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Aidspan White Paper: Scaling Up to Meet the Need: Overcoming barriers to the development of bold Global Fund-financed programs

If the Global Fund is to achieve the continued rapid growth that it is planning for, it has to examine closely, and address, some significant growing pains that are becoming increasingly apparent. Some of these growing pains exist within developing countries; others exist within the Fund itself. Accordingly, this white paper tackles three linked questions: What problems at the country level are preventing adequate scale-up to meet the need? (Example: Many implementing countries have weak health systems, limited capacity, and insufficient health workers.) What problems at the Global Fund level are preventing adequate scale-up by the countries? (Example: Some of the GF's rules for grant implementers are too burdensome, or they are enforced in too rigid a manner. The transaction costs of dealing with the GF are too high.) What should be done about these problems? (Example: On an open-ended basis, the GF should have just one "single-stream grant" for each country/disease/PR combination, extendable and expandable as and when agreed.) In the five years since Aidspan was founded, this is easily the most substantive report we have published on problems affecting the Global Fund and on recommendations to address those problems.