Global Fund forced to slam the breaks on AIDS response

Diarmaid McDonald

Last week the Global Fund to Fight AIDS, TB and Malaria was forced to take the unprecedented and potentially devastating decision to cancel all new programming until 2014 due to a severe lack of funds.

The move, caused by a disappointing total raised in a replenishment conference

Stop AIDS campaigners call on Minister O'Brien to increase the UK contribution to the pledge

Stop AIDS campaigners call on Minister O'Brien to increase the UK contribution to the pledge

last year combined with a failure by donors to pay what they promised, means it will fund no expansion in AIDS, TB or Malaria services for at least two and a half years placing millions of lives at risk. The global effort to achieve the Millennium Development Goals on health looks set to be severely undermined as a consequence.

Stop AIDS Campaign Chair, Mike Podmore said,

“The failure of donors to deliver on their promises means that rather than grasping the opportunity we now have to begin to bring an end to the AIDS epidemic, we’ll be seeing the response grind to a halt. Instead of accessing life-saving HIV treatment people will be added to waiting lists. Many of them will die before the new funding becomes available in 2014.”

The Global Fund to Fight AIDS, TB and Malaria – known as the Global Fund – was established in 2002 to address the growing crisis the three diseases were causing across the developing world and is now responsible for around half of the global response to HIV and AIDS, three-quarters of the efforts to tackle Malaria and over 80% of the response to TB. Its programmes have saved nearly 8 million lives.

This is the first time the Global Fund has been forced to cancel a funding round – which is the opportunity for developing countries to apply for resources to scale up their programming. An emergency reserve is being made available to ensure countries can maintain their current programmatic work, but there will be no expansion until donors replenish the Fund – currently scheduled for 2014.

The crisis is the result of insufficient commitments by donor countries – last year’s replenishment conference raised just over half [$11.7b] of what is needed [$20b] to scale up to reach all in need, and less than the minimum needed to maintain the Fund’s existing programming [$13b].

The poor total raised at the replenishment has been hugely exacerbated by donors failing to deliver on their pledges in due time. During 2001-2008 donors delivered more than 100% of the cash they promised the Fund. The conversion rate from pledges to payments dropped to 25% for the first nine months of 2011. The revelation that some of the Fund’s resources had been lost to corruption – less than 1% of the entire portfolio – led to some governments delaying their payments earlier this year.

In response, the Fund initiated a detailed review of risk management, the recommendations of which were fully accepted by the Fund’s board. A series of reforms in structure and operational procedures are now underway – known as the Consolidated Transformation Plan. In response, Germany, one donor that had withheld part of its contribution, has now released the full amount.

The UK government is one of the few donors to have paid up what they committed to deliver at the replenishment conference in October last year. However, a decision on a ‘significant increase’ in the UK contribution, as promised following the ‘very good value for money’ rating the institution received in the Multi-lateral Aid Review has not yet been announced. The government have said any increase is dependent on reforms at the Fund. Podmore continued,

“The UK government has committed to increase its contribution to the Fund once key reforms have been put in train. Following the approval of the Consolidated Transformation Plan we call on the government to do all it can to resolve the crisis at the Fund by leading renewed investment in this vital institution and putting sustained political effort into ensuring the countries who are not shouldering their share of the burden do so.

“The consequences of this crisis can barely be overstated. We need strong leadership now to save the lives that are at risk.”

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