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Executive Director Peter Sands is gung-ho about the future of the Global Fund
GFO issue 448

Executive Director Peter Sands is gung-ho about the future of the Global Fund


Christian Djoko

Article Type:
ED Report

Article Number: 2

The 51st Board meeting of the Global Fund opened with a speech by the Executive Director, Peter Sands, who presented the organization's past achievements and strategic plans for the future. He highlighted the organization's adaptability and resilience in the face of global health challenges and economic uncertainties, and discussed strategic measures to strengthen impact, improve operational efficiency and ensure sustainability in global health. This article gives you an overview of his presentation, together with feedback from stakeholders.


Peter Sands, the Executive Director of the Global Fund, made a verbal report to the organization’s first board meeting of the year as is the norm. This article is a summary of his verbal report and the stakeholders’ feedback.


A look back at 2023 priorities


According to the Executive Director, the year 2023 saw significant achievements for the Global Fund, with $5.1 billion effectively allocated to tackling global health challenges, making it the second largest annual disbursement after 2022. This substantial investment has facilitated the timely launch of 98% of projects, demonstrating the organization’s commitment to a rapid and effective response. The strategic decision to reprogram $2.2 billion, originally earmarked for the fight against the COVID-19 virus, to other essential health interventions, demonstrates a flexible and responsive approach to global health threats. This reprogramming has made it possible to strengthen disease surveillance and response efforts, particularly in regions overwhelmed by health crises. The funds have made it possible to adapt to the changing health landscape, ensuring that resources are channeled where they are most needed to optimize health outcomes.


However, according to 2023 Annual Financial Report and External audit results, in 2023, grant expenditure for activities including C19RM amounted to USD 4,438 million, which is 4% lower than in 2022 (USD 4,631 million). This decrease reflects the first year of Grant Cycle (GC7) and the third year of GC6 implementation, totaling USD 4,484 million. Compared to the GC5 implementation period in 2020, 2023’s expenditure shows a 9% increase, including C19RM. Grant disbursements in 2023 totaled USD 5,013 million, with USD 4,175 million allocated to HIV-TB-Malaria (HTM) activities and USD 838 million towards C19RM.




Between sound financial management and operational agility


In order to consolidate its organizational framework, the Global Fund has taken significant steps to strengthen its internal capacities and adaptability with the introduction of new roles within the organization, and hiring of new staff. It underlines the Fund’s commitment to ensuring that every decision made, and every action taken is guided by a strong sense of ethics and integrity.


In addition, the Executive Director emphasized the financial discipline that has prevailed in managing the Global Fund’s 2023 budget. Despite the financial challenges, the Fund was able to report slightly lower expenditure than forecast. According to the Executive Director, this financial prudence has enabled the organization to allocate its resources efficiently, maintaining a delicate balance between expanding operations and controlling costs.


This balanced approach has strengthened the Fund’s financial health and operational viability. By ensuring that every dollar is spent wisely, the Fund has been able to maximize the impact of its interventions while ensuring its long-term financial stability. This is testament, continued Peter Sands, to the Fund’s commitment to being an efficient, adaptable, and financially responsible organization.


Keeping Pace with Tech and Data


The Global Fund recognizes the crucial importance of technology in improving health data management and operational efficiency. With this in mind, it has made significant investments in IT infrastructure and data platforms. According to Peter Sands, these investments are aimed at strengthening the Fund’s capacity to collect, analyze and use health data effectively.


The establishment of a new IT service center represents a strategic measure to centralize and streamline technological support. This center acts as a focal point for all technological matters, providing Fund staff with access to the assistance and resources they need to carry out their tasks, while reducing operational costs and increasing service efficiency.


At the same time, the Fund has developed advanced platforms that not only simplify data collection, but also improve its accuracy and timeliness. These platforms use state-of-the-art technologies to automate and optimize data collection, ensuring that the most up-to-date and accurate information is always available to inform decisions.


These technological advances are crucial to supporting the Fund’s objectives of improving data quality and operational efficiency. By investing in technology and data management, the Fund ensures that it has the tools and information it needs to effectively manage healthcare programs and respond to global health challenges in a timely and efficient manner.


