HIGH-LEVEL PANEL DID NOT PROVIDE DIRECTION ON CERTAIN CRITICAL ISSUES, FORMER GLOBAL FUND E.D. SAYS

Author:

David Garmaise

Article Type:

Article Number: 2

ABSTRACT Richard Feachem, the Global Fund's first executive director, says that major reforms are needed to ensure the survival of the Fund and that, while the report of the High-Level Panel contains valuable recommendations, it "does not provide direction or solutions on certain critical issues that will define the further success and impact of the Global Fund."

“In some instances, the Global Fund should be doing less rather than more”

 

Richard Feachem, the Global Fund’s first executive director, says that major reforms are needed to ensure the survival of the Global Fund, and that, while the report of the High-Level Panel contains valuable recommendations, it “does not provide direction or solutions on certain critical issues that will define the further success and impact of the Global Fund.”

Feachem made the comments in a commentary dated 19 November 2011 in the journal The Lancet. Feachem made three main points in his article. They are summarised as follows:

 

First, the Global Fund must do more to “truly become the performance-based funding institution it aspires to be.” In this respect, the Global Fund should examine ways in which it could pay for impact and outcome instead of inputs. For example, he said, grant recipients that have proven the ability to manage funding responsibly could receive carefully calculated payments for each standard unit of verified output or outcome, rather than the complex and burdensome disbursements based on inputs that are currently the norm. Further development could lead to carefully calculated standard payments per case averted or death averted.

Second, instead of simply asking what more the Global Fund could do to responsibly manage high-risk investments, the Global Fund (and the High-Level Panel) should be asking what less the Global Fund could do to manage lower-risk investments. “Global Fund processes have become so onerous that they impede impact even in countries with good financial records, as shown by the recent resurgence of malaria in Rwanda as a result of delayed disbursement. Simplifying processes for low-risk countries would increase value for money and enable the Global Fund to focus scarce capacity on higher-risk investments.”

Third, as it undergoes reforms, the Global Fund must be careful not to evolve from a financing agency (its current role) into more of a technical and implementing agency. “The Panel rightly notes that true country ownership does not mean blindly accepting whatever a country proposes. Yet the Global Fund was established to break from the failure of aid models in which experts in Washington or Geneva determine solutions for African or Asian communities.” Some of the Panel’s recommendations, such as having Global Fund staff review and provide feedback on country proposals before final technical review, threaten to erode the separation of roles “that has been at the heart of the extraordinary impact of the Global Fund during its first decade.”

Feachem’s commentary in The Lancet is available here.