The Global Fund to Fight AIDS, TB and Malaria

The Global Fund to Fight AIDS, TB and Malaria, created in 2002, raises and distributes significant resources to combat HIV/AIDS, tuberculosis and malaria, which together killed nearly 4.2 million in 2007. Through innovative partnerships with governments, civil society, the private sector and affected communities, the Global Fund channels resources to country-driven programs with demonstrated results in delivering essential treatment, prevention and care services. Since 2002, programs supported by the Global Fund have saved an estimated 3.5 million lives.

Unique Attributes of the Global Fund

The Global Fund's pioneering approach allows resources to be delivered to locally-owned programs in a cost-effective, participatory and accountable manner. Several unique attributes of the Global Fund make this possible:

• Performance-based funding: Funding is released incrementally based on demonstrated results against agreed targets (e.g. delivering tangible services such as bed nets or anti-AIDS drugs). The Fund stops, reduces or accelerates grants based on their demonstrated performance against these targets.

• Country Ownership: Country-level structures allow recipient nations to design programs and allocate funds in accordance with their national health priorities. Applications and implementation are carried out by local partnerships among governments, health experts, civil society, faith-based organizations and the private sector.

• Technical Expertise: A Technical Review Panel of international experts in health and development reviews all grant proposals to ensure that only the most technically viable proposals for scaling up prevention, treatment and care are funded.

• Low Overhead: Exceptionally low overhead costs mean that virtually all funds are delivered to the people who need them. The Fund estimates that 97 cents of every dollar raised goes directly to grants.

• Transparency: All proposals, applications, grant agreements and progress reports are published on the Global Fund's website.

Real Results

Since its establishment, the Global Fund has signed grant agreements worth $11.3 billion across 137 countries. Of this total, $7.8 billion has been disbursed. To date, the Global Fund has achieved the following results globally:  

• Antiretroviral treatment for 2.3 million people with HIV
• DOTS treatment for 5.4 million patients with TB
• 88million insecticide-treated bed nets to protect families from malaria
• 74 million treatments for people with malaria
• HIV counseling and testing for 79 million people
• Basic care and support for 3.7 million orphans
• Training for 10 million people to deliver health services

Signs of Impact

Though still a young financing mechanism, evidence so far indicates that resources from the Global Fund are making a substantial contribution towards the achievement of the Millennium Development Goals. In several countries, Global Fund programs are already having a real impact on peoples' lives. Below are some examples:

• In Rwanda, three grants worth $166.8 million from the Global Fund have helped to dramatically expand the fight against HIV/AIDS. In 2003, less than 1% of the population who needed antiretroviral treatment had access to it. UNAIDS estimates that Rwanda is on track to achieve universal coverage of antiretroviral treatment by 2010, thanks to efforts by the Rwandan government and support from the Global Fund and other donors. Global Fund-supported programs have provided antiretroviral therapy to 59,900 patients, reached over 20,000 women with a complete course of ARV prophylaxis to reduce the risk of mother-to-child transmission and set up over 120 sites to offer counseling and testing services.

• In Ethiopia, two grants worth $214.5 million from the Global Fund and additional support from other donors have helped the government implement an aggressive strategy of malaria control. Until recently, Ethiopia was lagging behind many African countries in combating malaria, with less than 5% of households owning a mosquito bet net in 2003. In 2004, the government set an ambitious new target to have all households in high-risk areas own at least two long-lasting mosquito nets by 2008. Ethiopia had exceeded this target by March 2008 after delivering 20.5 million bed nets, representing a three-fold increase and achieving 95% coverage in endemic areas. Along with expanded access to effective treatment, this scale-up has fueled significant reductions in malaria incidence and mortality, with a 60% reduction in malaria cases and a 50% reduction in child deaths from malaria registered between 2004 and 2006.

Global Fund Financing Needs

The Global Fund's recent public success in getting people onto treatment and distributing bed nets has created a financial challenge for the Global Fund - the demand generated by strong proposals exceeds available funding.  The Global Fund estimates that $2 billion is needed to continue existing programs, $3.1 billion is needed for new Round 9 approvals, $0.4 billion is needed to fund national strategies applications, and $0.5 is needed as bridge funding, to ensure no gaps in dispursements.  Therefore, the total FY2010 request is $6 billion.