GFO Issue 464, Article Number: 5
ABSTRACT
Global health leadership remains unequal, with 75% of board seats held by high-income countries (Global Health 5050, 2022). The Global Fund’s Ethics and Governance Committee (EGC) enforces ethical standards and governance integrity, but faces challenges such as language barriers. African members, such as Dr. Magda Robalo, have advanced equity; however, broader inclusion efforts, like multilingual access, are still needed. AIDSPAN’s series highlights why African representation in such committees matters.
A famous proverb states: “If you’re not at the table, you’re on the menu.”
In its 2022 report, Global Health 5050 painted a sobering picture. According to the report, “Among more than 2,000 board seats, analysis reveals that 75% are held by nationals of high-income countries (home to 16% of the global population).”
Some may argue that progress has been made, that people from low- and middle-income countries are now more visible and better represented. However, the illustration below shows there is still a long way to go.
The Global Fund has recently renewed the composition of its committees and leadership. Aidspan will publish a series of three articles explaining the purpose of Global Fund committees and why it is critical for Africans to engage and contribute.
This first article focuses on the Ethics and Governance Committee (EGC).
What is the Ethics and Governance Committee?
The Ethics and Governance Committee (EGC) is one of three standing committees of the Global Fund Board. It is responsible for ensuring that the Global Fund and its stakeholders uphold appropriate standards of ethical behavior. The EGC oversees the implementation of procedures and operations related to the Fund’s governance structure and core governance functions, as mandated by the Board.
According to the Committee’s constitution (12 May 2022), the EGC’s role is to oversee compliance by the Global Fund and its stakeholders with the organization’s ethical standards as defined in its codes and related policies. It also monitors the implementation of governance-related procedures and activities.
The Ethics and Integrity Framework defines the Global Fund’s core ethical values: integrity, duty of care, accountability, dignity, and respect. The framework also outlines the responsibilities of key individuals and institutions. All individuals and organizations involved in Global Fund-financed activities - including agents and implementing partners - are expected to act in accordance with these core values. To support this, the Fund has adopted specific codes of conduct to ensure ethical behavior at all levels.
The outgoing committee was chaired by Mr. Paul Schaper and Dr. Magda Robalo (Guinea-Bissau). Over the years, many African leaders have contributed to this committee, including Dr. David Appuli (Uganda), Prof. Pascal Niamba (Burkina Faso), Mr. Rudolph Maziya (eSwatini), and General Randriamiandrisoa Edelin (Madagascar).
Who serves on the EGC?
The EGC is composed of eleven individuals serving in their personal capacity - meaning they do not represent a particular constituency. Each is appointed for a three-year term to provide subject matter expertise to the Global Fund Board. The composition includes:
- Four members from the implementer group,
- Four members from the donor group,
- Two non-voting members: a Chair and Vice-Chair, and
- One non-voting independent member with ethics expertise.
Committee members serve concurrent three-year terms or until their successors are appointed. The Chair and Vice-Chair are also appointed for three-year terms or until replaced.
According to Ms. Grace Rwakarema, current Vice-Chair of the EGC and former Vice-Chair (2018–2020) from Rwanda, the committee plays a vital role in identifying, assessing, mitigating, and monitoring risks related to ethical compliance. It also provides assurance regarding governance practices across the Global Fund. This reflects a strong commitment to maintaining high ethical standards and trust.
EGC members are expected to exemplify integrity and demonstrate alignment with the Global Fund’s values. This is essential to building confidence in the institution’s governance and decision-making.
Key challenges
Despite their expertise and commitment, many members, especially those from non-English-speaking regions, face challenges in fully participating in committee business. Meetings, documents, and submissions are conducted exclusively in English. This barrier exists across all three standing committees. As such, African constituencies consistently advocate for multilingual interpretation and translation of materials to ensure equitable participation and inclusion.
Dr. Magda Robalo, during her tenure, championed ethical principles such as integrity, transparency, accountability, and adherence to the rule of law as foundational to good governance and equitable health outcomes. She acknowledged the structural challenges faced by an institution as large and diverse as the Global Fund - including issues of sexual exploitation, abuse, and harassment in the context of program implementation.
Serving on this committee requires a commitment to ensuring that the Global Fund’s governance mechanisms remain robust, transparent, and effective in promoting equitable access to quality healthcare.
In her own modest way, Dr. Robalo contributed to narrowing the gender gap in global health leadership by lending her expertise, sharing her experience, and volunteering her time. Her presence served as a powerful statement in support of gender equity.
