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Overview of the Global Fund & its Financing Activities

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What is the Global Fund?

• A financial instrument, not an implementing agency, aiming to dramatically increase resources available to fight HIV/AIDS, TB and malaria in countries in need and contribute to poverty reduction

• The largest global fund of its kind, with US$ 5.4 billion currently pledged through 2008 by donor countries, foundations and the private sector

• A public-private partnership based in Geneva to serve as a partner to governments, NGOs and international agencies in the coordinated fight against the world’s deadliest diseases

• A financial instrument, not an implementing agency, aiming to dramatically increase resources available to fight HIV/AIDS, TB and malaria in countries in need and contribute to poverty reduction

• The largest global fund of its kind, with US$ 5.4 billion currently pledged through 2008 by donor countries, foundations and the private sector

• A public-private partnership based in Geneva to serve as a partner to governments, NGOs and international agencies in the coordinated fight against the world’s deadliest diseases

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17.222.0

14.0

36.02.9

15.3

0.6

HIV/AIDS Malaria TB "Other support“2

Total Domestic financing3

Donor resource requirements

Required AIDS, TB and malaria investment in 20071

US$ billion

1Limited to 85 countries with GDP per capita lower than US$ 1,200 per year2Includes strengthening of management systems, absorptive capacity, quality of national health care systems3CMH Assumption: countries can spend on average 0.65% more of their GNI on the three diseases by 2007Source:Commission on Macroeconomics and Health, December 2001

The Global Fund was created in January 2002 to fill a substantial global resource shortfall to fight AIDS, TB and malaria

US$ 5.4 billion in additional resources has been committed to

the Global Fund to date

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Recognizing the urgent need for an expanded response to the three epidemics, the global community demanded the creation of a global fund

2000 July G8 endorse new AIDS, TB and malaria targets in Okinawa

2001 April African leaders commit to greater response in Abuja

June Endorsement of the need for a global fund at UNGASS

July Over US$ 1.5 billion in pledges made by G8 in Genoa

October Transitional Working Group established in Brussels

2002 January Global Fund created at first Board meeting

April First round of proposals approved at second Board meeting

July Executive Director assumes role

November Initial disbursements of grants commence

Total funding available through 2008: US$ 5.4 billion. Total grants approved: US$ 2.1 billion

June Additional funding pledges made by G8 in Evian

2003 January Second round of proposals approved at fourth Board meeting

October Third round of proposals approved at sixth Board meeting

2004 April Invitation for fourth round proposals closes on 5 April 2004

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The mandate of the Global Fund is to raise and disburse large amounts of additional resources to achieve impact against the three diseases

Raise it

Spend itProve it

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The Global Fund adds value to existing international efforts by providing additional resources to effective country-driven programs through public-private partnerships

Additional resources for the three diseases

• US$ 5.4 billion has been pledged to the Global Fund to date

• Non-traditional ODA sources include private foundations and corporations – resource mobilization efforts on-going

Broadened public / private partnerships

• At the country level, public sector, NGOs, development partners and private sector participate in a country-led coordination mechanism for proposal design and implementation

• The Global Fund itself is governed by a Board with representation from donor and recipient governments, NGOs, communities, foundations and private sector

Performance-based funding aligned with harmonization efforts

• The Global Fund encourages grant recipients to focus on results rather than on inputs

• Use of grant recipients existing systems are encouraged as well as common/harmonized donor arrangements

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HIV/AIDS coverage after three rounds of proposals

* Anguilla (territory), Antigua & Barbuda, Bahamas, Barbados, Belize, British Virgin Islands (territory), Dominica, Dominican Republic, Grenada, Guyana, Haiti, Jamaica, Montserrat (territory), St. Lucia, St. Kitts & Nevis, St. Vincent & the Grenadines, Suriname, Trinidad & Tobago.

** Cook Islands, Federated States of Micronesia, Fiji, Kirbati, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu

BurundiChadComorosEritreaEthiopiaIranKenyaLesothoMadagascarMalawiMozambiqueSudanSwazilandTanzaniaUgandaZimbabwe

ArmeniaBelarusJordanKazakhstanKyrgyzstanMoldovaRussian FederationTajikistanUkraineUzbekistanYemen

BulgariaCroatiaEstoniaGeorgiaMacedoniaRomaniaSerbia

AfghanistanBangladeshCambodiaChinaIndiaIndonesiaLaosMongoliaMyanmarNepalPakistanPhilippinesThailandVietnamWestern Pacific Islands**

BeninBotswanaCentral African RepublicCongo (Dem Rep)GhanaNamibiaNigeriaSouth AfricaZambia

ArgentinaBelizeBoliviaChileColombiaCosta RicaCubaDominican RepublicEcuadorEl SalvadorGuatemalaGuyanaHaitiHondurasJamaicaNicaraguaPeruSurinameMulti-country Americas*

AlgeriaBurkina FasoCameroonCôte d’IvoireGabonGambiaGuineaLiberiaMoroccoNigerRwandaSenegalTogo

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Malaria coverage after three rounds of proposals

* Andean Region: Columbia, Ecuador, Peru, Venezuela** Cook Islands, Federated States of Micronesia, Fiji, Kirbati, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu

BoliviaGuyanaHaïtiHondurasMulti-country Americas (Andean)*

AfghanistanGeorgiaPakistanSomaliaSudanYemen

CambodiaChinaEast TimorIndonesiaKorea DPRLaosMyanmarNepalPapua New GuineaPhilippinesSri LankaThailandVietnamWestern Pacific Islands**

