More Health for the Money: Putting Incentives to Work for the Global Fund and Its Partners

Foreign assistance for health reached $28.2 billion in 2010, driven largely by funds to combat AIDS, tuberculosis, and malaria. Funding has since leveled off but the need for live-saving services and products has not, leaving governments and global health funders with the imperative to do more with existing resources.

The Global Fund to Fight AIDS, Tuberculosis and Malaria—a pioneer in global health since 2002—is foremost among organizations that could get more health for the money by focusing more on results, maximizing cost-effectiveness, and systematically measuring performance throughout its operations. This report, a product of CGD’s Value for Money Working Group, offers a strategy for improvement corresponding to four phases within the Global Fund’s grant-making cycle: allocation, contracts, costs and spending, and performance and verification.

Allocation: Instead of responding to countries’ requests for support of potentially non-optimal programs, the Global Fund should create a menu of effective and cost-effective options from which countries could select what they need.

Contracts: The Global Fund should revise current contracting practice to explicitly link funding to recipients’ performance toward end-goals of the program, such as reduction in the number of new HIV infections.

Cost and spending: The Global Fund should track the unit costs of services delivered, include that information in contracts, and publicize it to help reduce costs across the board.

Performance and verification: The Global Fund should identify new, more rigorous tools to measure the effect of its partners’ programs and hire an independent third party to verify the accuracy and quality of results.

Visit for an interactive summary of the report’s findings

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