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Africa: Global Fund Progress Report
AfricaFocus Bulletin
Sep 9, 2005 (050909)
(Reposted from sources cited below)
Editor's Note
"While the latest progress report points to a steady improvement in
results and a persistent trend of a high-performing grant
portfolio, it stresses that the Global Fund needs to sharply
increase the rate of program acceleration in the next four years if
it is to achieve its five-year targets." - Press Release from the
Global Fund to Fight AIDS, Tuberculosis and Malaria, August 23,
2005.
At the "replenishment meeting" in London for the Global Fund,
concluded on September 6, donors said they had pledged a total of
$3.7 billion for the Fund's budget in 2006 and 2007, of which $3.3 billion was tallied in
specific pledges. This is only 43% of the amount projected to be needed, despite an international
NGO appeal for full funding circulated during August and signed by
over 500 organizations in 87 countries (see
http://www.aidspan.org/globalfund/appeal).
This AfricaFocus Bulletin contains the August 23 press release from
the Global Fund on the Fund's progress report and excerpts from a
news report in the Global Fund Observer on the results of the
pledging meeting. The Global Fund Observer is an independent
newsletter (http://www.aidspan.org). Additional information from
the Global Fund is available at the Fund website
(http://www.theglobalfund.org).
According to figures compiled by the Global Fund Observer, based on
NGO proposals for "fair-share" contributions by donors, the U.S.
pledge in London for 2006-07 came to 23% of its fair share. Europe
as a whole pledged 55% of its fair share, and other countries
pledged 45% of their fair share. The highest percentage pledges
were from France (94%) and the UK (92%).
++++++++++++++++++++++end editor's note+++++++++++++++++++++++
Global Fund to Fight AIDS, Tuberculosis and Malaria
Press Release
23 August 2005
Global Fund Programs Exceed Targets
[Text only: press release including graphs available at
http://www.theglobalfund.org/en/media_center/press/pr_050823.asp]
Further information, please contact:
Rosie Vanek The Global Fund (Geneva, Switzerland) Phone: + 41 22
791 5951 Mobile: + 41 79 445 14 85 rosie.vanek@theglobalfund.org
Jon Liden The Global Fund (Geneva, Switzerland) Phone: + 41 22 791
1723 Mobile: + 41 79 244 6006 jon.liden@theglobalfund.org
300 Programs Drive Global Scale-up Against AIDS, TB and Malaria
103% of AIDS treatment targets achieved; 156% of Malaria Treatment
Targets
Fragile States Fare Better Than Expected
Geneva - Three years after its creation, the Global Fund to Fight
AIDS, Tuberculosis and Malaria is proving to be a key engine behind
the scale-up of the fight against the three pandemics worldwide.
Despite an average age of only 15 months, Global Fund-financed
programs support 220,000 people on AIDS treatment and have provided
treatment for 600,000 patients with TB and 1.1 million patients
with malaria. These results are ahead of mid-year targets for 2005.
The Global Fund currently contributes a fifth of all external
resources worldwide to fight HIV/AIDS, two-thirds of all external
resources against TB and well over half against malaria.
An analysis of the Global Fund's grant portfolio shows that of the
74 grants that have reached 18 months of age, 80 percent have met
or exceeded targets and that taken as a whole, the 74 grants have
exceed all targets except those for the distribution of
insecticide-treated bed nets (ITNs).
A separate analysis of grants to "fragile" states (defined as
states that "cannot or will not deliver core functions to the
majority of [their] people, including the poor") shows that grants
to such states perform only marginally less well than grants to
other low and middle-income countries.
"It is extremely gratifying to see that our grant portfolio is
doing well - even better than expected," said Dr Carol Jacobs, the
Chair of the Global Fund's Board. "It indicates that the Global
Fund's financing structure, which lets countries design and
implement their own programs and which rewards good performance,
works even in countries that traditionally are not able to use
external financing well."
