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The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) was founded in late 2001 to help finance the global battle against three devastating diseases that together kill more than 6 million people per year around the world. The Global Fund represents a dramatic change in the international community’s approach to fighting the three diseases,in two ways. First, GFATM has the potential to provide a substantial increase in financing to poor countries that could make a significant difference in turning the tide against the three diseases. Second, it could dramatically change the way that the international community delivers foreign assistance, both for health interventions and possibly for other development programs as well. The Global Fund has achieved significant progress during its first two years and has grown very quickly: as of June 2004 it had approved funding for 227 programs in 122 countries – a larger country profile than almost any other donor -- with signed two-year grants totalling $1.3 billion.
GFATM’s success, however, is far from assured. It faces many challenges, including raising sufficient financing to sustain current programs and initiate new ones, speeding its disbursement process, overcoming capacity constraints in recipient countries, maintaining a light administrative touch while demanding high standards, and establishing the incentives necessary to build a true performance based system. How the Global Fund and its major supporters respond to these challenges will determine the extent of its success or failure in the future. This analysis is aimed at assessing the Fund’s strengths and weaknesses as a foreign aid mechanism, with a view to enhancing the discussions about how it could improve its performance and build on its early achievements going forward.