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The Fund to Fight AIDS


Initial Questions on the Fund, February 2002




What is the Global Fund to Fight AIDS, Tuberculosis and Malaria?

The Global Fund is an independent, public-private partnership designed to attract, manage, and disburse new resources to fight the global crises of AIDS, tuberculosis, and malaria. The Fund’s objectives are to:
  •   finance effective programmes, balancing the needs for prevention, treatment, care, and support, in order to alleviate suffering, save lives, and help end these diseases
  •  dramatically increase the global resources dedicated to fighting these diseases

Why was the Fund created?

The Fund was created to fight the global HIV AIDS, TB, and malaria epidemics by sharing resources and expertise across national boundaries, and between the private and public sectors.

The concept for an international funding mechanism to fight HIV AIDS, TB, and malaria began at the Okinawa G8 Summit in July 2000. At the urging of UN Secretary General Kofi Annan and many national leaders, the concept of the Fund was unanimously endorsed in June 2001 at the first UN General Assembly Special Session to focus on HIV AIDS. In July 2001 at its meeting in Genoa, G8 leaders committed US $1.3 billion to the Fund.

Why address these three diseases?

The need for more rapid, sustained and concerted action on AIDS, TB, and malaria is overwhelming.  Together, these diseases have a devastating global impact, killing nearly 6 million people each year and causing major social and economic upheaval. While effective interventions now exist to help prevent and treat these diseases, they remain out of reach for most people in the developing world. A dramatic increase in resources to fight HIV, TB, and malaria is urgently needed to help reduce the suffering and death caused by these diseases.

How is the Fund different from previous efforts to address HIV AIDS, TB, and malaria?

The Fund is a unique global public-private partnership that includes donor and recipient country governments, multilateral agencies, NGOs, private sector representatives, and representatives from the communities affected by the three diseases. The full involvement of all these stakeholders reflects an unprecedented level of shared commitment to roll back these global health and development challenges. The Fund is a novel approach that emphasizes the achievement of results, independent technical validation of proposals, and efficient processes for utilizing resources.

Does the Fund replace current funding mechanisms for HIV AIDS, TB, or malaria?

The Fund is meant to supplement, not to replace, current funding mechanisms for HIV AIDS, TB, and malaria. In fact, support for current efforts to fight these diseases should also be increased.

How will the Fund ensure that it doesn’t duplicate or compete with the work of others in the field?

The Fund is not an implementing agency, so it will in no way compete with development or international agencies on the ground. Instead, the Fund is a mechanism to raise new funds to fight HIV AIDS, TB, and malaria, and to direct these resources quickly and efficiently where they are most needed, to programs and interventions that are not adequately funded now.  The Fund is committed to coordinating with and working through existing international, regional, and national mechanisms wherever possible.

Will the Fund address the root causes of these diseases, including poverty, gender disparity, lack of education, and poor nutrition and sanitation?

Effectively addressing HIV AIDS, TB, and malaria in developing countries will require action from a broad developmental perspective. The Fund will favour programmes that build on and coordinate with efforts to address factors that can be root causes of these diseases, including poverty, gender disparities, lack of education, lack of access to health care, and inadequate nutrition and sanitation.



How much money has been committed to the Fund? How much more is needed?

As of May 2002, US$ 2.08 billion has been committed to the Fund from industrialized and developing country governments, corporations, foundations, and individuals. A number of these commitments are multiyear, giving the Fund approximately US$800 million to disburse in 2002.

While far more resources are needed to adequately address HIV AIDS, TB, and malaria, current pledges to the Fund will allow the Board to begin funding programmes and demonstrate results. Once the Fund has shown that it is working as planned, it is hoped that current donors will increase their commitments, and that new donors will come to the table.

The UN Secretary-General has called for $7-$10 billion annually for AIDS.  How does this relate to the goals of the Fund?

Secretary-General Annan’s call for US$ 7-$10 billion annually for AIDS is based on an estimate of the total resources required annually to address the HIV AIDS epidemic in low- and middle-income countries – from all sources including the new Global Fund, bilateral and other donors, and the affected country governments themselves. Similarly, estimates suggest that about US $2 billion is needed annually from all sources to address TB and malaria.  The Fund is but one of many contributors to help address these overall needs.

The Fund was never intended to become the sole source of financial support to fight HIV AIDS, TB, and malaria. It is a new tool to attract, manage, and disburse additional resources. The Fund will also help to leverage additional financing mechanisms – such as debt relief, governments’ own budgets, health insurance schemes, development loans, private sector contributions and other new financing strategies.



What process was followed in setting up the Fund?

In July 2001, a Transitional Working Group (TWG) for the Fund was established, consisting of nearly 40 representatives of developing countries, donor countries, NGOs, the private sector, and the UN system. During the second half of the year, the TWG developed basic guidelines for the Fund’s operation, including its legal status, management structure, financial systems and general eligibility criteria. The TWG met three times – in October, November, and December 2001. In addition, the TWG held regional consultations in Africa, Asia, Latin America and Eastern Europe, as well as thematic consultations with NGOs/civil society, the private sector, and academia. 

In late 2001, members of each of the Fund’s constituencies – including donor countries, developing countries, NGOs, and the private sector – selected representatives for the Fund’s Board.  At its first meeting in January 2002, the Board reviewed the TWG’s recommendations and adopted a framework document that made the Fund officially operational.

How is the Fund staffed?

An Interim Secretariat, based in Geneva, is providing staff support to the Fund until a permanent Secretariat – also in Geneva – is established. The Interim Secretariat is staffed by secondments from governments and multilateral agencies. Permanent staff members will be recruited during the summer.

How will the Fund raise additional money?

