At its board meeting in Geneva on June 28-30, the Global Fund board approved 69 grants that will cost $968 million over the first two years and $2,912 million over five years. The successful proposals came from 50 countries. (For a complete list of approved and non-approved proposals, see "Analysis: Round Four Decisions," below.)

This was the Global Fund's biggest round of grants, both in terms of value of eligible proposals received, and in terms of value of proposals approved.

The board made no decision as to when the next round of grants will take place. In light of the considerable costs that the Global Fund will incur in 2005 and 2006 paying for the renewal of existing grants as they come to the end of their first two years, it may be that the next new round will not be before 2007.

The following tables summarize Round 4 results.

Results by Round

Round 4 results by disease

Round 4 results by region

Round 4 results by applicant type

Round 4 results by poverty level

Other highlights include the following:

• The number of people who will receive ARV treatment by the fifth year of Global Fund grants is:
  • Round 1 grants: 232,000 people
  • Round 2 grants: 283,000 people
  • Round 3 grants: 177,000 people
  • Round 4 grants: 932,000 people
  • Total 1,624,000 people
• By the end of Year 5 of Round 4 grants, the total results of all grants in all rounds approved thus far by the Global Fund will, according to the Fund, be 1.6 million people on ARV treatment (a six-fold increase over current coverage in developing countries), 52 million clients reached with VCT services, 3.5 million additional TB cases treated successfully under DOTS, 12,000 new DOTS+ treatments for drug-resistant TB distributed, 145 million ACT treatments for drug-resistant malaria distributed, and 108 million insecticide-treated bed nets financed to protect families from malaria.

• In Round 4, seven approved projects had five-year budgets in excess of $100 million. These were Ethiopia (HIV/AIDS) $405 m.; Tanzania (HIV/AIDS) $293 m.; Zambia (HIV/AIDS) $254 m.; Kenya (malaria) $186 m.; India (HIV/AIDS) $165 m.; Uganda (malaria) $158 m.; Russia (HIV/AIDS) $121 m.

• In Round 4, seven non-approved projects had five-year budgets in excess of $100 million. These were Ghana $305 m.; South Africa $243 m.; Zimbabwe $218 m.; Cote d'Ivoire $169 m.; Nigeria $166 m.; Kenya $142 m.; Burkina Faso $104 m. All of these were HIV/AIDS proposals.

• The Technical Review Panel (TRP) did not take into account availability of funds when it made its recommendations to the board.
• The budget breakdown of the approved Round 4 proposals was: drugs 38%; commodities 17%; planning and administration 12%; human resources 10%; infrastructure 8%; training 8%; other 7%.
• The cost of malaria grants has increased significantly, as follows: Round 1 $67 m.; Round 2 $242 m.; Round 3 $167 m.; Round 4 $406m. This is because the new (and much more effective) ACT drugs are more expensive than the older drugs.
• Only three Round 4 proposals mentioned co-investment from private sector companies. It is believed that none of these were successful. (In a few additional cases, companies approached CCMs to suggest working together on proposals, but the suggestion was not taken up by the CCMs in question.)
• In Rounds 1 through 3, the cost of funding Years 3-5 averaged 1.5 times the cost of funding Years 1-2. But for Round 4, the cost of funding Years 3-5 will be 2.0 times the cost of funding Years 1-2.
• Round 4 applicants were given 12 weeks to complete their application forms. At first, the only version of the application form that was available was the online version. As reported in GFO Issue 18, this had very slow response times. Seven weeks later, CD-ROM and Word versions were made available. In the end, only 15 out of 96 countries that applied managed to do so on-line; the majority used the Word version.
• Further grant details are available at www.theglobalfund.org/en/about/board/eighth.