Conclusion
My experience with the EGC has been deeply enriching due to the group’s diversity and multicultural nature. This diversity fosters a more inclusive and balanced approach to ethics and governance at the Global Fund, said Ms. Grace Rwakarema
A famous proverb states: “If you’re not at the table, you’re on the menu.”
In its 2022 report, Global Health 5050 painted a sobering picture. According to the report, “Among more than 2,000 board seats, analysis reveals that 75% are held by nationals of high-income countries (home to 16% of the global population).”
Some may argue that progress has been made, that people from low- and middle-income countries are now more visible and better represented. However, the illustration below shows there is still a long way to go.
The Global Fund has recently renewed the composition of its committees and leadership. Aidspan will publish a series of three articles explaining the purpose of Global Fund committees and why it is critical for Africans to engage and contribute.
This first article focuses on the Ethics and Governance Committee (EGC).
What is the Ethics and Governance Committee?
The Ethics and Governance Committee (EGC) is one of three standing committees of the Global Fund Board. It is responsible for ensuring that the Global Fund and its stakeholders uphold appropriate standards of ethical behavior. The EGC oversees the implementation of procedures and operations related to the Fund’s governance structure and core governance functions, as mandated by the Board.
According to the Committee’s constitution (12 May 2022), the EGC’s role is to oversee compliance by the Global Fund and its stakeholders with the organization’s ethical standards as defined in its codes and related policies. It also monitors the implementation of governance-related procedures and activities.
The Ethics and Integrity Framework defines the Global Fund’s core ethical values: integrity, duty of care, accountability, dignity, and respect. The framework also outlines the responsibilities of key individuals and institutions. All individuals and organizations involved in Global Fund-financed activities - including agents and implementing partners - are expected to act in accordance with these core values. To support this, the Fund has adopted specific codes of conduct to ensure ethical behavior at all levels.
The outgoing committee was chaired by Mr. Paul Schaper and Dr. Magda Robalo (Guinea-Bissau). Over the years, many African leaders have contributed to this committee, including Dr. David Appuli (Uganda), Prof. Pascal Niamba (Burkina Faso), Mr. Rudolph Maziya (eSwatini), and General Randriamiandrisoa Edelin (Madagascar).
Who serves on the EGC?
The EGC is composed of eleven individuals serving in their personal capacity - meaning they do not represent a particular constituency. Each is appointed for a three-year term to provide subject matter expertise to the Global Fund Board. The composition includes:
- Four members from the implementer group,
- Four members from the donor group,
- Two non-voting members: a Chair and Vice-Chair, and
- One non-voting independent member with ethics expertise.
Committee members serve concurrent three-year terms or until their successors are appointed. The Chair and Vice-Chair are also appointed for three-year terms or until replaced.
According to Ms. Grace Rwakarema, current Vice-Chair of the EGC and former Vice-Chair (2018–2020) from Rwanda, the committee plays a vital role in identifying, assessing, mitigating, and monitoring risks related to ethical compliance. It also provides assurance regarding governance practices across the Global Fund. This reflects a strong commitment to maintaining high ethical standards and trust.
EGC members are expected to exemplify integrity and demonstrate alignment with the Global Fund’s values. This is essential to building confidence in the institution’s governance and decision-making.
Key challenges
Despite their expertise and commitment, many members, especially those from non-English-speaking regions, face challenges in fully participating in committee business. Meetings, documents, and submissions are conducted exclusively in English. This barrier exists across all three standing committees. As such, African constituencies consistently advocate for multilingual interpretation and translation of materials to ensure equitable participation and inclusion.
Dr. Magda Robalo, during her tenure, championed ethical principles such as integrity, transparency, accountability, and adherence to the rule of law as foundational to good governance and equitable health outcomes. She acknowledged the structural challenges faced by an institution as large and diverse as the Global Fund - including issues of sexual exploitation, abuse, and harassment in the context of program implementation.
Serving on this committee requires a commitment to ensuring that the Global Fund’s governance mechanisms remain robust, transparent, and effective in promoting equitable access to quality healthcare.
In her own modest way, Dr. Robalo contributed to narrowing the gender gap in global health leadership by lending her expertise, sharing her experience, and volunteering her time. Her presence served as a powerful statement in support of gender equity.
Conclusion
My experience with the EGC has been deeply enriching due to the group’s diversity and multicultural nature. This diversity fosters a more inclusive and balanced approach to ethics and governance at the Global Fund, said Ms. Grace Rwakarema
