International Hotspots

AIDS, Tuberculosis and Malaria, and for immunization and vaccines. The World Bank is
an International financial institution. It is the largest funder of HIV/AIDS within the United
Nations system and has a portfolio of HIV/AIDS programs dating back to 1989. In 2000,
the Bank launched the first phase of its response to HIV/AIDS in Sub-Saharan Africa –
the Multi-Country AIDS Program (MAP). This came to an end in 2006 when a second
phase – Agenda for Action 2007-11 – came into effect.
GHI Funding
Tracking funding from GHIs poses challenges. However, it is possible to determine the
amounts of funding GHIs commit and disburse from sources such as the OECD
CRS online database, as well as data provided by individual GHIs (Figure 1).
Since 1989, the World Bank has committed approximately US$4.2bn in loans and
credits for programs, and has disbursed US$3.1bn. Of this total, the Bank's MAP has
committed US$1.9bn since 2000. Through bilateral contributions to HIV/AIDS and
Tuberculosis programmes and donations to the Global Fund, PEPFAR has donated
approximately US$25.6bn since 2003. In July 2008, the U.S Senate re-authorised a
further US$48 bn over five years for PEPFAR II, of which US$6.7bn has been
requested for FY 2010. During the period 2001-2010, donors have pledged US$21.1bn
to the Global Fund, of which US$15.8bn has been paid by donors to the Fund. Gavi has
approved US$3.7bn for the period 2000-2015
Political Economy of GHIs
The amount of political priority given to Global Health Initiatives varies between national
and international governing powers. Though evidence shows that there exists an
inequity between resource allocation for initiatives concerning issues such as child
immunization, HIV/AIDS, and family planning in comparison to initiatives for high-burden
disorders such as malnutrition and pneumonia, the source of this variance is unknown
due to lack of systematic research pertaining to this subject. Global political priority is
defined as the extent to which national and international political leaders address an
issue of international concern through support in the forms of human capital,
technology, and/or finances in order to aid efforts to resolve the problem. Global political
priority is demonstrated through national and international leaders expressing sustained
concern both privately and publicly, political systems and organizations enacting
policies to help alleviate the issue, and national and international agencies providing
resource levels that reflect the severity of the given crisis.
The amount of attention a given global initiative receives is considerably dependent on
the power and authority of actors connected to the issue, the power and impact of ideas
defining and describing the issue, the power of political contexts framing the
environments in which the actors operate to address the issue, as well as the weight
and power of issue characteristics indicating the severity of the issue (i.e.: statistical
indicators, severity metrics, efficacy of proposed interventions, etc.). Factors including
objective measurability, scalability of the issue and proposed interventions, ability to
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