Mobilizing additional public and private resources is a key goal of the Fund. A comprehensive strategy is being prepared to raise additional funds from current and potential donors. The Fund’s immediate priorities are to collect the donations that have already been pledged and to wisely and effectively disburse the funds it already has at its disposal.



How is the Board structured?

The Chair of the Board is Dr. Chrispus Kiyonga, Minister without Portfolio of the Government of Uganda. The Vice-Chair is Seiji Morimoto, Deputy Director-General of the Multilateral Cooperation Dept. of the Ministry of Foreign Affairs in Japan.

The Board includes an equal number of donor and developing country governments, with seven seats each. The seven donor countries represented on the Board are France, Italy, Japan, Sweden, the UK, the US and the European Commission. Some of these seats have alternates and will rotate among countries. 

The seven developing countries on the Board include Brazil (representing Latin America and the Caribbean), China (Eastern Pacific countries), Pakistan (Eastern Mediterranean), Thailand (Southeast Asian countries), Uganda (Eastern and Southern Africa), and Ukraine (Eastern Europe). The representative of West and Central Africa has not yet been confirmed.

The Board also includes two NGO and two private sector donor seats. The NGO seats include one representative of NGOs from the South and one representative of NGOs from the North. The two private sector seats include one representative of private foundations (currently the Gates Foundation) and one representative of private companies (currently Anglo-American PLC).

All members were chosen by their own constituencies. The majority of Board members, including the Chair and Vice-Chair, have two-year terms.

UNAIDS, WHO, and the World Bank hold ex-officio (non-voting) seats on the Board. The Board also includes a person living with or affected by HIV AIDS, TB or malaria, also in a non-voting seat.

For a complete list of Board members, please visit the Fund website, www.globalfundatm.org.

Are pharmaceutical companies represented on the Board?

The Board does not currently include a representative of the pharmaceutical industry.  The Board’s private sector representative was selected by the private sector through a broad and open process that began in early December with a consultative meeting held at the World Economic Forum (WEF) in Geneva. The process was facilitated by the WEF in conjunction with the Corporate Council on Africa, the Global Business Council on HIV & AIDS, the International Business Leaders Forum and the International Chamber of Commerce.

How will the Board make its decisions?

The Board will seek to reach consensus on all matters. If consensus cannot be reached, board action will require two-thirds majorities from two groups of Board members – the first group includes representatives of donor countries and the private sector and foundations, and the second group includes representatives of developing countries and NGOs

What is the legal status of the Fund?

The Fund has been established as an independent private foundation under Swiss law.  The World Bank has primary responsibility for collecting, investing, and disbursing funds, as well as financial reporting.

What is the role of the United Nations in the Fund?

The leadership and vision of UN Secretary-General Kofi Annan have been essential to the Fund’s success, especially in the areas of mobilizing resources and building political commitment. The Fund is not a United Nations entity, but an independent public-private partnership that includes governments, the UN and other international organizations, industry, academic institutions, foundations and other relevant civil society groups.

The Fund is coordinating closely with UN bodies including the World Health Organization (WHO) and the Joint United Nations Programme on HIV AIDS (UNAIDS), and is benefiting from the technical expertise of these organizations. UNAIDS Executive Director Peter Piot and WHO Director-General Gro Harlem Brundtland serve as ex officio members the Fund’s Board.  In addition, the Fund’s Technical Review Panel will consult with UNAIDS and WHO on technical matters before making its final recommendations to the Board.

To whom will be Fund be accountable?

First and foremost, the Fund is accountable to the millions of people affected by HIV AIDS, TB, and malaria, their families, and those at risk of infection. Regarding the use of funds and the achievement of results, the Fund is accountable to donors, technical partners and developing countries.



How much of the Fund’s resources will go to AIDS, and how much to the other diseases?

The Fund will target resources where the needs are greatest, based on country priorities. Current estimates of disease burden and economic indicators suggest that HIV AIDS will consume the greatest amount of Fund resources, followed by tuberculosis and malaria.

How much of the Fund’s resources will be spent on prevention compared to care?

One of the principles of the Fund is to pursue an integrated and balanced approach that covers prevention, treatment, care, and support. Taking a long-term perspective, preventing new infections is the most effective strategy for alleviating suffering and reducing the social and economic impact of these diseases. But care and prevention are clearly related – prevention efforts will never succeed if care and support services for the infected and directly affected are not provided.

Will the Fund support the purchase of antiretroviral treatment?

Provision of antiretroviral treatment is currently included in the Fund’s scope as an example of the types of activities that could be supported. The Board of the Fund will balance the available resources against the priorities that countries themselves identify within the context of comprehensive health system strategies and plans.

Will the Fund be able to purchase generic drugs or will it be held to patent protections?

The Fund will not act as a procurement agent. Instead, its resources may be used to support programmes that include procurement of critical health products for the treatment and prevention of the three diseases.

The Fund will encourage efforts to make high-quality, safe and effective drugs and products available at reasonable prices. The use of the Fund' s resources will be consistent with international law and agreements. It should be noted that many of the most critical drugs and products - such as antibiotics to prevent and treat tuberculosis and other AIDS-related opportunistic infections - are not protected by patents and are available from a variety of manufacturers.


How does the Fund keep track of its donations? 

The World Bank manages public donations; private donations to the Fund will be made through the UN Foundation. In order to disburse funding to approved projects, public and private donations will be merged into a single bank account and subsequently disbursed either to national Ministries of Health or to NGOs directly.

How does the fiduciary mechanism work?

The World Bank is the Trustee of the Global Fund. The Trustee’s primary responsibilities include collection, investment and management of funds, disbursement of funds to countries and programs, and financial reporting. The World Bank will disburse funds on the instruction of the Fund's Board of Directors.