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Summary:
The Global Fund to Fight AIDS, Tuberculosis, and Malaria, headquartered in Geneva, Switzerland, is an independent Swiss foundation 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 $4.8 billion has been pledged to the Fund, while about $1.7 billion has been received or was in process as of November 1, 2003. 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 three rounds of grant awards, the Global Fund has committed to disbursing $2.1 billion to 121 countries and three territories in the Caribbean through 2006. 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. Some have expressed concern about the absorptive capacity of recipient countries. 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. Appropriations bills currently before Congress (H.R. 2800 and H.R. 2660) would provide twice this amount or more. H.R. 1298/P.L. 108-25, 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. 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.
