Global Fund To Fight AIDS, Tuberculosis and Malaria needs improved oversight of programs

The Global Fund To Fight AIDS, Tuberculosis and Malaria needs to improve its oversight of programs in developing countries and find ways to ensure that programs it funds are effective, according to a report released on Wednesday by the Center for Global Development, the Boston Globe reports.

Although the Global Fund has "[s]everal success stories" in countries like Rwanda and China, "trouble persists" in many African countries that have histories of corruption or with "little expertise in managing vast amounts of donor funds," according to the Globe. There are three countries where Global Fund programs have had "particularly rocky starts" -- Kenya, Nigeria and Uganda, the Globe reports. Kenya has disbursed 38% of its $235 million in grants, and one malaria program in the country receiving Global Fund support is running six months behind schedule, according to the Globe. Nigeria pledged to use its Global Fund grant to provide 14,000 people with access antiretroviral drugs in one year, but no one received the drugs, the Globe reports. The Global Fund in April suspended its HIV/AIDS grant to Nigeria, retracting $81 million, according to the Globe. Uganda's five Global Fund grants were suspended in 2005 because of mismanagement by the Health Ministry, and although the funds later were reinstated, programs in the country are running an average of six months behind schedule, the Globe reports.

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The report also says that the Global Fund's Geneva headquarters "feels chaotic" because staff are "constantly making a new rule for a new situation," Celina Schocken, who has worked at the Global Fund and contributed to the report, said. She added that health ministries receiving grants from both the Global Fund and the President's Emergency Plan for AIDS Relief often respond faster to requests from U.S. officials who live in the country. The Global Fund "is not breathing down anyone's neck asking for a meeting to get things going, but others are," Schocken said. Bernard Rivers -- editor of the Global Fund Observer and one of 22 health specialists who produced the report -- said whoever is selected next week to replace Richard Feachem as executive director of the Global Fund "must be really focusing on grants that are in trouble or could be in trouble." Steve Radelet, chair of the report, and some U.S. officials think that rather than hiring hundreds of technical experts to oversee its grants, the Global Fund should coordinate its programs more closely with U.S. and European donors, as well as U.N. agencies, the Globe reports. British and German aid organizations have started assisting the Global Fund's programs in a few countries, and the U.S. has set aside $12.5 million in technical assistance (Donnelly, Boston Globe, 10/26). According to sources familiar with the Global Fund executive director selection process, Rep. Jim Kolbe (R-Ariz.) and Vice Chair of MTV Networks Bill Roedy, who also is president of MTV Networks International, are on the list. Michel Kazatchkine, a former Global Fund vice chair and France's global ambassador for HIV/AIDS and communicable diseases, also is a finalist. The two other candidates on the list are Michel Sidibe, director of UNAIDS' country and regional support department, and Hilde Johnson, Norway's former minister of international development (Kaiser Daily HIV/AIDS Report, 10/10).