accelerate those recovery efforts. To fight drug-resistant TB, the Global Fund is encouraging and supporting countries to transition to shorter oral regimens for drug-resistant TB, which are more effective.

Corruption And Misuse Of Funds

In January 2011, the Associated Press reported vast corruption in some programs financed by the Global Fund, citing findings of the Global Fund Office of the Inspector General an auditing unit independent from the Global Fund Secretariat that up to two-thirds of funds in some of the reviewed grants were lost to fraud. The Office of the Inspector General report showed that systematic fraud patterns had been used across countries. The Global Fund responded to the story with a news release, stating, “The Global Fund has zero tolerance for corruption and actively seeks to uncover any evidence of misuse of its funds. It deploys some of the most rigorous procedures to detect fraud and fight corruption of any organization financing development.”

After the Associated Press story, a number of op-eds, including one by Michael Gerson published in The Washington Post in February 2011, sought to put the controversy surrounding the misuse of Global Fund grants in perspective. Gerson stated, “The two-thirds figure applies to one element of one country’s grant the single most extreme example in the world. Investigations are ongoing, but the $34 million in fraud that has been exposed represents about three-tenths of 1 percent of the money the fund has distributed. The targeting of these particular cases was not random they were the most obviously problematic, not the most typical.”

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Why Support The Global Fund Look To The Next Generation

Ive been an advocate for over two decades. Im excited to see a new generation getting involved, including Gracious Lekgoathi, a college student from Limpopo, South Africa. She works with HER Voice, advocating for the rights of young women across South Africa. I hope youll take time to read her photo essay below.

With this new generation, things are changing. My friends and I wrote letters and waited by the fax machine for a reply. The younger generation sends a tweetand sometimes, a president writes back!

We used to stage sit-ins and die-ins to demand change. We were confrontational. Now, young advocates sit at the table with ministers and tell them: If you dont invest in the health of your citizens, you are not building the wealth of your country. They have a different approach, and its inspiring to see.

This September, countries will have a chance to replenish the Global Fundand if we do, we could save 20 million more lives.

Ensuring that young people are actively involved in the fight against AIDS, TB, and malaria is key because its their future. And we need to stand behind them all the way. This September, countries across the globe will have a chance to replenish the Global Fundand if we do, we could save 20 million more lives.

Thinking about Gracious, Im reminded why I got involved in the first place: to ensure that her generationincluding my own childrennever have a closet full of black clothing.

World Leaders Pledge Billions To Fight Aids Tuberculosis Malaria On Un Sidelines

Davos gives an $18 billion boost to a fund to fight AIDS, tuberculosis and malaria

U.S. President Joe Biden delivers remarks at the Global Funds Seventh Replenishment Conference in New York, U.S., September 21, 2022. REUTERS/Leah Millis

UNITED NATIONS/NEW YORK, Sept 21 – The Global Fund to fight AIDS, tuberculosis and malaria on Wednesday reached $14.25 billion pledged as world leaders seek to fight the killer diseases after progress was knocked off course by the COVID-19 pandemic.

U.S. President Joe Biden, who hosted the conference in New York on the sidelines of the annual high-level meeting of the United Nations General Assembly, said the funding is crucial to combating the diseases.

“This is an investment that will save another 20 million lives, reduce mortality from these diseases another 64% in the next four years,” Biden said.

The United States had previously said it would pledge $6 billion for the next funding cycle.

The fund, a public/private alliance based in Geneva, is seeking $18 billion for its next three-year funding cycle from governments, civil society and the private sector. Before Wednesday’s conference, it had already raised more than a third of the total.

The Global Fund said the $14.25 billion figure is likely to increase as more donations are expected.

“For the government and people of Malawi, this is not a conference but a life saver,” Lazarus Chakwera, the president of Malawi, said earlier in the day, pledging $1 million.

The fund estimates its work has saved around 50 million lives since its inception in 2002.

