Annual Report 2004 © The Global Fund to Fight AIDS, Tuberculosis and Malaria 2005
ISBN 92–9224–023–4
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Global Fund concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the Global Fund in preference to others of a similar nature that are not mentioned.
This Page Homecare volunteer Thulile Dlamini, aged 25, packs her bag with homecare supplies such as gloves, paracetamol and soap. She walks long distances to visit clients in the areas surrounding her village in Swaziland. The Global Fund Annual Report 2004
5 Message from Chair + Vice-Chair 7 Message from Executive Director 8 Core Operating + Governance Structures of the Global Fund
10 World maps illustrating country coverage of Global Fund grants by disease
11 World map illustrating per capita health investment by the Global Fund
12 2004: The Year in Review 18 Performance Measurement What the Global Fund Measures + How
Global Fund Operations + Results 22 Resource Mobilization, Communications + Advocacy 26 Pledges + Contributions to the Global Fund 28 Secretariat Management 36 Grant Performance
Country Profiles 11 Moldova 17 Burundi 39 Morocco
Approved Grants + the Organization 44 Approved Grants 54 List of Board Members (2004) 56 Technical Review Panel (2004) 58 Global Fund Secretariat
63 Financial Statements 2004 In Central Jail, Bilaspur, India, treatment success has increased significantly with the introduction of diagnosis and treatment under DOTS, funded with a Global Fund grant. Inmates in the tailoring workshop make clothes, which are sold in the prison shop and local markets. Global Fund Annual Report 2004 5
Message from the Chair + Vice-Chair
The Global Fund to Fight AIDS,Tuberculosis and Malaria was created out of a global commitment to stop the spread of three diseases which together kill six million people every year and put a brake on economic and social development in large parts of the world.
In 2004,we displayed this commitment through a substantial increase in pledges and a fourth round of grant approvals,which bring the Global Fund’s total pledges to US$ 5.9 billion and its grant commitments to US$ 3.1 billion for over 300 grants in 127 countries.
The past year has been a year of expansion,of consolidation,and of development.The volume of our activities has grown substantially.The Board,the Secretariat,recipients and partners have continued to find ways of working better together.We have further established and embedded our procedures for the Global Fund’s work.Most important, the grants have turned into actual programs on the ground,which in time have turned into results.
The Global Fund finances effective programs,designed,owned and implemented by public- private partnerships in recipient countries.We measure our success by the results achieved by these programs.In 2004,the first results appeared.While they naturally are modest in scope,these early results are heartening and reinforce our belief in performance-based funding,a core principle for the Global Fund.
The past year has provided numerous lessons in what is needed to achieve results and in how to assist in overcoming challenges.These lessons have deepened and focused the collaborations between all the partners and stakeholders who together make up the Global Fund network.The achievements of this year are the achievements of all those who have participated in the projects we fund; the challenges are ours to solve together.
The Global Fund is unique,but it is a product of the collective experience and vision of all who have engaged in its creation and development.The year reviewed in this publication reinforces our belief that the Global Fund is a worthy endeavor.It strengthens our commitment to further develop and improve our ability to save lives.
It has been an honor to serve the Fund and the communities it aids over the past two years.We offer our thanks and gratitude to the staff of the Secretariat and our fellow Board members for their support and commitment.
Tommy G.Thompson Dr Hélène Rossert-Blavier Chair of the Board Vice Chair of the Board
Secretary of Health and Human Services Director General Department of Health and Human Services AIDES United States of America France In Bucharest, Romania, outreach workers travel by van and on foot at night to reach injecting drug users with needle exchange services, condoms and referrals for HIV testing. Global Fund Annual Report 2004 7
Message from the Executive Director
The year 2004 was a year of substantial growth and progress for the Global Fund and its mission. Total resources pledged to the Global Fund rose from $4.9 billion to $5.9 billion.Round Four of investments was launched,bringing our total portfolio of investments to 310 programs in 127 countries.At the end of the year,the two-year value of this portfolio stood at $3.1 billion and the five-year value at $8.1 billion.
An extremely successful Partnership Forum was held in Bangkok,at which the Global Fund was able to listen to and learn from the criticisms and suggestions of many stakeholders from all around the world.The Global Fund held its first African Board Meeting in Arusha,Tanzania,and Board Members were able to undertake informative site visits to programs in Kenya,Rwanda, and Tanzania.I particularly appreciate the assistance and hospitality of President Benjamin Mkapa and the Tanzanian Government in making this historic event so successful.
The year 2004 was also a year in which the Secretariat,the exceptional group of women and men in Geneva who do the daily work of the Global Fund,strengthened and expanded.Staff numbers increased during the year from 80 to approximately 120.The Secretariat was reorganized at mid- year.Importantly,systems and procedures were steadily improved to ensure that our services are of the highest quality and that we are fully able to respond to the rapid expansion in our portfolio of investments.
The results that we share with you in this report and elsewhere show substantial achievement and provide reassurance that the Global Fund is on the right track and that the programs we are financing are making a positive difference in the lives of millions of people around the world.The results reported also give confidence that our overall model of country-led,performance-based financing is sound and is working.However,there is no room for complacency.At the end of 2004 the average age of the programs in our portfolio was only 11 months.Phase 2 Renewals,the acid test of performance-based financing,had not yet begun and,most importantly,the large-scale results,in terms of infections prevented and lives saved,had not yet been achieved.There is much yet to be done,and 2005 will be a pivotal year,especially for the achievement of results and our ability to measure these results in a credible and transparent fashion.
