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Global Health Policy Blog


The Global Fund Board will decide this week if it will launch a sixth round of funding this year. Round 5 was officially approved by the Board meeting in September 2005. If announced at this Board meeting, the Round could be approved this fall when the Board meets in Mexico.

Bernard Rivers of Aidspan recently wrote a good explanation of the issues surrounding Round 5. The main arguments for a Round 6 in ’06 are that continued funding is needed to meet the MDGs, the UNGASS Declaration, and the calls for Universal Access; that the Board agreed to hold at least one funding round per year; that countries need regular access to funding in order to plan; that several grants are ending this year and the countries have not secured other funding; and that many countries need another round to re-submit proposals that were narrowly rejected in previous rounds.

The problem is that the Fund doesn’t have the money, and at least two donors - the US and Japan - are opposed to launching a new round. Modifying the Comprehensive Funding Policy to allow pledges for 2007 and beyond to be used for this round is really a shell game. The Fund might be able to launch in 2006, but they will be that much shorter of cash in 2007. The real problem is that the donors are not meeting the need.

Recipient countries have demonstrated that they can achieve results and dramatically scale up services. Good grants in Rwanda, Liberia and many other countries are reaching the end of their lifecycles. Unless there is another round, these excellent programs will be forced to shut down. The Fund’s Continuation of Treatment Policy only extends the grant lifecycle for life-prolonging drugs, like ARVs, but do not continue prevention and many other services.

Without regular rounds of funding, or a shift to continuous funding, the countries will not be able to plan their programs. How can countries scale up HIV testing, change to more expensive malaria drugs, or increase DOTS if they can’t plan for the future?

What seems increasingly likely will be a limited round this year. Board members are discussing limiting the round to programs set to end in the next year, to proposals that were rejected in the last round, or to countries with few existing grants. While this would be good for those countries, it is a dangerous move for the Fund. It sets up a future precedent for small rounds, and consequently a smaller Fund. And most likely it would allow the donors to claim that they are adequately funding the Fund.

If the Fund can’t fully launch this year, it is a poor omen for the future. It is time for the donors to step up and fully fund the Fund, as they promised they would.

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