Global Fund to Fight AIDS, Tuberculosis and Malaria

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created in 2002 to increase funding to tackle three of the world’s most devastating diseases. It has approved $22.6bn (£14.1bn) for programmes in 150 countries and is estimated to have helped save millions of lives. The Global Fund was given a high rating in the UK’s Multilateral Aid Review, published in March 2011, after which the Secretary of State for International Development announced the UK would increase its contribution significantly. More than a year later, however, the Department for International Development (DFID) is yet to deliver these additional funds or confirm how much it will contribute.

This delay has coincided with the most difficult period in the Global Fund’s history, with lower than expected donor contributions, negative publicity concerning fraud, the resignation of its Executive Director and the implementation of major reforms. In November 2011 the Global Fund cancelled its eleventh round of grant-making (“Round 11”), due to fears of inadequate funding. NGOs argue that the cancellation of Round 11 poses a “significant threat to millions of lives”, although this is disputed by the Secretary of State. We held a short inquiry in view of the serious consequences of the developments at the Global Fund, with a particular focus on the role of DFID.

Our key findings are :

•

The Global Fund is invaluable; it needs to overcome its problems and return to full operation as soon as possible; • There are diametrically opposed views about the impact of the cancellation of Round 11 on people in developing countries. An independent impact assessment of the cancellation of Round 11—endorsed by the Global Fund, DFID, other key donors and leading NGOs—should be undertaken to help inform future policy and programming; • The speedy appointment of a permanent Global Fund Executive Director is important for confidence; • DFID is a key partner whose increased contribution to the Global Fund could unlock funds from other donors. It should do all possible to commit additional funds earlier than 2013 by prioritising its assessment of the Global Fund ahead of, and separately from, the broader update of the Multilateral Aid Review; • The G20 meeting in Mexico in June provides a good opportunity for DFID to announce new funds, but only if the Department’s conditions are met and UK taxpayers’ money is adequately safeguarded.

DFID’s contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria 5 Report 1. We held oral evidence on 17 April 2012 with the Secretary of State for International Development, the Rt Hon Andrew Mitchell MP, about the Department for International Development’s (DFID) funding contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (referred to here as “the Global Fund”). We also took evidence on that day from Mr Gabriel Jaramillo, the new General Manager of the Global Fund, from Aidspan (the Global Fund’s independent watchdog) and from non-governmental organisations (NGOs) representing the AIDS, TB and malaria communities.1 This short report sets out our views following that session.

2. The Global Fund was created in 2002 to increase funding to tackle three of the world’s most devastating diseases.2 It has earned a reputation over the past decade as an effective international financing institution and claims to have helped save millions of lives.3 It currently provides about 65% of all international financing for TB and for malaria and 21% for AIDS.4 Mr Jaramillo told us that the Global Fund was “the one institution that can link money to lives saved more directly than any other that exists in the landscape”.5 The Secretary of State believed that the Global Fund had delivered “extraordinary results over the past ten years”.6 DFID’s Multilateral Aid Review (MAR), published in March 2011, rated the Global Fund as one of the highest-performing multilateral organisations, which gave “very good value” to the taxpayer and had “very high standards for financial management and audit”.7 Following this positive assessment, the Secretary of State announced that the UK—which is the Global Fund’s third largest donor—would “significantly increase” its contribution to the Fund. This is in addition to £384m already pledged between 2012 and 2015.8 But, more than a year since the MAR, DFID is yet to deliver these additional funds or confirm how much it will contribute.

3. This delay has coincided with the worst period in the Global Fund’s history. In November 2011 the Global Fund cancelled its eleventh round of grant-making (“Round 11”), which would have involved some $1.5bn (£930m) in expenditure, due to fears of inadequate funding. The global economic downturn, negative media coverage regarding fraud by some grant implementers (exposed in part, Aidspan argued, by the Global Fund’s commendable commitment to anti-corruption and transparency)9 and earlier forecasting 1 We also received written evidence from 24 organisations. We are grateful to all those who contributed to our inquiry.

2 Kofi Annan, Secretary-General of the United Nations announced the idea of a “Global Fund” in April 2001.

3 Ev 33. DFID has said that the Global Fund has helped save 7.7 million lives in 150 countries (HC Deb, 20 February 2012, col 520W). The Global Fund One Campaign says the Global Fund has helped save 6.6 million lives (Global Fund website, 2012, http://onemillion.theglobalfund.org.) The Global Fund is currently revising the methodology with which it makes these estimates.

4 Global Fund to Fight AIDS, Tuberculosis and Malaria, Review of HIV/AIDS, Tuberculosis and Malaria Landscape for the Global Fund Strategy 2012-2016, November 2011, pp 8, 14, 21.