U.S. Government Positions on Decision Points from the Forty-Fourth Board Meeting of the Global Fund

U.S. Government Positions on Decision Points from the Forty-fourth Board Meeting of the Global Fund

The Administration provides this report pursuant to Section 202(d)(6) of the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, as amended, which requires that “Following each meeting of the Board of the Global Fund, the Coordinator of United States Government Activities to Combat HIV/AIDS Globally shall report on the public website of the Coordinator a summary of Board decisions and how the United States Government voted and its positions on such decisions.”

Overview

The Global Fund to Fight AIDS, Tuberculosis (TB), and Malaria (Global Fund) – a unique financing mechanism that relies on partnerships among governments, the private sector, and civil society – continues to receive strong support from key donors including the United States, the United Kingdom, France, Germany, Japan, and the Bill and Melinda Gates Foundation.

The U.S. government remains the largest bilateral donor to the Global Fund. In 2019, Global Fund investments provided HIV/AIDS treatment for over 20.1 million people, TB testing and treatment for 5.7 million people, and distributed 160 million insecticide-treated bed nets for malaria prevention.

The Global Fund held its 44th Board meeting virtually November 11-12, 2020. The Board approved three decision points, including the 2021 Work Plan and Operating Expenses Budget.

The U.S. government holds a permanent seat on the Global Fund Board and currently maintains membership on the Board’s standing Strategy Committee. Committee members began their two-year terms on May 15, 2020.

The COVID-19 pandemic has presented unprecedented challenges to Global Fund investments. In April 2020, the Global Fund’s Board unanimously approved two decision points enabling temporary, extraordinary measures to 1) allow the Global Fund to grant funding flexibilities to ensure business continuity and delivery of the Global Fund’s core mission, and 2) provide direct support to countries to rapidly respond to COVID-19 through the newly-created COVID-19 Response Mechanism (C19RM). Each mechanism is funded up to $500 million, for a combined total of $1 billion toward the COVID-19 response. While the United States did vote to approve the decisions, we signaled that it is our expectation that we will have timely and full cooperation from the Secretariat in order for the U.S. government to fully account for fund use. COVID-19-related risk mitigation measures for programs to fight HIV/AIDS, tuberculosis, and malaria must remain the number one priority use of these funds. We also expressed concerns about the weakening of the Quality Assurance Policy, and the Secretariat has agreed to only use these exceptions when there are no alternatives and there is significant risk of program disruptions.

The U.S. government interagency delegation to the 44th Global Fund Board Meeting was led by Board Member Ambassador Deborah Birx, U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy, with Dr. Angeli Achrekar, Principal Deputy Global AIDS in the State Department’s Office of the Global AIDS Coordinator and Health Diplomacy as Alternate Board

Member. High-level representation from USAID included Alma Golden, Assistant Administrator for the Bureau for Global Health and Ken Staley, U.S. Global Malaria Coordinator.

All decisions taken at the meeting are available online at: https://www.theglobalfund.org/en/board/decisions/

All U.S. government positions are outlined below.

U.S. Government Positions on Board Decision Points – Note: all of the Decision Points below were approved by the Board during the 44th Board Meeting

Appointment of the Rapporteur (GF/B44/DP01)

The U.S. government supported the decision to designate Robin Montgomery from the Developed Country NGOs constituency as the Rapporteur for the 44th Board Meeting.

Approval of Agenda (GF/B44/DP02)

The U.S. government supported this decision point.

2021 Work Plan and Operating Expenses Budget (GF/B44/DP03)

The United States voted to approve the Secretariat’s request for $315 million for the 2021 Operating Expenses Budget. This is $10 million more than the 2020 budget, and while COVID-19 delivered cost-savings in some areas such as travel, the Secretariat expects to incur greater costs responding to the effects of COVID- 19 in 2021. The budget therefore includes COVID-19-related costs, continued investment in strategic capabilities, including finalizing the Monitoring, Learning, and Evaluation Framework, reinforcing financial performance, investing in digital and IT infrastructure, and maintaining investments in organizational maturity, risk and assurance management, and overall business process improvement.