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The Global Fund to Fight AIDS,Tuberculosis, and Malaria:Progress Report and Issues for Congress
Updated June 11, 2007
Tiaji Salaam-BlytherSpecialist in Foreign AffairsForeign Affairs, Defense, and Trade Division
The Global Fund to Fight AIDS, Tuberculosis, andMalaria: Progress Report and Issues for Congress
Summary
The Global Fund to Fight AIDS, Tuberculosis, and Malaria, headquartered inGeneva, Switzerland, is an independent foundation that seeks to attract and rapidlydisburse new resources in developing countries aimed at countering the threediseases. The Fund is a financing vehicle, not an implementing agency. The originsof the Fund as an independent entity to fight the three diseases lie partly in a Frenchproposal made in 1998, in ideas developed in the 106
th
Congress, and inrecommendations made by United Nations Secretary-General Kofi Annan in April2001. Though the Global Fund was established in January 2002, President Bushpledged $200 million to such a fund in May 2001.As of May 8, 2007, donors have pledged more than $10 billion to the Fund, of which more than $7 billion has been paid. The funds have been used to support morethan 400 grants totaling more than $7.5 billion for projects in 136 countries. Eachyear, the Fund awards grants through Proposal Rounds. There have been six Rounds,with the Board approving proposals in each year since its inception. In 2005, theFund approved Round 5 grants in two tranches, because initially there wereinsufficient donor pledges to approve all the recommended proposals. The Fundapproved the first group of proposals in September 2005 and the second group inDecember 2005, after donors pledged to make additional contributions. The GlobalFund only approves proposals if it has sufficient resources on hand to support thefirst two years of a proposed project. This policy is designed to avoid disruptions toprojects due to funding shortages. Funding lapses can cause interruptions in treatmentregiments, leading to resistant strains of the diseases or death. Funding for a grant'sthird through fifth years depend on grant performance and on donor contributions. The Unites States is the largest single contributor to the Global Fund. To date,it has appropriated nearly $3 billion to the Fund, providing $724 million in FY2007,the single largest U.S. contribution to date. Of those funds, $247.5 million wastransferred from the U.S. Agency for International Development (USAID), $377.5million from the State Department, and $99.0 million from the Department of Healthand Human Services (HHS).There has been some debate about the level of U.S. contributions to the Fund.Some critics argue that the United States should temper its support to the Fund,because the Fund has not demonstrated strong reporting and monitoring practices;contributions made to the Fund in excess of the President's request are provided atthe expense of U.S. bilateral HIV/AIDS, TB, and malaria programs; and the Fundneeds to secure support from other sources, particularly the private sector.Supporters of current funding levels counter that the Fund has improved its reportingand monitoring practices, greater U.S. contributions to the Fund parallel increases inU.S. bilateral HIV/AIDS, TB, and malaria programs, and the Fund has attempted toraise participation by the private sector through the launching of Product Red™. Thisreport, which will be periodically updated, discusses the Fund’s progress to date,describes U.S. contributions to the organization and presents some issues Congressmight consider.
Contents
Background......................................................1Global Fund Progress to Date........................................2Funding Procedure.................................................3Suspended, Discontinued, or Cancelled Grants...........................4Suspended Grants..............................................4Chad....................................................4Ukraine..................................................4Discontinued Grants............................................5Nigeria..................................................5Pakistan.................................................5Senegal..................................................6South Africa..............................................6Uganda..................................................7Terminated Grants ............................................7Burma (Myanmar).........................................7North Korea..............................................9Projected Financial Needs ...........................................9Meeting Millennium Development Goals ..........................9Meeting Escalating Grant Requests...............................10Congressional Actions.............................................10Issues for Congress...............................................11Strengthen Reporting and Monitoring.............................11Reauthorize Limits on U.S. Contributions to the Global Fund..........13Appropriations to the Fund Versus Bilateral HIV/AIDS Efforts.........15
List of Figures
Figure 1. U.S. Contributions to the Fund and All U.S. International HIV/AIDS,TB, and Malaria Spending......................................16Figure 2. U.S. Contributions to the Fund as a Percentage of All U.S. InternationalHIV/AIDS, TB, and Malaria Spending............................17
List of Tables
Table 1. Global Fund Targets: 2004-2009..............................1Table 2. Results of Global Fund Grants to Date..........................2Table 3. Grant Agreement Totals to Date...............................3Table 4. Funding Requirements, 2008-2010............................10Table 5. U.S. Appropriations to the Global Fund........................11
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