Challenges and perspectives


The Executive Director’s report examines in detail the challenges posed by the global economic downturn and political instability, which impact on the financing and operating environments essential to the Fund’s initiatives. It highlights the need to address the current crisis in human rights and gender barriers, which are integral to achieving health equity. The Fund has launched multiple actions and strategies for initiatives that target communities most affected and in need so as to build their capacity and improve rights-based approaches to health, ensuring that vulnerable populations have better access to necessary quality health services.


In addition, the focus on financial sustainability through increased domestic resource mobilization and effective public financial management underscores, according to Peter Sands, the Fund’s strategy to ensure the long-term resilience of health systems. By advocating a stronger in-country leadership and national financial base, the Fund aims to reduce country dependence on international funding, thereby strengthening the sustainability and self-sufficiency of national health systems.


At the Global Fund Board, feedback from the stakeholders to the Executive Director’s report revealed a mixture of appreciation and concerns. Delegations welcomed the comprehensiveness of the strategic information provided but expressed significant concerns about a number of pressing and priority issues, including human rights, the resilience of health systems and the need for strong political commitment to advance the Global Fund’s mission.


Indeed, the importance of upholding human rights was strongly emphasized, with a pressing call to move to concrete policies rather than mere declarations. The need to use political leverage to combat human rights violations linked to health crises was also highlighted, underscoring the urgent need for bold action on the part of the Global Fund in this area.


Secondly, stakeholders expressed concern about the decline in official development assistance (ODA)  and stressed the need for greater political commitment at both national and international level. Discussions also focused on the need for sustainable funding models and regional collaboration to ensure a steady supply of medical products. The promotion of local production was also mentioned as a means of reducing dependence on international aid and strengthening the resilience of healthcare systems.


In addition, community involvement and effective supervision were identified as key levers for maximizing the impact of interventions on the ground, underlining the importance of ensuring transparent and efficient use of funds.


In the face of political change, financial constraints and new health threats, the importance of the Global Fund adapting its strategies in a flexible and responsive way was stressed.


Finally, calls were made for the development of strategic policies adapted to current and future needs, with an emphasis on building the capacity of healthcare systems to anticipate and manage crises.


In response to the Executive Director’s report, while there was appreciation of work done, there was also concern about the long-term sustainability of funding models that are heavily dependent on external sources. Stakeholders expressed and emphasized the importance of developing strategies to secure consistent funding that goes beyond just donor contributions. This includes exploring innovative financing mechanisms and ensuring the efficient and transparent use of allocated funds. Ultimately, the goal is to maximize the positive impact on the ground while achieving financial stability for the organization’s future endeavors.


Stakeholders emphasized the need for a balanced approach that protects human rights while maintaining essential health services. Stakeholders also called for stronger guidance and policies to prevent abuses, as well as increased collaboration with governments and communities.


Finally, they urged the organization to develop a more strategic plan to address climate change and its impact on health. There was a call for a balanced approach in applying sanctions so as not to aggravate the situation of vulnerable and key populations, reviewing and strengthening policies to ensure compliance with human rights standards, and promoting community participation to ensure that programs respond to the needs and rights of all, particularly in gender and human rights contexts.


Moreover, the Executive Director recognized the importance of adopting a strategic approach to integrating climate change concerns into health and rights programs, as well as the need for effective coordination of resource mobilization efforts given the upcoming replenishment and collaboration between partners to manage the complex relationships between health, human rights and climate change.





The Executive Director’s report provides a strong framework for the future direction of the Global Fund, characterized by a commitment to strategic growth, organizational resilience and sustainable health initiatives. The achievements cited in the report reflect a solid foundation built on effective strategy implementation, rigorous financial management and innovative technology integration. Looking to the future, the Fund intends to remain true to its mission of eradicating disease by 2030 as a threat to public health, striving to extend its impact through strategic collaborations, technological advances and community-centered approaches.


Despite this ambitious vision set out by Peter Sands, it must be acknowledged that the Global Fund faces many major challenges, such as in human rights violations, particularly those affecting key populations. In this respect, let’s hope that the indicators will be in the green (Figure 2) for the next few Boards.


Figure 2: Performance Paths – KPI progress across reporting periods


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