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Commentary & Opinion

Time for More Global Fund Accountability

January 14, 2011

Ahead of a Global Fund to Fight AIDS, Tuberculosis and Malaria meeting next week to address the issue of donor drugs getting stolen and not reaching the intended patients in Africa, American Enterprise Institute Fellow Roger Bate writes in a Foreign Policy magazine opinion piece that the fund's current "accountability standards don't nearly measure up to its hefty budget and vast influence." Bate provides examples of where donor drugs have been stolen and asserts that each "year, perhaps as many as 30 million donated malaria treatments are stolen, similarly diverted from their intended, needy recipients into the hands of profit-driven distributors."


"The Global Fund gets a third of its donations from the United States, but more than U.S. dollars, it needs American oversight," Bate argues. "Currently, the administrative work done by the international health specialists working for the Global Fund Secretariat is overseen a 20-member board, in which the United States has only one seat. The Global Fund board's consensus-based decision-making is politically expedient, but it lacks the executive, investigative power to ensure real accountability. The Global Fund simply doesn't have the resources to both administer and audit medicinal grants," he writes.

"One model for the Global Fund may be the U.S. medicinal aid system, which controls its own drug purchases for the developing world far more tightly," Bate recommends before explaining how the U.S. system works. "When it encounters a problem with public-sector drug distributors, as it has in Angola, it completely bypasses the troublesome actor -- in this case the Angolan government -- and looks for other private distribution networks, including direct handoffs from U.S. contractors to in-country clinics. The global health community doesn't approve of this approach, however, suggesting that it wastes funds that could in principle be used to treat more people. Perhaps, but it's indisputable that the drugs at least get to where they're supposed to go," he writes. "The new U.S. Congress is lead by a Republican Party that has promised to take a hard look at wasteful spending decisions. The Global Fund, and its broken distribution systems, would be a good place for them to test their mettle," he concludes (1/11).

Back to other news for January 2011

This information was reprinted from with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives, and sign up for email delivery. © Henry J. Kaiser Family Foundation. All rights reserved.

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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily U.S. HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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