The Global Fund: A Public-private Partnership to

Fight Deadly Diseases

Professor Rifat AtunDirector, Strategy, Performance and Evaluation Cluster

Presentation Structure

• Global Health Public Private Partnerships

• Segmentation

• The Global Fund

Total annual resources available for AIDS: 1986-2008

0

1

2

3

4

5

6

7

8

9

US

$ B

illi

on

2921623

8297Signing 2001 UN Signing 2001 UN

Declaration of Commitment Declaration of Commitment

on HIV/AIDS (UNGASS )on HIV/AIDS (UNGASS )

1996 1997 1998 1999 2000 2001 2002 2003 2004 20051986 1987 1988 1989 1990 1991 1992 1993 1994 1995

Less than US$ 1 million

59212

World BankMAP launch

Global Fund

PEPFAR

257

Notes: [1] 1986-2000 figures are for international funds only [2] Domestic funds are included from 2001 onwards

UNAIDS

2006 2007 2008

10

11

12

10

1313

Global Health Partnerships

Almost 100 in number

• New actors in the global health landscape– Country governments (donors and recipients), philanthropy (e.g.

Gates), Private Sector, Pharma, Med Tech and Civil Society

• New global governance mechanisms– Transcend traditional multilateral institutions

AE

RA

SA

CH

AP

D

ND

i FIN

D

GA

VI

GFA

TM

IDR

I IP

M

IOW

H

Lilly

MD

R-T

B P

artners

hip

MM

V

MV

I P

AT

H

PD

VI

Sto

p TB

Part

nership

TD

R

TB

Alli

ance

Tota

l

0

5 0

1 0 0

1 5 0

2 0 0

2 5 0

2 0 0 0

4 0 0 0

6 0 0 0

8 0 0 0

1 0 0 0 0

1 2 0 0 0

US

$ M

illio

ns

Foundations – Multilateral Agencies - Private

Governments

Investment in GHPPP (received) by 2007

• Global Health Public Private Partnerships

• Segmentation

• The Global Fund

Segmenting Global Health PPPs (1)

Segmenting Global Health PPPs (2)

Push Mechanisms: Product Development Partnerships

• Global Alliance for TB Drug Development (TB Alliance)

• International AIDS Vaccine Initiative (IAVI)

• International Partnership for Microbicides (IPM)

• Malaria Vaccine Initiative (MVI)

• Medicines for Malaria Venture (MMV)

• Microbicide Development Programme (MDP)

Number of GHPPP along the R&D value chain

Number of GHPPPs along the R&D value chain by disease area

Push Mechanisms: Product Access Partnerships

• Global Alliance for the Elimination of Lymphatic Filariasis

• Global Polio Eradication Initiative (GPEI)

• International Trachoma Initiative (ITI)

• Malarone Donation Program

• Mectizan Donation Program

• WHO/Novartis Coartem® (Coartem)

Pull Mechanisms: Global Financing Institutions

• The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund)

• Global Alliance for Vaccines and Immunization (GAVI Alliance)

• Global Health Public Private Partnerships

• Segmentation

• The Global Fund

Scaling up in investment

By September 2009

• Total pledges $21.2 Bn

• Approved ~ $16.2 Bn

• Disbursed ~ $8.6 Bn

(142 countries and ~ 600 grants)

Proportion of External Global Investment (2008)

• 23% of HIV

• 60% of TB

• 75% of Malaria

Accelerating Scale Up

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

2004 2005 2006 2007 2008

ARV

and D

OTS (millions)

-

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

ITN

(millions)

DOTS

ARV

ITNs

Affordable Medicines Facility – malaria

Retailers, private clinics and public providers

Patients

First line buyers

MedicinesMoney

Multiple eligible ACT manufacturers

Private Buyers

(e.g. National Wholesalers)

NGO Buyers(e.g. PSI, MSF)

Co-payment

DistributorsCentral medical

stores

Public Buyers(e.g. Ministry of

Health)

Wholesalers