Estimates, while still preliminary and unaudited, show that the Global Fund disbursed a total of US$3.3 billion in 2012, delivering money that is being used to prevent and treat AIDS, TB and malaria all over the world.
That is 26 percent more than was disbursed in 2011. At the same time, the Global Fund cut operating expenses by 5 percent. That is a powerful indicator of success for the transformation of the Global Fund led by Gabriel Jaramillo, the General Manager who steps down next week. He will hand over the leadership of the organization to Mark Dybul, who begins as Executive Director on Monday, 21 January.
More efficient disbursement of grant money in 2012 grew out of a reorganized and better-run Grant Management division. It's about managing intelligently. By concentrating more staff on the countries with high disease burden, managers and program officers could address emerging problems more effectively and also were able to focus on achieving targets and making sure that available funding was being disbursed in a timely way. "The quality of our disbursements continued to improve," said Mark Edington, Head of the Grant Management division. Grant performance and financial absorption were vigorously checked, and the risk environment was fully taken into account, he added. "We took calculated risks, and we understand the risks better," he said. The ground has been well prepared for the next stage, just as the Global Fund prepares to launch a new funding model.
New Funding Model Takes Shape
The Global Fund has developed a new funding model that will allow it to invest more strategically, engage implementers and partners more effectively and achieve greater global impact. The new model will begin over the course of 2013, a transition period. The new model will provide implementers with more flexible timing, better alignment with national strategies, greater predictability on the level of funding available, close engagement and early feedback on grant applications, and an ability to express full demand. Improvements in the management of existing grants are already underway.
The Global Fund will launch its new funding model in February 2013. Access to funding in 2013 will be by invitation, with special consideration given to implementers in countries most in need, with programs that are underfunded or at risk of service interruptions, as well as programs in a position to achieve rapid impact. A limited number of these participants will articulate their need by submitting a concept note, which will enable Global Fund staff to evaluate end-to-end processes. There will be diversity across regions and diseases and types of applicants.
The timing is interesting. In 2013, the Global Fund will appeal to governments and other donors for financial resources needed for 2014 to 2016, so implementing countries can move toward defeating AIDS, TB and malaria programs and can make significant health improvements for their people. The new funding model will help show everyone how effective investments can make a difference. To be most effective, we need a fully funded Global Fund.
Anyway, in information sessions beginning after the launch, Fund Portfolio Managers and others at the Global Fund will be briefing implementers on the steps they can take, as the New Funding Model begins. Staff at the Global Fund are drawing up a guidance package for implementers invited to participate in the transition period. An information package will also be available on the Global Fund's website.
HIV Prevention in Ukraine
Andriy Klepikov is the Executive Director of Alliance Ukraine, a leading nongovernmental organization in Ukraine, where 230,000 people are living with HIV - the most severe HIV epidemic in Eastern Europe. Alliance Ukraine has been working for more than 20 years to prevent the spread of HIV among injecting drug users, sex workers, men who have sex with men and prisoners. It has been a Principal Recipient for Global Fund-supported programs in Ukraine since 2004.
We spoke with Klepikov during a recent visit to Ukraine, and he was quite direct about the tremendous obstacles there. One is the stark inequality in access to treatment. HIV-positive people who use drugs are six times less likely to obtain antiretroviral treatment than others adults. In Klepikov's view, the young drug users now filling up prisons in Ukraine should be put on treatment programs instead. "There is no funding available from the state for harm reduction programs, and this is a huge mistake," Klepikov said. Prevention services supported by the Global Fund and provided by civil society organizations are regularly reaching 160,000 injecting drug users, and have led to a steady decline of HIV incidence among this group, he said. "I remember that when the Global Fund started its programs in Ukraine, the principle of complementarity was a cornerstone," he said. "The Global Fund cannot be the only source of funds, a sort of magic bullet that can solve all problems. It's time for Ukraine to change the trend of the epidemic over the next three to five years. But for this we need a combination of political will and a major increase in both domestic and international funding."
Alliance is seeking to build a sustainable system of comprehensive services of HIV prevention, treatment, care and support for key populations and people living with HIV. It is hard work. There are countless obstacles. Yet the need is compelling, and there are people, like Klepikov, who are determined to try.