Investing for Impact: Global Fund to Fight AIDS, Tuberculosis, and Malaria (October 2010)

As part of the Third Replenishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), the United States commits to:

·         Seeking resources for a contribution of $4 billion over three years

·         Working through the Global Fund Board to develop and implement a comprehensive set of reforms to maximize the impact of Global Fund grants


Statement of Principle


The United States is deeply committed to the success of the Global Fund as a central element of the global response to the three diseases.  Our investment in the Global Fund is a vital element of our response to the three diseases and under the Global Health Initiative.  The Global Fund has demonstrated remarkable success over the past eight years in mobilizing and disbursing resources.  We must build upon and amplify this success, not just through aggregation of financial resources, but also through focused efforts to strengthen and improve grant management and implementation to ensure these resources are saving as many lives as effectively and efficiently as possible.


Call to Action


The United States calls upon our fellow donors, implementing country partners and other stakeholders to develop and implement a comprehensive set of reforms to maximize the impact of Global Fund grants.  We warmly welcome the commitment of the Executive Director, Board Chair, and Vice-Chair to lead this effort.


The Global Fund has delivered impressive results, but more can and must be done to streamline its processes and maximize the impact of its grants.  The Global Fund is a financing mechanism, with a business model that requires the active and sustained engagement of all partners to ensure Global Fund resources deliver high-quality, cost-effective health services and support for people infected with and affected by the three diseases.  We must all work together to support and strengthen the management and impact of Global Fund resources.


We applaud the Global Fund Secretariat’s recent work in implementing internal reforms designed to improve grant management processes and increase accountability, including the adoption of a “country team” approach to grant management.  We also welcome Secretariat efforts to improve quality control, transparency, accountability, and coordination with the Office of the Inspector General.  The Secretariat must continue implementing these reforms as a matter of the highest priority and with clear timelines and measurable indicators to ensure contributions to the Global Fund are utilized as effectively and efficiently as possible.



The Secretariat’s internal reforms are positive and essential, but a more comprehensive agenda is needed. Board constituencies and the institutions they represent must work together to improve Global Fund processes and policies around proposal development, review, and funding.  In addition, the Secretariat, grant recipients, development partners, and UN and other technical partners must improve how we work together at country level to support the development, implementation, and review of strategic, high-quality, and cost-effective grant programs that support national goals and complement, rather than supplant, existing resources.  We look to implementing countries for their leadership in defining and advancing reforms that will result in true improvements at the country level.


We call on the Global Fund Board to develop a clear action agenda as a matter of utmost urgency that includes clear timelines and measures of progress so all parties can be held accountable for concrete steps in their respective areas of responsibility.  This action agenda should be grounded in Board discussions around the Global Fund’s 3-5 Year Strategy.  As part of the U.S. annual budget process and when considering the scale of U.S. contributions to the Global Fund beyond the Third Replenishment period, The USG will conduct a careful review of: 1) measurable progress in delivering on an action agenda for improved grant impact, 2) maintaining the Global Fund’s focus on combating the three diseases, and 3) continued financial support from other donors.


The United States believes a comprehensive action agenda must include a focus on:

·         Improving Global Fund processes and policies to enhance the efficient and strategic disbursement of resources by, for example,

o    Improving grant management processes such as grant signature, performance review, communication, expenditure tracking, and disbursement processes

o    Improving oversight over resources and program results through Secretariat staff, Local Fund Agents, and the Office of the Inspector General

o    Strengthening policies around proposal development and technical review, value for money, eligibility and prioritization of funding

·         Strengthening country-level coordination and capacity to maximize the impact of Global Fund resources by, for example,    

o    Supporting joint planning, program review, and evaluation at the country level

o    Strengthening local monitoring and evaluation systems

o    Empowering Country Coordinating Mechanisms to carry out their dual roles of coordinating proposal submissions and conducting grant oversight

o    Increasing access to technical assistance for grant implementation and improved program quality and impact


In order to advance this call to action, the United States commits to:

·         Work through the Global Fund Board, under the leadership of the Board Chair and Vice Chair, to develop a concrete action agenda with clear timelines and deliverables and to monitor progress in its implementation  

·         Support implementation of reform recommendations through 1) strong engagement with the Board and 2) providing bilateral resources to support partner coordination and technical assistance at the country level

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