The Global Fund to Fight AIDS, TB and Malaria is under assault, and without a strong response from the global health community to this week's unwarranted attack, the Fund's future could be in doubt.
The attack came in the form of an Associated Press and Fox News stories that appeared days before President Obama's State of the Union address, when the president outlines his priorities and sets the stage for submission of his budget. The timing of the story -- and the velocity with which it was picked up by newspapers nationally and internationally -- is no coincidence. It's always easier to cut programs that have been criticized. Congress -- carving knives at the ready -- is preparing to make critical decisions about how the U.S. spends money.
Some of that money in recent years has gone to The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), an international financing institution that invests pledges from donor countries to local and national groups that determine priorities for their fight against disease. But the Global Fund has become a prime target, more so than other U.S. aid programs, because it is an independent, multi-lateral body not subject to U.S. diplomatic or defense considerations. The Global Fund simply does critical, important work to save lives.
In fact, the Global Fund has become the world's most effective international organization, having saved more than six million people infected with AIDS, TB and malaria.
By coincidence, I was in Geneva last week meeting with Global Fund officials when the AP story appeared. Great alarm permeated the halls of the Global Fund. This is an organization that has placed intense focus on being both transparent and meticulous about its funding, placing significant power in the hands of its inspector general.
It is that very transparency that led to the story. Last year, the Global Fund itself reported a handful of problems in four of the Global Fund's 145 grant-receiving countries. In total, it noted financial impropriety in 3/10s of one percent of its grants -- and most of the money has already been recovered.
Let me repeat that number: 3/10s of one percent of its grants, involving three percent of its recipient countries. I don't know about you, but I'm not that accurate balancing my own checkbook. Don't get me wrong: This is a huge amount of money -- $34 million out of $3 billion dispersed funds reviewed thus far -- and the Global Fund must account for every penny. But these are honest officials saving millions of lives by getting treatment directly where it is needed. And they are carefully protecting donor funds.
Another 25 country programs will be reviewed by the Inspector General this year, so as the Global Fund's zero tolerance for corruption policy is implemented, please do not be surprised when these findings are transparently made public in the months ahead.
Any fraud is outrageous. But corruption is a danger whenever money changes hands, particularly in the developing world. Tax fraud in the U.S. itself reaches hundreds of billions of dollars. Lest we forget, massive banking fraud was uncovered during the recent U.S. financial crisis. The Global Fund is unusual in how public and proactive it has been.
Additionally, the Global Fund is a learning organization which continually strives to optimize efficiency and impact. A year ago, the Global Fund board announced a series of changes in its funding mechanism, revising prioritization, streamlining its grants process to reduce transaction costs and tweaking eligibility standards. It also is doing a much better job of coordinating with other funders to make itself more effective. These reforms demonstrate a real commitment to improvement, and to saving even more lives.
What's really going on? The Obama Administration is about to release its next fiscal year budget. The stakes are huge, with enormous pressure from Congress to rein in spending. The easiest of targets is international aid, particularly when it is detached from U.S. military priorities. Cutting foreign assistance doesn't matter much to voters back home.
The Obama Administration came up painfully short on its Global Fund pledge last fall, offering $4 billion over three years, or $2 billion short of its fair share. That may sound like a lot of money, but consider by comparison that the U.S. has chosen to forgo $68 billion through recent changes to the estate tax that exempt inheritances of $5 million or more.
The Global Fund is set up so that donors pledge matching funds. Therefore, the U.S. shortfall significantly reduced overall pledges, forcing the Global Fund to scale-back its programs, rather than scale-up or maintain treatment levels. The result is that three million HIV-infected people will go without anti-retroviral treatment, leaving 500,000 babies vulnerable to transmission from their mothers, adding to the world's burden.
President Obama did not say a single word about global health and development in his State of the Union address. The Global Fund clearly is not a priority. That means there is a real danger that the AP story will be enough for those seeking to gut the Global Fund to argue against further financial commitments.
It is up to us to make sure that the President and Congress leave the Global Fund alone. I urge you to take a simple action: Email this column to everyone you know, particularly your member of Congress and the White House. Let our leaders know that the Global Fund to Fight AIDS, Tuberculosis and Malaria is too important to be decimated because of false attacks.
Dr. Paul Zeitz is president of the Global Peace Action Network, whose signature program is the Global AIDS Alliance
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