Global Fund forges ahead – Key countries face reapplication

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Despite uncertain funding, the Global Fund Board has decided to issue a call for proposals for Round 11, which will launch on Aug. 15, 2011 with a submission due date for applicants of Dec. 15, 2011. The board recently concluded its 22nd meeting in Sofia, Bulgaria.

This is a later launch date than health advocates had hoped for.  Funds will not actually flow to the countries until early 2013 because it takes on average eight months to negotiate and sign grants with the Global Fund.

However, it is welcome news that the call for proposals will take place in 2011, instead of even later or not at all.  The Fund is the world’s largest source of financing for tuberculosis programs and it is a crucial source of financing for malaria and AIDS programs.

At the meeting, the board also approved grants for Round 10 worth a total of $1.7 billion – $732 million for HIV and AIDS, $574 million for malaria, $299 million for TB and $128 million for health systems strengthening.   Zambia, South Africa and Kenya were among the list of countries with successful HIV proposals, while TB proposals from Afghanistan, Indonesia and Bangladesh, among others, also succeeded.  But, as stated in a previous posting, the Fund rejected a large number of proposals for Round 10 from countries in urgent need of external resources, including many in Africa.

The Fund’s Technical Review Panel (TRP) rejected HIV proposals from Ethiopia, Nigeria, Congo DRC, Tanzania, Mozambique, Lesotho, Swaziland, Zimbabwe and Malawi, among others. The part of Uganda’s proposal providing for direct services for those with or at risk for HIV disease was also denied, while the health system strengthening component was accepted. The TRP also rejected TB proposals from Zimbabwe, Tanzania, Mozambique and Ethiopia, among others.  Also of note, outside of Africa HIV and TB proposals from Cambodia and Tajikistan also failed.

AIDSPAN has a full list of proposals by country, and the TRP will be releasing a report with general comments and concerns on the proposals.

Many of these proposals can be resubmitted following substantial revisions, and so the decision to proceed with Round 11 was certainly welcome news.  Medecines Sans Frontieres warned that the Global Fund is a lifeline for many countries, given that “governments and donors such as [the President’s Emergency Plan for AIDS Relief (PEPFAR)] and UNITAID are requesting the Global Fund to take over the responsibility for ensuring the continuity of HIV/AIDS funding in several countries.”

“It is urgent that countries like Malawi–with a bold plan to halt mother-to-child transmission of HIV which did not have a successful grant this round–have a chance as soon as possible to get urgently needed resources flowing,” said Matthew Kavanagh of Health GAP (Global Access Project). “But we are very glad to see that the board reaffirmed its commitment to the Global Fund’s demand-driven model, financing all quality programs in Round 10.

“What is outrageous, though, is that some donors like Spain are not fulfilling the pledges they’ve made and collectively the donors are coming up short of what is needed,” Kavanagh continued. “ I hope the Obama administration—having made a three-year pledge—both builds up this pledge but also turns its diplomatic muscle to ensuring the global commitment is maintained to the most vulnerable people on the planet.”

The Fund’s board also issued a decision point that encourages countries to strengthen the maternal and child health content of their applications, and it directed the secretariat to provide guidance for this to countries.

The launch of Round 11 makes it even more important that President Obama include a large increase for global AIDS, including for the Fund, in his fiscal year 2012 budget proposal, as urged this week by Donna Shalala, PhD; Paul Farmer, MD, PhD; Michael Klag, MD, MPH; Jim Yong Kim, MD, PhD; Julio Frenk, MD, MPH, PhD, and other public health leaders.

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