Global Fund suspends new projects until 2014 because of lack of funding

BMJ 2011; 343 doi: (Published 29 November 2011) Cite this as: BMJ 2011;343:d7755
  1. Peter Moszynski
  1. 1London

The Global Fund to Fight AIDS, Tuberculosis and Malaria has for the first time in its 10 year history cancelled the pending funding round and suspended new grants because of a lack of funding from donors.

The fund is the world’s largest international funder of programmes to treat tuberculosis and malaria and the second largest for HIV and AIDS, after the US President’s Emergency Plan for AIDS Relief.

At the fund’s 25th board meeting in Accra, Ghana, on 20 November, the board voted to cancel all plans for new grant making. Projects that are currently supported by the fund have guaranteed funding for their full lifetimes, but there will be no money for new initiatives until 2014.

The fund’s director of external relations, Christoph Benn, told the BMJ that it had already dispersed some $8.5bn (£5.5bn; €6.4bn) and had approved an additional $1.5bn for 2011-13. However, the recent “critical global economic situation” meant that the board anticipated that it might not be able to achieve the 20% extra funding it estimates is needed to scale up services in the near future, although it has appealed to donors to “provide additional funds to enable countries to meet their millennium development goal targets.”

The fund will instead provide a “transitional funding mechanism” whereby countries known to be facing disruption of their programmes for HIV, tuberculosis, and malaria before 2013 will be offered a chance to apply for funding to cover their most essential needs. However, it says that such funding will be “restricted to the continuation of essential prevention, treatment, and/or care services currently financed” by the fund.

For HIV, this funding can cover drugs for people already receiving treatment but does not provide money for treating new cases of HIV.

Mike Mandelbaum, chief executive of the UK charity TB Alert, told the BMJ that the reduction in funding will have “a catastrophic effect and directly lead to many avoidable deaths.”

He added, “The Global Fund is a very effective funding mechanism and is a huge success. Last year the number of people who died from tuberculosis fell to 1.4 million from 1.7 million the previous year. This progress costs money, and the fund has become a key donor across the world. In Africa, for example, it funds 85% of TB programmes.

“It would be a human catastrophe to take a backward step now. Instead the international donor community should follow the example of the United Kingdom in increasing support to high quality aid programmes.”

In a press statement the UK Coalition to Stop TB said, “The ramifications of this decision will be tragic for millions of people around the world who depend on the Global Fund for lifesaving treatments.

“Without TB drugs and healthcare workers, millions of people with TB and multidrug resistant TB, especially those coinfected with HIV, have little hope of survival. Furthermore, this decision will make it impossible to achieve the millennium development goals on health, and failure to support the Global Fund will drive us further away from controlling the three killer diseases.”

Awa Marie Coll-Seck, executive director of the Roll Back Malaria Partnership, told the BMJ: “The Global Fund currently represents nearly two thirds of international malaria funding. If we don’t have sufficient resources to continue the fund’s work, we will lose the tremendous gains we have made in malaria control in recent years and put millions of lives at risk.”

Tido von Schoen-Angerer, director of Médecins Sans Frontières’s access to medicines campaign, said, “There’s a shocking incongruence between both the new HIV science and political promises, on one hand, and the funding reality that is now hitting the ground, on the other. Donors are really pulling the rug out from under people living with HIV and AIDS at precisely the time when we need to move full steam ahead and get lifesaving treatment to more people.”

Stephen Lewis, director of AIDS Free World, described the move as “the most serious, catastrophic setback in the fund’s decade of existence.” In a speech to the Yale School of Public Health on 28 November he said that the donors’ failure to live up to their commitments amounted to murder and that their leaders should be tried for “crimes against humanity.”

Earlier this year the Global Fund committed itself to reforms in response to specific incidents of countries’ misuse of funds and corruption (BMJ 2011;342:d603, doi:10.1136/bmj.d603).

A spokesperson for the UK Department for International Development told the BMJ: “The international development secretary has been clear that while the Global Fund performed well in the UK’s multilateral aid review, reform is needed. Future UK funding levels will depend on the fund implementing the recommendations in the recent high level panel report and on the success of its consolidated transformation plan.”


Cite this as: BMJ 2011;343:d7755