Global Fund to Fight AIDS, Tuberculosis and Malaria

Table - International Partner Funding, by Account (in millions)

Global Fund to Fight AIDS, Tuberculosis and Malaria: Table - International Partner Funding, by Account (in millions)

Participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), an international financing mechanism, is an integral part of the Administration's global strategy against the three diseases. The United States’ maximum contribution in FY 2010 is $1.05 billion but this ceiling is subject to a number of statutory and discretionary withholdings. The implementing mechanism is a USAID grant to the World Bank acting as trustee. The initial authorization of the Leadership Act and subsequent appropriations have stipulated terms for USG contributions to the Global Fund, most notably that the cumulative USG contribution may not constitute more than 33% of total contributions to the Global Fund. Statutory provisions also require withholding funds if the Global Fund is found to have provided financial assistance to the governments of states that consistently support terrorism, if administrative expenses and salaries exceed certain benchmarks, or if the Global Fund fails to satisfy certain criteria regarding performance-based funding and support for in-country entities. Statutory provisions also allow PEPFAR to withhold a portion of the USG contribution to fund technical assistance to improve the implementation of the Global Fund grants.

The Global Fund is a public-private, non-profit foundation created in 2001 to attract and disburse funding to combat HIV/AIDS, tuberculosis, and malaria. The Global Fund is a demand-driven financing mechanism, not an implementing agency, and funds grant proposals generated by recipient countries. The Global Fund grant proposals are developed and overseen by “Country Coordinating Mechanisms" or equivalent groups comprised of representatives from government ministries, non-governmental organizations, the private sector, international partners and people living with the diseases. The Global Fund grant recipients can be public, private or international organizations. The Geneva-based Global Fund Secretariat authorizes disbursements of grant money on a quarterly basis, contingent upon grant performance, from the Global Fund's trustee account at the World Bank. Under the Global Fund model, disbursement of funds is contingent upon the grant recipient’s ability to demonstrate results achieved to date.

The Global Fund Board solicits grant proposals on a periodic basis through individual grant “rounds” and a few pilot initiatives such as the National Strategy Application and Affordable Medicines Facility for Malaria funding channels. An independent panel of experts reviews grant proposals on the basis of technical merit and makes funding recommendations to the Board, which approves the final funding decisions. The Global Fund Board has thus far approved nine rounds of grants, with grant commitments of $19.3 billion in 144 countries.

Under the Comprehensive Funding Policy, the Global Fund Board does not approve grant proposals unless it has funds available to cover the full amount approved. The Global Fund Secretariat currently projects it will have sufficient resources to cover the second phase of all current grant commitments (years 1-2 of all grants, and years 3-5 of grant proposals that demonstrate satisfactory performance) approved as part of Round Nine, contingent upon the identification of efficiency savings mandated by the Board at its 20th meeting in November 2009.

The USG holds a permanent seat on the Board of the Global Fund, and will continue to engage at the Board level to support the development of policies and practices that improve effectiveness and efficiency of Global Fund grants, value for money, and strategic investment of Global Fund resources.

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