WHO CAN FIX FOUR FUNDAMENTAL GLOBAL FUND PROBLEMS?

Author:

Bernard Rivers

Article Type:

Article Number: 2

Bernard Rivers, founder of Aidspan and of GFO, returns briefly from several years away to consider four problems – two new and two old – that plague the Global Fund. What will it take for the Global Fund to recognize that these problems urgently need to be addressed?

After twelve years of immersing myself in the Global Fund world, including attending twenty-five board meetings, followed by eight years away from the Fund, I recently spent some time studying the Global Fund again.

At first, my heart surged. The Global Fund’s mission is the noblest imaginable and coming back was like returning to an old love.

But on digging deeper, I found four broad problems. The first two depressed me because I had not previously been aware of them. And the second two depressed me because I had previously been aware of them – all too aware – and nothing has been done to fix them.

Problem #1: Global Fund transparency is decreasing

The Global Fund Board passed a resolution in 2011 reaffirming “the Global Fund’s strong and continuing commitment to the highest standards of transparency.” And the Fund’s current Strategy document says: “The work of the Global Fund is based upon four principles – partnership, country-ownership, performance-based financing, and transparency.” And the Fund’s Operational Policy Manual says “Transparency: All final reports from in-country program reviews and evaluations [must be made] accessible to all stakeholders.” (All italics added by me.)

However, these commitments to transparency are no longer being honoured. It used to be very easy to find and view full information regarding each grant, including Grant Performance Reports and other documents that spell out what exactly has happened with the implementation of individual grants. It’s now significantly harder to find grant information, and when you do find it, the Grant Performance Reports and other key documents are not available. (See here for details. And see a previous complaint in GFO here.)

It’s also no longer possible to find the names and contact details of Global Fund staffers who work in, or at least who lead, each Secretariat department, or to find contact details for Board Constituency Focal Points.

Problem #2: Replenishment is not going well

Every three years – most recently in September of this year – the Global Fund invites its donors to attend a replenishment conference at which they pledge how much money they will give to the Fund over the subsequent three years.

After every replenishment conference, the Fund has announced that a record amount has been pledged. But there are two problems. First, some donors don’t end up giving all the money they pledge. (For instance, Italy has not yet paid €260 million of its 2008-2010 pledge, and the UK has not yet paid £200 million of its 2014-2016 pledge.) And secondly, inflation reduces the buying power of the money the donors give.

 

This chart shows in green the total amount that was pledged, i.e. promised, including additional pledges made after the replenishment conference. And in blue it shows how much of this has actually been given. Finally, in red it shows the inflation-adjusted value of the amount that has been given. Straight-line trends have been added. Green is climbing nicely; blue is climbing rather less; and red is declining. (For source data, see here.)

Yes, it’s true that pledges for the 2023-2025 replenishment period may still increase. (At the time of writing, the UK and Italy have not made pledges.) And yes, some of the money not yet paid for the 2020-2022 replenishment period will probably be paid by early next year. And yes, the US won’t pay its full pledge unless all other donors combined give twice as much as the US. And yes, small portions of some pledges were given in kind as technical assistance rather than in cash to the Global Fund. But I don’t think any of these factors change the broad picture,which is that in terms of actual buying power, the Global Fund’s income has not been increasing. Which makes it unlikely that the world will reach its Sustainable Development Goal of ending the epidemics of AIDS, TB and malaria by 2030.

Problem #3: Global Fund documents are too complex

Key Global Fund documents are written using what some people call Fundspeak – meaning, wording that is sometimes verbose, often overly technical, and nearly always hard to understand. This is because these documents are primarily written by full-time Global Fund Secretariat staffers: good, committed people who unfortunately talk Fundspeak all the time.

The reason that this is a problem is that many of the intended readers of these documents are people who don’t deal full-time with Global Fund issues and/or for whom English is not their first language. For instance, how many of these people will clearly understand the very first paragraph of the Fund’s press release announcing the new Strategy, which said that the Strategy “accelerates the shift to more integrated, people-centered models of treatment, prevention and care”. (See also previous complaints in GFO here, here and here.)

This use of complex and confusing terminology creates a wall around the Global Fund that serves as a barrier to understanding by people who don’t have both feet firmly in the Global Fund world.

