CGD Policy Blogs

The Global Fund to Fight AIDS, Tuberculosis, and Malaria recently announced an ambitious goal of raising $15 billion in its fourth replenishment later this year, of which they hope the United States will contribute one-third ($5 billion, or $1.65 billion a year for three years).  So I was interested to see these two sentences tucked into the White House’s 2014 budget request: 

After a year-long period of upheaval and reform, the Board of the Global Fund for AIDS, TB and Malaria today named Mark R. Dybul as its new Executive Director.

This is a joint post with Heather Lanthorn.

The Global Fund Board’s decision over the Affordable Medicines Facility – malaria (AMFm) rapidly approaches, and tensions within the malaria community are acute. In her global health blog for The Guardian, Sarah Boseley characterizes the rift as one of

“huge arguments and intense passions…[because] it is about the belief on one side that the private sector is the most effective way to get medicines to those who need them – and the certainty on the other side that bolstering the public sector to diagnose and treat people is a fairer and safer way to go. These are not just practical matters, but highly political.”

As the Global Fund’s November board meeting approaches – where the future of the Affordable Medicines Facility for Malaria (AMFm) hangs in the balance – there is much anxiety that AMFm will be terminated in 2013. The reason for such anxiety is clear: no donors have pledged funding commitments for after December 2012. But there’s another elephant in the room: the US government’s apparent lack of support, particularly its legislated “opt-in” stance on AMFm: “the Global Fund should not support activities involving the ‘Affordable Medicines Facility-malaria’ or similar entities pending compelling evidence of success from pilot programs as evaluated by the Coordinator of United States Government Activities to Combat Malaria Globally.” (Conversely, an opt-out stance would be to support AMFm unless no compelling evidence is presented.) This very specific and strict provision makes the AMFm’s continued survival all but impossible without an explicit endorsement by US Global Malaria Coordinator (currently Rear Admiral Tim Ziemer) who leads the US President’s Malaria Initiative (PMI) housed in the US Agency for International Development (USAID).