Managing Inequality at the Global Fund
Donors haven’t stepped up to the plate for the Global Fund for HIV/AIDS, TB, and Malaria, creating a significant funding shortfall in their upcoming grant cycle of about $5 billion dollars. In the face of these broken promises, the Global Fund, coming out of their recent Board meeting, is having to resort to perverse bureaucratic management techniques. As the CGD blog’s David Wendt describes, GFATM is using “creative” ways to address the funding gap, by forcing developing country governments to propose increased “efficiency”. I might term the measure “brutal” more than “creative”. It must be difficult for an NGO leader or Ministry of Health member in Haiti, say, to figure out how to distribute and spend their few pennies in the best way possible. Wendt points out that:
Efficiency cuts assume that countries are asking for more than they need or that they could do more with less. According to resources needs estimates by folks like UNAIDS and Roll Back Malaria, many developing countries need far more than what they are asking for. Claiming these cuts will help poor countries “trim the fat” might be viewed as condescending. Whether they can do more with less is probably a moot point.
More than “condescending”, its shameful that donor governments continue to fall short of their responsibilities. The Global Fund here is just the messenger for these broken promises, trying to do the best with what they’ve been given. I know I’m living in utopia, but indulge me atleast in wondering….will there ever be a day where developed countries go beyond the call of duty, instead of falling short? Why is the US or the UK asking instead Rwanda or Haiti or Ethiopia, countries beset with pandemics and poverty, to “trim the fat”? When I read the headlines about the US government failing to trim their own bloated and mal-distributed health care budget or bigger-than-the-entire-world-combined defense budgets, I can’t but wonder how unfair this all really is.
Victor! Thanks so much for writing this post. I’m working in Indonesia now, for the next year, with a community-based organization serving people living with HIV, most of whom are drug users. And I’m seeing the world of international development from a whole new – and very scary! – angle (at KCA our funding is from private donors, students, foundation grants – but not national govts or GF). You make excellent points and it is truly unfair and bizarre, the way this all plays out. It’s irresponsible to create such an enormous mechanism for international assistance only to fail to utilize that system, and leave recipients scrambling to have to replan and reconsider their hard work, to keep services together for people who so desperately need them. Here’s hoping you and I can be in a position to make a serious change one day soon (although in many ways we are already)! Thanks for writing, for living passionately, and I hope all is well at Cambridge
xoxo ko
hi kate,
well said. thanks so much for the comment and for all your work in indonesia. i’m sure you are learning lots – you are much closer than I am – sitting here in nice old Cambridge – to seeing the difficulties that occur when promises are not kept, and countries are over-burdened by intensely shifting priorities, funding probabilities, reporting requirements, etc…lookin forward to hearing more soon and thanks again.
- victor
Thanks, Roy for that statement. I feel choked to hear such comment from Global Fund. I am working in 95 community in Adaklu Anyigbe District in Volta Region in Ghana , my NGO is Strength of Women Foundation . Over the last 5 years we have been supported by National Malaria Control Program, our country recipient for the finding to prevent malaria among pregnant women and children under five. The issue is that most children under five years and pregnant women will be dying from malaria if funding ceases .Maternal and infant mortality will rise and we have to sit down and look on hopelessly. such is life. Anyway thanks for your concern!!!
Thank you for your posting.
Although i don’t come ‘face to face’ everyday with the epidemic of HIV/AIDS or Malaria, I find it repugnant that poor countries that are truly suffering more than others are told to trim the fat. These are the countries that need to be helped the most.
It’s almost like telling a homeless person that you’ll only give them .50 cents this week because they need to learn to stretch their money.