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Viii Analyses Of The Global Fund

The Global Fund provides a wealth of information on its website, and has been very receptive to research and reflection on its model of aid delivery. Consequently, there have been many analyses conducted on the Global Fund during its four years. Several analyses are specific to certain aspects of the Fund architecture, such as CCMs, LFAs, or private sector involvement. The analyses listed below are more general in nature. Additional analyses can be found on the Global Fund website or on the Aidspan website.

Early Life And Education

Peter Sands was born in the UK on 8 January 1962 to British parents who had themselves been born in Asia. His father, was born in Malaya, a British colony until 1957, where his grandfather ran rubber plantations for the and his mother was born in India, another former British colonial outpost.

Sands was taken to Malaysia as a baby and spent much of his life outside Britain, mostly in Malaysia and Singapore. He was educated at in London, and the in , Canada, before he went to Oxford.

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Aims Of The Global Fund

The 201722 strategy ‘Investing to end epidemics’ underscores the central mission of the Global Fund whilst affirming that the endeavours to eliminate the three diseases must be accompanied by strenuous efforts to improve the health and well-being of the most vulnerable population groups. It establishes four strategic objectives:

  • to maximise impact against HIV/AIDS, TB and malaria
  • to promote and protect human rights and gender equality
  • to build resilient and sustainable systems for health
  • to mobilise increased resources
  • This strategy is consistent with the relevant global guidelines on HIV/AIDS, TB and malaria issued by UNAIDS, the WHO and the partnerships Stop TB and Roll Back Malaria. Its implementation will contribute to combating the three diseases as well as to attaining the Sustainable Development Goals.

    The Global Fund To Fight Aids Tuberculosis And Malaria: Background

    Feature Stories

    The Global Fund to Fight AIDS, Tuberculosis, and Malaria, headquartered in Geneva, Switzerland, is an independent foundation intended to attract and rapidly disburse new resources in developing countries for the struggle against infectious disease. The Fund is a financing vehicle, not a development agency, and its grants are intended to complement existing efforts rather than replace them.

    The origins of the concept of an independent funding mechanism to fight AIDS and other diseases lie partly in a French proposal made in 1998, in ideas developed in the 106th Congress, and in recommendations made by U.N. Secretary General Kofi Annan in April 2001. President Bush made the âfounding pledgeâ of $200 million for a disease fund in May 2001. The Global Fund was established in January 2002, following negotiations involving donor and developing country governments, non-governmental organizations , the private sector, and the United Nations.

    This report will not be updated. Instead, for up-to-date information on the Fund refer to CRS Report RL33396, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress, by Tiaji Salaam-Blyther, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress.

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    How To Strengthen Health Systems

    Predating the crisis resulting from financial irregularities were discussions among implementers, researchers, funders and other global health actors on the effects of large scale funding by the Global Fund and other GHIs on countries health systems. Within the first 5 years of the fund’s operation, it became apparent that the scale up of disease-specific programmes was affected and potentially limited by weak health systems in recipient countries. This included lack of physical health facilities, lack of health workers, limited appropriate skills of health workers, weak procurement systems and poor health information systems, all of which posed a challenge to meeting and monitoring the fund’s results.14,15

    Although the GFATM began funding some health system-related activities in the fifth round of its funding in 2007, much debate following its initial 5 years of work centred on whether the organisation should retain its focus on the initial three diseases, explicitly open a funding stream to strengthen health systems or, in a potentially more radical departure, change its mandate to become a global fund for health.16 These discussions resulted in the creation of a joint platform for health system strengthening, in which the Global Fund, Global Alliance for Vaccines and Immunization Alliance, World Bank and WHO work together to harmonise funding and support at national level in an effort to strengthen health systems.

