In some countries, PEPFAR and the Global Fund provide 90% of total funding for responses to HIV, yet the planning and implementation processes of the two donors are not always aligned. This is one of the findings of an evaluation of the US President’s Emergency Program for AIDS Relief (PEPFAR) conducted by the US Institute of Medicine.
The Global Fund and the US President's Emergency Plan for AIDS Relief (PEPFAR) announced on December 1, World AIDS Day, that between them they are now supporting antiretroviral treatment for 1.2 million people living with AIDS. This represents a three-fold increase in the total number of people receiving treatment in low- and middle-income countries since December 2003, and a doubling in the past year.
A key feature of the Global Fund is that it says it is "results-based" - that it can measure the impact that its grants have, and it can prove to its donors that their money is well-spent.
Recently, PEPFAR (the $15 billion US bilateral AIDS program) has had a difficult time coping with some confusions that its published numbers have caused. The experience provides a sobering lesson for the Fund.
The Global Fund board has chosen Ambassador Randall Tobias, head of PEPFAR, the $15 billion US bilateral AIDS program, to serve as Chair of the Global Fund's key Policy and Strategy Committee. The resolution to approve Tobias, which came despite complaints by activist NGOs and a critical editorial in the New York Times, nearly failed to pass as a result of several votes not being received by the deadline.
When you have a donor giving billions of dollars for AIDS, politics inevitably raises its head from time to time. And when you have two such donors, and they're working out how to dance with each other, the politics gets heavier. This has certainly been the case with the Global Fund and the US's PEPFAR program.
The Global Fund and PEPFAR (the US President's fifteen-billion-dollar Emergency Plan for AIDS Relief, led by Ambassador Randall Tobias) have both made some mis-steps in claiming credit for their respective roles in financing the 700,000 people who are now receiving treatment for HIV/AIDS.
The International AIDS Conference, which takes place every two years, ended today. Based this year in Bangkok, the conference was attended by 19,000 people. The Global Fund featured prominently. Thanks in large part to criticisms of President Bush's $15 billion PEPFAR initiative, the Fund was widely and somewhat simplistically portrayed by many as the knight on a shining white horse that could do no wrong.