Global Fund in ‘Disarray,’ Editorial Says

Although action on issues such as the fight against HIV/AIDS and malaria worldwide "requires institutions," the Global Fund To Fight AIDS, Tuberculosis and Malaria is "in disarray," a Washington Post editorial says. The Global Fund "provides one-fifth of all donor funding for AIDS, nearly half for TB and two-thirds for malaria" and is "central to the battle against all three diseases," according to the Post. Five years after it was launched, Richard Feachem, the Global Fund's first executive director, is "stepping down," the editorial says, adding that last month, "donors and recipient countries on the organization's board deadlocked over the choice of a successor." In addition, the "uncertainty over the Global Fund's leadership is compounded by uncertainty over its business model," according to the Post. The Global Fund "started out as an institutional experiment in the aid world," the editorial says, adding that it "kept overheads low by resolving not to design programs, instead collecting and evaluating funding requests prepared by agencies in poor countries." Although the "principle here is attractive" because "recipients will feel a greater stake in their success and will implement" programs better, developing countries "often need technical assistance, both to design programs and to deal with implementation headaches," according to the Post. Until the Global Fund's "leadership question is resolved and until the new leader finds the right balance between hands-off and hands-on, there will also be uncertainly about" the Global Fund's finances," the editorial says. Although the Global Fund has had a "quick start for a new agency" and over the past five years has disbursed more than $3 billion to 136 countries, it "needs to grow," the editorial says, adding that it perhaps needs to provide "half of the $8 billion plus per year that's reckoned to be needed to meet the challenges of these three diseases." The editorial concludes, "Without this sort of boost, there won't be enough money to deploy the medical tools that already exist, let alone make use of new discoveries" (Washington Post, 12/18).