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When the Global Fund was created in 2002, it was intended to combat the global burden of AIDS, tuberculosis and malaria, while simultaneously delivering aid in new, innovative ways. The increasingly austere budget climate, has added pressure for the Global Fund to explore new approaches to global health financing and generate better “value for money—a top concern to global health donors, who want the biggest bang for their buck in terms of lives saved and epidemiological progress. To respond to these needs, the Global Fund is in the process of overhauling its operations and radically reshaping its funding model.
The old system of funding rounds and open-ended invitations for funding requests has been thrown out and there is ongoing debate about how to allocate constrained finances across countries, diseases, and interventions. It is clear that the outcomes of this process will far-reaching implications for the Global Fund and the trajectory of the three pandemics. Less recognized are the significant implications these decisions will have for the direction of health and aid broadly: the Global Fund has been the most prominent driver of several innovations in channeling development aid (e.g., stringent performance-based funding) and its ability to maintain, refine, and/or expand those innovations despite its current challenges will impact the viability of similar aid reform efforts.
In this forum, we ask prominent thinkers and practitioners what reforms the Global Fund should prioritize and how it should best fulfill its mandate of improving the way development aid is managed in addition to advancing the fight against the three diseases as its Board considers new policies and its new Executive Director prepares to takes office.
Deborah Derrick,President, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria
Matthew Greenall, Director of Policy and Programs, International Council of AIDS Service Organizations