By Steve Radelet
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The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) was established very quickly in 2001 in response to a widespread perception that a rapid scale-up in financing was critical in the fight against the three diseases. Since it began operations in January 2002, GFATM has made important progress. It has raised substantial funding and become the world’s largest donor for TB and malaria. 70% of the programs reaching the two-year renewal stage are showing solid results. Rwanda, for example, has put over 4,000 people on ARV treatment, more than double its program target, and GFATM programs in aggregate have financed ARV treatment for 130,000 people to date.
Nevertheless, GFATM faces several significant challenges. Programs in some countries, such as Uganda, Kenya and others, are experiencing acute difficulties. The process of starting programs and disbursing funds has been slow in many countries. Certain GFATM procedures are adding to recipient burdens and fragmentation, and there are major challenges in integrating GFATM finances with existing mechanisms such as SWAps (sector-wide approaches).
By introducing some key changes, GFATM can become stronger and more effective. This year’s renewal decisions for over 100 grants signal the end of GFATM’s start-up phase, and provide the ideal time to revise its policies and procedures to help make it more successful and bring its promise to reality.