Headline Results
June 2005 Dec. 2004 Increase
HIV:
People on ARV treatment 220,000 130,000 69%
TB:
People treated under DOTS 600,000 385,000 56%
Malaria:
Insecticide treated
nets distributed or
re-treated 3,100,000 1,350,000 130%
"We are financing programs to most of the world's poorest
countries, and the health sector traditionally receives the
smallest part of these countries' budgets," said Professor Richard
Feachem, the Executive Director or the Global Fund. "Starved of
educated personnel and infrastructure, these countries are rarely
well prepared to turn large new resources into results quickly. The
fact that these programs have achieved substantial results after
such a short time is a tribute to the tremendous efforts made by
thousands of health workers operating under extremely difficult
conditions."
The analysis published today is the third in a series of reports on
Global Fund performance. The full text of "Sustaining Performance,
Scaling Up Results: Third Progress Report 2005" is available at
http://www.theglobalfund.org/en/files/about/replenishment/progress_report_3 rdreplenishment.pdf.
"The Impact and Results of the Global Fund Model: Aid in Fragile
States" is available at
http://www.theglobalfund.org/en/files/about/replenishment/fragile_states_3r dreplenishment.pdf .
While the latest progress report points to a steady improvement in
results and a persistent trend of a high-performing grant
portfolio, it stresses that the Global Fund needs to sharply
increase the rate of program acceleration in the next four years if
it is to achieve its five-year targets..
Annual targets have been set - based on grant agreements - for the
scaling up of Global Fund-supported grant activities in order to
reach 1.6 million people with ARV treatment for AIDS and 3.5
million people with TB treatment, and to distribute or re-treat 108
million ITNs to protect families from malaria over the five-year
lifespan of all grants approved to date. If these targets are
reached, this will increase global coverage two or more times from
current levels.
While most programs financed by the Global Fund have a five-year
time-frame, the Global Fund initially commits funds only for the
first two years. Continued funding depends on performance towards
agreed-upon targets, measured when the grants have been in
operation for 18 months. Grants are graded according to their
performance, and decisions on continued funding are taken based on
the performance-grading combined with an assessment of contextual
information. So far, 70 of the 74 grants that have gone through
this process have received commitments of continued funding for
years three through five ("Phase 2"); one has been terminated and
three are still under consideration by the Global Fund Board.
Nineteen of the 74 grants assessed for Phase 2 funding were from
fragile states. While the analysis cautions that this sample size
is too small to draw strong conclusions, it indicates that the
incentives of performance-based funding and innovative
collaborations between public and private sectors are factors that
have led to successful performance of grants in states where such
performance is unexpected. The study of grants from fragile states
will continue as the number of grants that undergo Phase 2 review
increases. One-third of the Global Fund's total portfolio of US$
3.7 billion has been committed to states determined to be fragile.
The Global Fund Portfolio
Global Fund grants enable countries to scale up their fight against
the three diseases in a sustainable way by strengthening health
systems and paying for drugs, diagnostics, mosquito nets and other
commodities.
The Global Fund has allocated US$ 3.1 billion for the first two
years of 316 programs in 127 countries with a total five-year value
of US$ 8.1 billion. Of the US$ 3.1 billion committed over the first
two years, 56 percent goes to fight HIV/AIDS, while 13 percent goes
to fight TB and 31 percent to malaria. Sixty percent is spent in
sub-Saharan Africa.
A total of US$ 1.4 billion has been disbursed to programs so far.
Expenditure targets for Global Fund grants are 49% for drugs and
related supplies, 20% for human resources, 13% for physical
infrastructure, 6% for monitoring and evaluation, 7% for
administration and 5% for other purposes.
Projected Outcomes over Five Years
The following are the projected outcomes of programs financed by
the Global Fund over their five-year life-spans. The programs are
on track to reach these targets set for HIV/AIDS and TB, but are
behind on targets for malaria. A substantial effort is underway to
ensure that malaria targets are reach by the end of the programs'
lifetime.
