The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Progress Report and Issues for Congress

Publication Date: April 2008

Publisher: Library of Congress. Congressional Research Service

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Research Area: Health

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Abstract:

The Global Fund to Fight AIDS, Tuberculosis, and Malaria, headquartered in Geneva, Switzerland, is an independent foundation intended to attract and rapidly disburse new resources in developing countries for countering the three diseases. The Fund is a financing vehicle, not a development agency, and its grants are intended to complement existing efforts rather than replace them.

The origins of the concept of an independent funding mechanism to fight AIDS and other diseases lie partly in a French proposal made in 1998, in ideas developed in the 106th Congress, and in recommendations made by U.N. Secretary General Kofi Annan in April 2001. President Bush made the "founding pledge" of $200 million for a disease fund in May 2001. The Global Fund was established in January 2002, following negotiations involving donor and developing country governments, nongovernmental organizations (NGOs), the private sector, and the United Nations.

The Global Fund has approved more than 350 grants totaling nearly $5.2 billion for projects in 131 countries, of which about $2.1 billion has been disbursed in 127 countries. To date there have been five "rounds" of funding, with the Board approving proposals in April 2002, January 2003, October 2003, June 2004, and September 2005. However, in September 2005, due to a lack of available funding from donors, only a portion of proposals recommended for approval in Round 5 were officially approved. The remaining tentatively approved proposals received final approval in December 2005 after additional contributions were made. The Global Fund will make grants only if it has funds on hand to cover the first two years of the proposed projects -- an approach known as the Comprehensive Funding Policy. The policy is designed to avoid disruptions to projects due to funding shortages. This is regarded as particularly important with respect to antiretroviral therapy, since interruptions in treatment can lead to the emergence of resistant strains of HIV and to death. Funding for the third through fifth years of the projects is dependent on grant performance and on new donor contributions.

After deducting the mandated 1% rescission, U.S. congressional appropriators provided $544.5 million for the Fund in FY2006. The Administration has requested $300 million for a U.S. contribution to the Global Fund in FY2007. Many supporters of the Fund propose that the United States provide more than the Administration request but others contend that a larger contribution could result in less funds for U.S. bilateral programs. This report discusses the Fund's progress to date, including U.S. contributions to the organization and some potential issues for Congress. This report will be updated as needed. For a comprehensive description of the structure and functions of the Global Fund, see CRS Report RL31712, The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Background.