Reaching the marginalized: EFA global monitoring report, 2010; 2010

THE AID COMPACT: FALLING SHORT OF COMMITMENTSReforming the Fast Track Initiativeresubmitted, and if it is again rejected, theapplicant country can appeal to an independentpanel. Another institutional mechanism, theGlobal Implementation Support Team, hasprovided funds to build the technical capacityof Country Coordinating Mechanisms. 39 Theseprocesses contrast with FTI arrangements intwo key respects. First, at the national level thelocal donor group is just one of several actorsdeciding whether national plans should besubmitted for funding. Second, once plansare submitted, donors have a limited voice indetermining whether they are endorsed. Inmarked contrast, the Catalytic Fund committeecan reject applications with no explanationand give applicants no recourse to appeal.Working in fragile states and countries affectedby conflict. From the outset the board of theGlobal Fund has recognized the need to developways of working in conflict-affected countriesand fragile states, which receive about a thirdof total financing (Sridhar and Tamashiro, 2009).While the FTI’s Catalytic Fund committeerejected a financing request from Liberia andhas failed to disburse funds to Sierra Leone, theGlobal Fund has delivered about US$54 millionto Liberia and US$43 million to Sierra Leonesince 2004 (Global Fund, 2009b, 2009e). Concernsover national capacity and reporting systems inFigure 4.21: The Global Fund has broad-based donor supportTotal donor allocations to the Global Fund to Fight AIDS, Tuberculosis and Malaria, 2001–20096 donors*:US$500-999 million8 donors**:US$100-499 million30%4 donors***:US$20-99 million1%13%28 donors****:Less than US$20 million1%7%Italy: US$1.0 billion8%26%14%United States: US$3.5 billionJapan: US$1.0 billionFrance: US$1.9 billion* Canada, the European Commission, the Bill and Melinda Gates Foundation, Germany, the Netherlandsand the United Kingdom, each contributing US$500-999 million.** Australia, Denmark, Ireland, Norway, (RED), the Russian Federation, Spain and Sweden, each contributingUS$100-499 million.*** Belgium, Luxembourg, Switzerland and UNITAID, each contributing US$20-99 million.**** Brazil, the Chevron Corporation, China, the Communitas Foundation, Debt2Health, Finland, Greece,the Hottokenai campaign, Hungary, Iceland, Idol Gives Back, India, Kuwait, Latvia, Liechtenstein, Mexico,New Zealand, Nigeria, Poland, Portugal, the Republic of Korea, Romania, Saudi Arabia, Singapore, Slovenia,South Africa, Thailand and Uganda, each contributing less than US$20 million.Allocations are reported up to April 2009.Source: Global Fund (2009c).Box 4.16: Private sector initiativesOne feature of the Global Fund has beensignificant contributions from philanthropicorganizations, along with a range ofinnovative financing strategies. Amongthe most important are:Private foundations. The Bill and MelindaGates Foundation has committed overUS$11 billion to global health programmessince it was set up in 1994. Since 2001,it has contributed US$550 million to theGlobal Fund.Debt2Health. Under a programme begunin 2007, national debt to foreign creditorsis converted into a fund to supportnational health programmes. Germanyand Indonesia took the first step,converting US$72 million in debt.Germany has agreed with the Global Fundto make a further US$290 millionavailable by 2010.(Product) RED. Launched in 2006, (RED)is a brand leased to companies topromote sales in return for the transferof a small share of the profit to the GlobalFund. Partners include American Express,Apple, Dell and Motorola. The initiativehas generated more than US$134 millionfor the Global Fund.UNITAID. Created in 2006 in a jointinitiative by Brazil, Chile, France, Norwayand the United Kingdom, this is aninternational drug purchase facilityfinanced largely by air ticket levies. Ithas raised more than US$600 million,including around US$39 million directedthrough the Global Fund.Sources: Global Fund (2008a, 2008c, 2009c);UNITAID (2008).The Bill andMelinda GatesFoundation hascommitted overUS$11 billion toglobal healthprogrammes39. Seven agencies – WHO,UNFPA, UNICEF, UNDP,UNAIDS, the Global Fund andthe World Bank – formed theGlobal ImplementationSupport Team (GIST) in 2005to address capacityconstraints. Based atUNAIDS, it now includesGermany and the UnitedStates as well as otherorganizations. It hasdeveloped technical toolsand a database to supportcapacity development.263