Problem #4: Global Fund governance is too cumbersome

As a result of efforts to ensure fairness and equity, the Global Fund has Board meetings at which 28 Board members are authorized to speak, and at which there are over 150 people in the room. Board members who wish to speak sometimes have to wait thirty minutes to do so, meaning that Board meetings don’t involve a conversation, they involve a series of statements.

Furthermore, although each Board member has a duty to represent the interests of the Global Fund as a whole, all of them except the Chair and Vice-Chair also have a duty to represent the interests of their own constituency. When these loyalties conflict, it’s often constituency interests that dominate.

These issues have led to certain tensions. For instance, most Board members think that the Board does a pretty good job, whereas Secretariat leaders often privately think otherwise.

These governance problems have been studied in various reports (e.g. here and here), but despite some innovative recommendations in these reports, the Board has done little other than to occasionally tweak the roles and working methods of Board committees. As a result, the Board is just as cumbersome a decision-making body as it was twenty years ago. During that time, many comparable organizations have improved the structure and effectiveness of their boards, but the Global Fund has not.

So, what should be done?

If all four problems could miraculously be resolved, it would dramatically improve the Fund’s effectiveness. But how can this be achieved? For the Fund to follow “board procedures as usual” is not going to fix things. The Global Fund is like a large ocean liner that sails grandly on, ignoring any waves of outside criticism that may slap its hull from time to time.

Part of the problem is that the Fund is something of a two-headed monster. The Board includes many members who are relatively new to the role and are struggling to understand what exactly is going on. And the Secretariat is run by talented and driven people who at times don’t have a whole lot of use for the Board as it currently functions. The Board and the Secretariat need each other; but they don’t always work well together.

So my heartfelt recommendation is that the new Chair and Vice-Chair, who will be chosen in March and will start their three-year terms in May, should be chosen based on their ability and willingness to be considerably more proactive than has traditionally been the case.

For instance:

• Regarding Problem #1 (Transparency decreasing): The Chair and Vice-Chair could insist to the Executive Director that transparency be restored to the level that the Board resolved on in 2011. And they could inform the Board if this doesn’t happen quickly.
• Regarding Problem #2 (Replenishment not going well): The Chair could hold private meetings or Zoom calls with decision-makers in those donor countries that have not fully delivered on their past pledges or whose pledges have decreased rather than increased. Secretariat staffers have done their best, but they don’t have the standing to say “Minister, I’m the Chair of the Global Fund, and I would very much appreciate the chance to have a private conversation with you on how best to proceed regarding this sensitive matter.”
• Regarding Problem #3 (Documents too complex): The Chair and Vice-Chair could make use of “the politics of embarrassment” by reading out at each Board meeting one or two examples of new Global Fund documents that make excessive use of Fundspeak.
• Regarding Problem #4 (Governance too cumbersome): The Chair and Vice-Chair could review the options that have already been documented (see reports above), and then propose – and passionately advocate for – some ways of making the Board a more nimble body.

The good news is that having a more proactive Chair and Vice-Chair doesn’t require changing the Fund’s bylaws. The only thing that has thus far prevented Chairs and Vice-Chairs from following this path is tradition plus a culture of politeness.

The bad news, however, is that in the job description for the new Chair and Vice-Chair, I see no evidence that the candidates will be asked what their ‘platform’ is. They will be asked who they ARE, but not, I suspect, what they will DO.

I think that’s a mistake. If, when candidates are being considered for these two positions, they can’t prove that they have a track record of “making things happen”, they should not be chosen, however impressive their employment history may be. And if, by the time they take office, the selected candidates don’t already have a very clear idea of the Fund’s strengths and weaknesses and of its complex working methods, they’re not going to accomplish much in the way of change.

The Global Fund needs a Chair and Vice-Chair who have the knowledge and vision to see the problems, the articulateness to describe them clearly to the Board, the insight to come up with innovative solutions, and the political skills to persuade the Board and Secretariat to implement those solutions.

If Board members and their delegations agree with this perspective, they will be doing the Fund a service during the next two months by seeking and nominating candidates for Chair and Vice-Chair who meet these criteria.

*  Bernard Rivers founded Aidspan and its Global Fund Observer newsletter in 2002, the year that the Global Fund started, with the objective of monitoring, explaining and critiquing the Global Fund from a supportive perspective. After ten years he handed over to new leadership and spent 2013-2014 as a visiting fellow at Cambridge University, where he researched and wrote a paper on Options for Reforming the Global Fund Board. All opinions in this Commentary are his own.