In January 2002, a new effort was launched to get money to worthy projects in developing countries to fight three major diseases. Since then, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved three billion US dollars for over 300 grants in nearly 130 countries. But the Fund has also had its growing pains.
In November, the Global Fund announced, “We stand on the brink of a significant global expansion in the coverage of proven interventions to prevent and treat AIDS, TB and Malaria.”
More than 60 percent of its grants have gone to sub-Saharan Africa. Most of the money it’s awarded, 56 percent, has gone toward HIV/AIDS.
The Global Fund was founded on the principles of transparency, accountability and partnerships. It has a tough review policy to find health projects that have been proven effective. But since its inception, the biggest issue with the Global Fund has been money, or more specifically, getting it.
The Fund relies on donations and is constantly urging donors to follow through on their commitments - or urging them to contribute more.
One of those who took part in the planning of the Global Fund is Richard Burzynski, head of ICASO, the International Council of AIDS Service Organizations. It represents many NGO’s around the world. He says in its short existence, the Fund has done much.
He says, "You know, they’re getting money out into the field in over a hundred countries. They’re supporting projects, which are part of the scale-up of anti-retrovirals, which form part of the three million by 2005 initiative by WHO. They have been getting mosquito nets off to people. They have been getting TB drugs off to people and in country – and building an infrastructure that in many cases didn’t exist before - or was hard-pressed to do anything differently."
He says while the Global Fund is planning to announce a new round of grants, not all donors have done their fair share.
"We have on the one hand countries who have not put money into the Global Fund. We have countries that have made pledges but have not been able to keep up with their pledges. We have some countries that haven’t even begun to look at putting money into the Global Fund. At the same time, we have countries that continue to look at the Global Fund as a bilateral donor, just for them," he says.
Mr. Burzynski says for many of those active in the fight against HIV/AIDS, watching developments brings a mixture of satisfaction and frustration.
"I think for those of us involved in it, yes, we wish it were a lot faster. Yes, we wish money was getting out to the field. But we also recognize what we’re doing now can be used and will be used at country level for years to come. So, we’ve got to get it right. And the same time, you’re building the boat and sailing it at the same time. And I think most people working in the HIV field understand this. But if you’re at the village level and you’ve heard about the Global Fund and you’re waiting for medications to be able to be purchased and brought to your home, I think in some instances this is far more complex than what anyone ever imagined," he says.
Politics may also play a role in donations to the Global Fund. Some have objected to funding projects that promote the use of condoms, rather than placing an emphasis on abstinence. In the absence of a cure or a vaccine, Mr. Burzynski is opposed to limiting options in the fight against HIV/AIDS.
He says, "What we believe worldwide and what certain common knowledge is saying – and the body of scientific evidence is illustrating is that we need to have long-standing, unequivocal messages about safer sex and condom promotion. It’s about microbicides for women. It’s about condoms for women and men. It’s about a variety of new technological prevention. And that has to be part of the overall package."
The Global Fund has released some projections on the effects of five years of funding projects. Regarding HIV/AIDS, it expects more than 1.6-million people to be on anti-retroviral drugs; more than 50-million people reached through voluntary counseling and testing for HIV; and over one million orphans supported through medical, educational and community services.