A global health fund: a leap of faith?

See also Editorial by Verheul and Rowson and Paper p 139

After the 2000 G8 summit at Okinawa, the leaders of the world's richest countries announced an ambitious commitment to achieve substantial reductions in the global burden of disease and death due to HIV infection and AIDS, tuberculosis, and malaria by 2010.1 A new global health fund, to be highlighted at the forthcoming G8 summit in Genoa, could form the cornerstone for meeting this commitment. The fund will be heavily dependent on resources from the richest countries, working in partnership with United Nations' agencies (especially the World Health Organization), the commercial sector (especially major pharmaceutical companies), other donors, non-governmental organisations, and governments of developing countries. Funds are intended to be additional to existing aid from multilateral and bilateral agencies and will be managed and disbursed by a new entity, the Global Health Fund. This is a major new form of governance (see box 1).

The Global Health Fund follows a plethora of recent global public-private partnerships to promote wider availability of existing products and stimulate product development as well as initiatives with a broader focus on health systems (see box 2).2 Debates about these partnerships in the past year are relevant to the proposed global fund; they concern issues such as governance structures and functions, the balance of power between partners, the ability of recipient countries to determine how resources are used, and the balance between support to health systems and funding of health products. International policymakers are looking to the Global Alliance for Vaccines and Immunization (GAVI) for lessons, as this is one of the first such partnerships, with an established fund for disbursing free vaccines and funds to support health systems in some countries with a gross domestic product less than $1000 (£714).