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Summary:
The Global Fund to Fight AIDS, Tuberculosis, and Malaria, headquartered in Geneva, Switzerland, is a public-private partnership intended to attract and rapidly disburse new resources in developing countries for the struggle against infectious disease. The Fund is a financing vehicle, not a development agency, and its grants are intended to complement existing efforts rather than replace them. Approximately $4.6 billion has been pledged to the Fund, while about $1.5 billion has been received or was in process as of June 13, 2004. A May 2003 report by the U.S. General Accounting Office (GAO) praised the Global Fund for "noteworthy progress in establishing essential governance and other supporting structures" but noted that the Fund's ability to finance additional grants was threatened by a lack of resources. At the June 2003 Global Fund Board meeting, Executive Director Richard Feachem appealed for $3 billion in additional contributions through 2004, including $1 billion from the United States, $1 billion from Europe, and $1 billion from other sources. The origins of the concept of an independent funding mechanism to fight infectious disease lie partly in ideas developed in the 106th Congress and in proposals made by U.N. Secretary General Kofi Annan. The Fund was established in January 2002 following negotiations involving donor and developing country governments, non-governmental organizations (NGOs), the private sector, and the United Nations. As a result of two rounds of grant awards, the Global Fund has committed to disbursing $1.5 billion to 153 programs in 92 countries in 2003 and 2004. Proposals are submitted to the Global Fund by Country Coordinating Mechanisms (CCMs) based in the recipient countries and including representatives of government, NGOs, faith-based groups, and others. Grants are made to Principal Recipients (PRs), which may be NGOs or government agencies, and their operations must be audited. PRs are also monitored by Local Funding Agents (LFAs), which may be accounting firms or other independent organizations and which report to the Global Fund. The GAO has noted initial difficulties in the operations of CCMs and in the appointment of LFAs but has also reported that the Global Fund has taken steps to deal with these problems. The absorptive capacity of recipient countries is a longer term concern. U.S. contributions to the Global Fund will total $623 million through FY2003. The Administration has requested $200 million for the Fund in FY2004 and has pledged the same amount annually through FY2008. However, H.R. 1298/P.L. 10825, the major AIDS bill signed into law on May 27, 2003, authorizes up to $1 billion as a contribution to the Global Fund in FY2004. Appropriators have warned that it will be difficult to finance this amount in view of competing budgetary demands. For further information, see U.S. General Accounting Office Report GAO-03601, Global Health: Global Fund to Fight AIDS, TB, and Malaria Has Advanced in Key Areas, but Difficult Challenges Remain; and CRS Report RS21181, HIV/AIDS International Programs: Appropriations, FY2002-FY2004.
