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Lancet Report on Global Fund Donors Doesn’t Tell the Whole Story

Kolleen Bouchane — August 8, 2011 – 9:41 am

Ann Danaiya Usher’s report in the August 6 Lancet (pp 471 to 472) on the state of pledges to the Global Fund to fight AIDS, TB, and Malaria has an incomplete understanding of the current state of donor country attitudes towards the Global Fund.


Usher rightly highlights that the Global Fund is likely to face a critical funding shortfall as it looks to sign off on the latest set of agreements for AIDS, TB, and malaria treatment and prevention programs for the next 5 years. Usher also correctly links this shortfall to the reaction of a handful of key donors to media pieces that ran in early 2011, ones that inflated the Global Fund’s own reporting of $34 million lost to fraud, misappropriation, and miss-management in four Global Fund grant recipient countries. However, Usher’s portrayal is only part of the story on attitudes donor towards the Global Fund, as she fails to mention important developments that point to sustained and renewed trust.

The Global Fund came out “strong” in the United Kingdom’s Multilateral Aid Review, placing it in the top tier of multilaterals reviewed, and where it was noted that that it exhibited a “likely capacity for positive change.” It performed similarly in Australia’s very recent aid review. Its track record against the three diseases is seen by the Australians as a strong case for increased investment. Usher mentioned neither in her article.

The article focused largely on knee-jerk initial reactions reaction from a handful of donors to the media attention on fraud uncovered by the Global Fund itself, but left out recent statements and reactions from key donors. These include the recent pledge and endorsement from the Netherlands, which took place despite significant pressure on their overall aid budget. It was accompanied by a strong supporting statement by the Dutch Minister of International Cooperation, Ben Knapen, who was, “satisfied about the measures taken by the Fund ... and therefore sees no reason to reduce the Dutch contribution.” Moreover, Stephen Harper, prime minister of Canada, while juggling a busy schedule at the Davos Economic Forum, insisted that Canada stands behind its investment in the Global Fund.

Usher also mentions that Italy, Spain, and Ireland have yet to make new pledges to the Global Fund, but leaves out that that is most likely due to significant budgetary constraints brought on by debt crises in those countries.

All donors eagerly await the final findings of the independent international panel assessing the risks in Global Fund grants, due out in September. I would hope for a more balanced piece from the Lancet after the completion of the panel’s review, detailing donor reactions not only to panel findings, but to the implementation of the Global Fund’s own reform agenda.