HIV/AIDS
- 1.6 million people on antiretroviral treatment, a six-fold
increase over current coverage in developing countries
- 52 million clients reached with voluntary counseling and testing
services for HIV prevention
- More than one million orphans supported through medical services,
education and community care (only Rounds One through Three)
TUBERCULOSIS
- 3.5 million additional tuberculosis cases treated successfully
under the DOTS treatment strategy after case diagnosis
- Quadrupling of treatment of multidrug-resistant tuberculosis,
with more than 12,000 new treatments
MALARIA
- Delivery of 145 million artemisinin-based combination drug
treatments for resistant malaria
- 108 million bed nets financed to protect families from
transmission of malaria
HIV/AIDS
Global Fund-financed HIV/AIDS programs are aiming to build up a
sustainable effort to turn the tide of the HIV/AIDS pandemic and
stop it in its tracks where it is still in its early stages.
Resources from the Global Fund therefore go to a wide range of
activities, from training and infrastructure strengthening to
expand testing, treatment and care to large-scale prevention
programs, and care and support for orphans.
To date, 397,000 children orphaned by AIDS have been provided with
social, medical and educational support. More than 2.5 million
people have been tested for HIV and received counseling through
Global Fund-financed programs, tens of millions have been reached
through a wide range of prevention programs - from condom
distribution and targeted support for injecting drug users and sex
workers to behavior change programs and information provided
through the media, schools and the entertainment industry.
AIDS treatment: A Joint Effort
Of the HIV/AIDS grants, one half of the money is dedicated towards
treatment and care, while the other half is financing prevention
activities and HIV testing. Global Fund grants finance HIV/AIDS
treatment in over 100 countries and to date have supported national
programs that provide ARV treatment for 220,000 people with a goal
of reaching 400,000 by the end of the year.
The scale-up of AIDS treatment is a truly collaborative effort,
where donors, international organizations and non-governmental
organizations all play critical supporting roles in the impressive
national campaigns of many countries to roll out treatment - often
under extremely difficult circumstances.
International partners, including UNAIDS, the World Bank, the
Global Fund, the U.S. President's Emergency Plan for AIDS Relief
(PEPFAR) and the World Health Organization met in December 2004 to
agree on a methodology to provide consistent international figures
in support of the goal of bringing three million patients on
treatment by 2005. The figures released today follow this
methodology.
Together, the Global Fund and PEPFAR are the major financial
engines to achieve greatly increased treatment numbers over the
coming years. In 15 countries, Global Fund grants and PEPFAR are
supporting different parts of the same national scale-up efforts.
Tuberculosis
Tuberculosis grants are financing national efforts in high-burden
countries to reach globally agreed targets for detection and
successful TB treatment. Global Fund grants are also paying for a
quadrupling of patients having access to expensive drugs for
multi-drug-resistant TB.
So far, just over 600,000 people have received treatment under the
DOTS strategy for TB control thanks to Global Fund financing. In
addition, multidrug-resistant TB treatment has increased greatly
through Global Fund projects, which until now has been too costly
for most countries to provide.
Malaria
The Global Fund is the single largest financier of malaria-related
activities globally, with financed activities focused on priorities
set by the Roll Back Malaria Partnership. Funding has been
predominantly invested in financing a change to new, more effective
malaria drugs and providing insecticide-treated mosquito nets
throughout regions with high malaria incidence. Substantial amounts
are also spent on strengthening national malaria programs through
improving staffing, training and infrastructure.
To date, 1.1 million people have been reached with malaria
treatments (227,000 of them have received new and effective ACT
treatment for drug-resistant malaria) and 3.1 million nets have
been distributed. These numbers are expected to continue to rise
rapidly over the coming months provided that supply-side problems
with the new malaria drugs and the long-lasting pre-impregnated
insecticidal nets can be overcome.
