The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)
The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)

The Global Fund galvanizes support for the fight against AIDS, TB and malaria, working with partners to support the most effective prevention and treatment. We have an historic opportunity to seize new advances in science and apply practical experience to defeat these diseases and remove them as threats to public health. Working together, we can do great things.


An introduction to the Global Fund: The Global Fund was created to save lives. Since it was founded in 2002, it has changed the way world is working to defeat AIDS, tuberculosis and malaria. In this short film are portrayed some of the Global Fund's achievements thus far, and the prospect for a world where AIDS, Tuberculosis and Malaria can be overcome.

The Global Fund’s model is based on the concepts of country ownership and performance-based funding, which means that people in countries implement their own programs based on their priorities and the Global Fund provides financing on the condition that verifiable results are achieved.

Since its creation in 2002, the Global Fund has become the main financier of programs to fight AIDS, TB and malaria, with approved funding of US$ 22.9 billion for more than 1,000 programs in 151 countries. To date, programs supported by the Global Fund have provided AIDS treatment for 3.6 million people, anti-tuberculosis treatment for 9.3 million people and 270 million insecticide-treated nets for the prevention of malaria. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts in dealing with the three diseases.

A New Development Framework

When global leaders adopted the "Monterrey Consensus" in 2003, it was a milestone in the evolution of development and international affairs. It established a framework firmly rooted in a 21st Century approach that moves beyond the paternalism of the past to a new era of shared responsibility and mutual accountability for results between, on the one hand, low- and middle-income countries and, on the other, high-income countries.

Now, with the Millennium Development Goals approaching their due date in 2015, important discussions are heating up in capitals around the world about what will come next. Let's consider some basic principles and fundamental changes in the global economic and political landscape since the turn of the Century.

Existing institutions, including direct programs between countries, UN organizations and development banks, have realigned their work to the new principles; and a number of new institutions, including the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Global Alliance for Vaccines and Immunizations were created in purpose and structure as manifestations of Monterrey's principles. The work of these institutions has helped to enable remarkable gains in lives saved and lifted up, although much remains to be done.

Today, a number of countries have significant economic growth and political clout and with increasingly prominent roles on the world stage. This new status is reflected in the establishment of, and growing influence of, the G20.

Although the basic principles of shared responsibility and mutual accountability are universally applicable, the existing development frameworks were largely created as a reaction to the paternalism of the past. In fact, although a shift has begun, the very language of development --- "donors," "recipients," "assistance" -- remains tinged with the asymmetries inherent in traditional development doctrine. That framework leaves little room for those who have transitioned from colonies and/or low-income countries but, understandably, have little interest in a framework that viewed them as recipients in need of assistance.

Perhaps it is time for a new Monterrey Consensus to define the principles and framework for the engagement of emerging powers in development. This new consensus would not replace the sound principles of the current agreement, but would identify the unique role of an important group of important countries -- membership in which will grow over time -- within that framework.

Principles might include: reaffirmation of the basic principles of shared responsibility and mutual accountability; a commitment to support and participate in the planning processes and funding priorities of low- and middle-income countries rather than create parallel engagement; focusing investments globally or in regions or countries of particular interest as co-investors with other development partners under national strategies; technical exchange, and; over time, increasing participation as a funder of multilateral organizations that recognize the importance and unique roles of the emerging powers in their governance structures.

Emerging powers are well positioned to have an enormous impact on the regions in which they reside as well as on the global stage. They should maximize this impact in positive and mutually beneficial ways, helping to lead and support strategies for global and regional growth. However, it would better fit the underlying development framework to co-invest with current partners supporting national strategies rather than further complicating an already messy array of organizations countries must work with. It is important that emerging powers not fall into the errors of the past, creating new forms of paternalism or neo-colonialism.

Countries that have transitioned more recently from development struggles are uniquely positioned to share their experience and technical knowledge because their circumstances are closer than those of high-income countries. However, there should be a two-way exchange because, as many emerging powers know from their own experience, spectacular innovation can occur in resource constrained environments.

Although there are mechanisms intended to give such countries a "seat" and a "voice" at the table, through the G20 or the rotating members of the UN Security Council, this has not often translated into meaningful and actionable political weight around common interests. In seeking to represent and lead on shared rather than purely national interests, emerging powers can step up on the world stage in a powerful and influential way.

Having benefited in many cases from external multilateral resources over the past decades, it is also time for the emerging powers to consider expanding their investments through such organizations to become fully engaged in the global dialogue and in the investment approaches required to realize the principles of shared responsibility and mutual accountability.

But we should not expect emerging powers to simply adapt to existing models of development. They may generate their own models, which the rest of the world should welcome and support. And collectively, those of us in the development community should think hard about how we -- in our models and institutions -- must evolve to embrace and promote the emerging powers' potential for effecting positive impact regionally and globally. We will also need to imagine and create new, structured ways of measuring and encouraging accountability around new models and principles.

As the first Monterrey Consensus laid the lasting foundations for a new approach to development, round two could establish the framework for the productive engagement of emerging powers. It is only with the full participation and leadership of these countries that we can achieve a harmonious, sustainable world in the post-MDG era. (by Mark Dybul and Julio Frenk, 9 January 2014)

Mark Dybul is the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Julio Frenk is the Dean of the Harvard School of Public Health.

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