    Why Is It Important

    • Ending the epidemics of HIV, TB, and malaria is critical to the development of effective health systems that can deliver health and well-being for all.
    • Since 2002, the Global Fund has disbursed more than $45.4 billion toward the fight against HIV/AIDS, TB, and malaria and for programs to strengthen health systems across more than 155 countries.
    • Health programs supported by the Global Fund have saved 38 million lives as of the end of 2019.
    • In 2019, the Global Fund provided 20.1 million people antiretroviral therapy for HIV, treated 5.7 million people with TB, and distributed 160 million mosquito nets.
    • AIDS, TB, and malaria claim more than 5 million lives annually.
    • 7,000 adolescent girls and young women are infected with HIV every week.
    • Multidrug-resistant TB is on the risenearly 600,000 people were afflicted worldwide in 2017.
    • Globally, only half of the MDR-TB patients who initiate treatment are successfully treated, mostly due to high mortality and falling out of treatment programs.
  • Globally, an estimated 3.4 billion people in 92 countries are at risk of being infected with malaria.
  • Since 2017, over 435,000 people have died of malaria.
  • A child dies of malaria every two minutes.
  • Funding supports the Global Funds Sixth Replenishment, which runs from 2020 to 2022.
  • Health programs supported by the Global Fund have saved 38 million lives as of the end of 2019.

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    Possible Negative Or Offsetting Impact

    We believe the potential for negative or offsetting impact is relatively high. The Global Fund gives funding directly to governments, as noted above, and could potentially be interfering with or substituting for their responsibilities and accountability, even strengthening harmful governments in some cases. In addition, many of the interventions promoted by the Global Fund – such as antiretroviral treatment – may often require highly skilled labor. We see a serious risk of the Global Fund funding’s distorting the allocation of labor, if expenses are not calibrated extremely carefully

    Thinking Outside The Box

    Global Fund Conference: $14 billion pledged to fight AIDS, tuberculosis and malaria

    08 April 2019

    Weve all been there: You take an item out of the package, immediately throw the package away and think, What a waste.

    Now imagine that happening again and again, with bottles of HIV medicines used around the world. Certainly, theres a better way to package and ship lifesaving medicines.

    The Global Fund and Zambian Ministry of Health decided to tackle the problem. For one large order of antiretroviral drugs, we asked the manufacturer to switch to carton-free packaging and saved 100 tons of paper.

    The result was 45 percent fewer shipping containers needed to send the medicines to Zambia, and only half as much warehouse space required to store them when they arrived. This equates to savings of US$766,000 money that has been reinvested in Zambia’s HIV program.

    What if less packaging for medicine could save more lives?

    The Global Fund has also cut the amount of plastic packaging for mosquito nets to prevent malaria, bundling them for shipment rather than putting each one on a plastic bag. The change has eliminated 930 tons of plastic waste and saved US$2.6 million in 2018 alone.

    These common-sense changes reduce waste and cost, generating savings that can be reinvested in lifesaving health services.

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    Iii Structure Of The Global Fund

    The Global Fund has established a unique architecture under which programs are proposed, selected, managed and implemented at country and headquarters levels.

    Headquarters

    a.SecretariatBecause the Global Fund is a financing mechanism and not an implementing agency, the institution has no direct presence in recipient countries. Global Fund operations are managed by a lean staff of approximately 200 people based in Geneva, Switzerland. Executive Director Richard Feachem manages the Secretariat. He announced in March 2006 that he would not seek a third term and a new executive director is expected to be appointed in the near future.

    The key structures of the Secretariat are Operations , Strategic Information and Evaluation, Business Services, External Relations, and Board Relations. An Office of the Inspector General was also recently added. For more information on the roles and responsibilities, see: .

    c. Technical Review PanelThe technical review panel is an independent group of approximately 26 experts drawn from around the world who review all proposals for Global Fund grants and rate them on technical merits. This panel is appointed by the Board of Directors before each round of proposals is due. The Technical Review Panel makes recommendations to the Board of Directors about which proposals should be approved, which should be revised and which should be rejected.

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