AngolaBeninBurkina FasoBurundiCameroonChadComorosCongo (Dem Rep)EritreaEthiopiaGambiaGhanaGuineaKenyaLiberiaMadagascarMalawiMaliMauritaniaMozambiqueNamibiaNigerNigeriaRwandaSenegalSwazilandTanzaniaTogoUgandaZambiaZimbabwe

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BeninCameroonChadCongo (Dem Rep)Côte d’IvoireEthiopiaGhanaGuinea-BissauKenyaLesothoLiberiaMauritaniaMozambiqueNamibiaRwanda (HIV/TB)Sierre LeoneSomaliaSouth Africa (HIV/TB)SudanSwazilandTanzaniaTogoUgandaZambia

Afghanistan (integrated)KyrgyzstanMoldova (HIV/TB)RomaniaRussian FederationSerbiaTajikistan

Tuberculosis coverage after three rounds of proposals

** Cook Islands, Federated States of Micronesia, Fiji, Kirbati, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu

BoliviaDominican RepublicEl SalvadorHaïtiHondurasNicaraguaPanamaParaguayPeru

BangladeshEast TimorIndiaIndonesiaKorea, DPRLaosMongoliaMyanmarPhilippinesSri LankaThailandVietnam

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Almost half of approved grants are for Africa with substantial funding also for other affected regions

South Asia, Middle East &North Africa (6%)

Sub-SaharanAfrica (59%)

East Asia, South East Asia, Oceania (14%)

Latin America (12%)

Eastern Europe & Central Asia (8%)

*Percentages may not add up to 100 due to rounding

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Tuberculosis (16%)

Malaria (24%)

HIV/AIDS (60%)

60% of Global Fund grants are for HIV/AIDS with substantial funding for the other two diseases

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Expected outcomes for grants approved in Rounds 1, 2 and 3 include significant progress in the fight against the three diseases

HIV/AIDS:

• More than 700,000 people will receive antiretroviral treatment, tripling current coverage in developing countries (11-fold increase in Sub-Saharan Africa)

• 12-fold increase in current voluntary counseling and testing coverage (40 million clients)

Tuberculosis:

• 3 million additional tuberculosis cases will be detected and an equal number successfully treated with DOTS (the internationally approved treatment strategy for TB)

• 13 million new treatments for multi-drug resistant tuberculosis will be provided

Malaria:

• 22 million combination drug treatments for resistant malaria will be delivered

• 64 million bed nets will be financed to protect from transmission of malaria (16-fold increase from current coverage)

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Faith-based organizations (4%)

Half of grant proceeds will go to the public sector and half will go to non-public sector entities*

Private sector (5%)

People living with HIV/TB/malaria (3%)

Government (50%)

Other (6%) NGOs (29%)

Academic &educational organizations (3%)

* Rounds 2 and 3 only. Information not available for Round 1

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Almost half of the grants will finance drug and commodities purchases. Major investments will be made in strengthening capacity.

Physical Infrastructure

(15%)

Administration (4%)

Drugs & Commodities

(46%)

Other (5%)

Human Resources &

Training (25%)

Monitoring & Evaluation (5%)

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The Global Fund’s model for grant accountability aims to find the right balance between key priorities

Sustainability/Ownership

AccountabilitySpeed

• Rely on local stakeholders at the country level to implement programs and manage grant proceeds

• Encourage the use of existing standards and processes

• Monitor and evaluate programs and make decisions on future funding based on performance and accountability

• Promote rapid release of funds to assist target populations

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National Health Strategies

SWAps

At the country level, linkages have to be ensured with national strategies and broader development frameworks

PRSPMainstream development frameworks

National AIDS Strategies

MAP

Bilateral programs

Foundations

UN funded programs

National TB Strategies

National Malaria Strategies

NAC

MDGsUNGASS

CCM

Government

Multi-/BilateralDevelopment Partners

NGOs/CBOs

PLW Diseases

Private sector

Religious/ Faith-Based Organizations

Academic/ Educational Sector

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Global FundApproval

Technical review

Screening

There are multiple partners to the Global Fund’s grant program arrangements

Secretariat

Sub- recipientsTrustee (World Bank)

Instruction to disburse

Grant agreement

AdviceReports

Government

Multi-/BilateralDevelopment Partners

NGOs/CBOs

PLW Diseases

Private sector

Religious/ Faith-Based Organizations

Academic/ Educational Sector

Country Coordination Mechanism

Provides technical and capacity building support

Proposal

• Prepares and submits proposals

Assessment

FundsFundsReports

• Oversees implementation

Local Fund Agent Contract

Principal Recipient(s)

• Selects Principal Recipient(s)

• Requests continued funding from the Global Fund for years 3-5

Technical Review Panel

Board

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The signings of grant agreements and disbursements to countries accelerated rapidly in 2003

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20

40

60

80

100

120

140

160

Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar

Gra

nt A

gre

em

en

ts S

ign

ed

0

50

100

150

200

250

300

US

Dol

lars

(m

illio

ns)

Dis

burs

edGrant Agreements

Disbursements

Note:Figures reflect totals at the end of each month from December 2002, when the first grant agreements were signed

31 March 2004:149 grant agreements signed with 81 countriesUS$ 284 million disbursed to 77 countries

December 2002 – March 2004

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The Global Fund’s First Biennial Partnership Forum

• 7-8 July 2004 in Bangkok, just before the XV International AIDS Conference in Bangkok, 11-16 July 2004

• A broad-based consultative process

• An opportunity for feedback from stakeholders and open debate on issues

• Close linkage with capacity-building and training