The Global Fund is a unique global public-private partnership
dedicated to attracting and disbursing additional resources to
prevent and treat HIV/AIDS, tuberculosis and malaria. This
partnership between governments, civil society, the private sector
and affected communities represents a new approach to international
health financing. The Fund works in close collaboration with other
bilateral and multilateral organizations to supplement existing
efforts dealing with the three diseases.
Apart from a high standard of technical quality, the Global Fund
attaches no conditions to any of its grants. It is not an
implementing agency, instead relying on local ownership and
planning to ensure that new resources are directed to programs on
the frontline of this global effort to reach those most in need.
Its performance-based approach to grant-making is designed to
ensure that funds are used efficiently and create real change for
people and communities. All programs are monitored by independent
organizations contracted by the Global Fund to ensure that its
funding has an impact in the fight against these three pandemics.
Global Fund Observer
7 September 2005
http://www.aidspan.org
Replenishment Meeting Falls Short of Expectations
Governmental donors yesterday [September 6] pledged $3.7 billion
to the Global Fund. This commitment, which fell short of
expectations, will be sufficient to pay for grant renewals during
2006+7, and also for the anticipated 2005 shortfall, but will not
cover the cost of any new Rounds.
The Global Fund has in the past conducted its fundraising by
encouraging donors to give what they can, when they can. Then,
in an attempt to bring more predictability to the process, the
Fund decided to hold a three-part "Replenishment" meeting every
two or three years. The first Replenishment ended yesterday in
London.
The Fund had called upon donors to pledge $3.4 billion to cover
grant renewals during 2006+7, $0.4 b. to cover the anticipated
2005 shortfall, and $3.7 b. to cover the cost of launching Rounds
6, 7 and 8 during 2006+7, for a total of $7.5 b. Until recently,
the Fund had expected to raise well over $4 billion at this
week's meeting, but at $3.7 billion, it fell somewhat short of
that. "We come out of this replenishment with a whole lot less
money than we would have liked to see," said one donor.
Fund officials put a brave face on the outcome, saying that this
is "a solid base on which to build," and pointing out that the
donors decided to hold an additional meeting next June, by which
time it is hoped that sufficient new pledges will be obtained to
permit the launching of further Rounds of grants.
In the Fund's first two years, 2002-3, pledges to the Fund
totaled $1.8 b. Then in the next two years, pledges increased to
$2.9 b. So with pledges for the third two years currently
standing at $3.7 b., and certain to climb further, the Fund is
still on a steady growth path. However, now that many grants are
coming to the end of their first two years and need to be
renewed, the Fund's growth is not proving fast enough to permit
new grants to be launched at the rate they were earlier.
"Contributions to the Global Fund should not be based on
voluntary pledges," said Dr Mohga Kamal Smith of Oxfam. "Funding
should be predictable and based on countries' fair shares."
The largest pledge made for 2006+7 was by France, at $658
million. Next came the US, at $600 m., followed by Japan, at
$500 m. However, the US pledge is almost certain to be increased
by Congress later this month.
The $3,100 million in pledges for 2006+7 by non-US donors puts
the US in a somewhat difficult position. The US has said for
some time that it will provide "no more than a third" of the
Fund's income; but many US officials, including a number of
Republican lawmakers, regard the one third as a goal, not just a
cap. Yet if the US is to continue to provide one third of the
Fund's income, it will have to increase its total pledge for
2006+7 from $600 m. to $1,550 m.
During yesterday's meeting, one particular discussion item ended
up taking far more time - over an hour - than any other. This
was the question of whether, in the communiqu‚, the single
sentence that mentioned the UNAIDS/WHO estimate on how much money
needs to be spent globally on tackling the three diseases should
appear in the main text or should be relegated to a footnote. As
we go to press, the communique has still not been finalized; nor
has the list of how much was pledged by each country
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues,
with a particular focus on U.S. and international policies.
AfricaFocus
Bulletin is edited by William Minter.
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