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The Global Fund’s Transformation

The Global Fund's Transformation
Time for reform: 1200 pages – an application to the Global Fund

As I wrote last week, the recent appointment of Gabriel Jaramillo as General Manager to The Global Fund signals the international community’s conclusion that the Fund is “too big to fail”.  A former banker, Jaramillo has wasted no time in making promised changes to the Fund.  Since his appointment, the 600 jobs at the Fund have been reviewed and revised (as outlined in Science Speaks), with a number of Fund employees without jobs or competing for new roles.

The big shake-up has shifted the vast majority of the jobs (61%) into grant management, a direct response to the findings of the financial audits last year that revealed fraud amongst grant recipients.  An additional 14% will be focused on Strategy, Investment and Impact (SIID) and the remaining 25% will be focused on support, resource mobilisation and control.

The Fund has published a presentation on its website that outlines the key priorities of the transformation.  The presentation outlines three “workstreams” that will be the focus of 2012, including (1) organizing to deliver; (2) quality and timeliness in proposal development and grantmaking; and (3) simplification of in-country monitoring of grants and risk.  (Clearly Jaramillo has got his management consultants working overtime :))

The new Secretariat structure looks like this:

Resource Mobilisation and Donor Relations is headed up by Christoph Benn, an MD with specialist training in tropical medicine; Grant Management by Mark Edington, a relative newcomer to the Fund who joined earlier last year from Save the Children; and SIID by Debrework Zewdie, a former World Bank-er with a doctorate in immunology.

Why is all of this so important?  After an age of largesse in global health funding, the financial crisis has caused funding increases to come to a screaching halt.  EU sources have all but dried up, the new US budget proposal signals a decrease in PEPFAR (long the largest source of HIV/AIDS funding globally) and private foundations are following suit.  Despite commitments that far outstretch current revenues, the Global Fund is still the most viable multilateral providing funding for global health.  National governments have signalled their hope in the Fund by re-upping their commitments.  Significantly, Obama’s new budget calls for an increase to Global Fund contributions (but a decrease in PEPFAR).

Global health has long been the poster child for success in development funding.  Slowing down the pace of progress at this critical juncture will have implications that reverberate far beyond the realm of current programs.

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