I would like to thank the many people and organizations who have contributed to the Global Fund’s success and helped us to improve our systems and procedures.Particular thanks should go to the many partners and stakeholders who have expanded the guidance and technical assistance that they provide to recipients of Global Fund finance,often in spite of their own limited resources. The Global Fund is a financing mechanism.The massive scale-up in response to AIDS,TB and malaria,that we all desire,can only be achieved if we work closely with all partners,including multilateral and bilateral organizations,civil society and the private sector,to ensure that the money flows to well designed and effectively managed programs which will bring real and rapid improvement in the lives of people and communities throughout the developing world.We look forward to further strengthening these partnerships in 2005.
Professor Richard G A Feachem Executive Director
8 Global Fund Annual Report 2004 Core Operating + Governance Structures of the Global Fund
mented in a phased approach in Seven core structures form the basis for 2005. In July 2004,the Global Fund held the governance and operation of the Global its First Biennial Partnership Forum in Bangkok with 450 participants Fund: the Board, the Secretariat, the Techni- from varied stakeholder constituen- cies.The Forum,which is a formal cal Review Panel, Country Coordinating part of the Global Fund’s governance structure,provides an external advi- Mechanisms, Principal Recipients, Local sory function by inviting diverse stakeholders to review the Global Fund Agents and the Partnership Forum. Fund’s progress and provide input for improvement.The Forum was the culmination of six months of re- These bodies are complemented by a private sector and private founda- gional meetings and on-line commu- broad network of partners that pro- tions,as well as key operating part- nications,which provided the basis vide critical support for the develop- ners.At its eighth Board meeting in for discussion and debate in ment of grant proposals,the imple- June 2004,the Board approved the Bangkok.A formal report containing mentation of funded programs and status change of the member for a series of recommendations by the the smooth running of related NGOs Representing Communities Forum was submitted to the Global processes such as drug procurement Affected by the Diseases from non- Fund’s Board for consideration at its or human resource development. voting to voting member.This in- tenth meeting in November 2004. The Global Fund’s Board ap- creased to 19 the number of voting A Secretariat,staffed by approxi- proves grants and supports resource members and reduced to 4 the num- mately 120 professional and admin- mobilization to meet the Global ber of non-voting members.An ad- istrative personnel in 2004,conducts Fund’s financial needs.In March ditional (voting) seat representing day-to-day operations; mobilizes re- 2004 at its seventh meeting,the donors will be added to the Board at sources from the public and private Board appointed Dr.Hélène Rossert- a future date. sectors; manages grants; provides fi- Blavier,the General Director of the In 2004,the Board had six ad hoc nancial,legal and administrative sup- French NGO AIDES and the mem- committees: Governance and Part- port; collects strategic information ber representing Developed Country nership; Monitoring,Evaluation,Fi- and monitors performance; supports Nongovernmental Organizations,as nance and Audit; Portfolio Manage- the Board,its committees and the its Vice-Chair,replacing outgoing ment and Procurement; Resource Technical Review Panel; and reports Vice-Chair Dr.Suwit Wibulpol- Mobilization and Communications; information regarding the activities prasert from the Ministry of Public Partnership Forum and Ethics.At its of the Global Fund to the Board and Health in Thailand.Until June 2004, tenth meeting in Tanzania in Novem- to the public.The Secretariat is based the Board had 18 voting members ber 2004,the Board approved in Geneva,Switzerland.At its seventh and five non-voting members,repre- changes to its committee structure to meeting in March 2004,the Board senting donors and recipient coun- increase effectiveness and streamline reappointed Dr.Richard Feachem as tries,NGOs and communities living Board processes.These changes will Executive Director of the Global with and affected by the diseases,the be further elaborated and imple- Fund for a second two-year term. Core Operating + Governance Structures Global Fund Annual Report 2004 9
As the Global Fund has no staff Guiding Principles outside its Secretariat in Geneva,it contracts a Local Fund Agent (LFA) for each recipient country to assess Seven principles guide the policies and operations of the Global Fund, from the capacity of a nominated PR to its governance to its grant-making. These principles reflect a consensus manage and administer grant pro- by the many stakeholders whose consultations in 2001 laid the foundation ceeds,manage the implementation of for the Global Fund. funded programs and report on fi- nancial and programmatic progress. The Global Fund: The LFA also verifies all disburse- ment requests,progress updates and 1. Operates as a financial instrument, not an implementing entity. reviews annual audit reports.In 2. Makes available and leverages additional financial resources. 2004,following a competitive inter- 3. Supports programs that evolve from national plans and priorities. national tender,the Global Fund confirmed the following firms as its 4. Operates in a balanced manner with respect to different geographical LFAs in recipient countries around regions, diseases and health-care interventions. the world: Chemonics International 5. Pursues an integrated and balanced approach to prevention, treatment, Inc.,Crown Agents for Overseas care and support. Governments and Administrations 6. Evaluates proposals through an independent review process. Ltd.,Deloitte Touche Tohmatsu 7. Operates transparently and accountably and employs a simplified, Emerging Markets Group,KPMG rapid and innovative grant-making process. International,Pricewaterhouse Coopers,the Swiss Tropical Institute of Chad and the United Nations Of- fice for Project Services. The Global Fund is a financing institution and not an implementing agency.As such,it relies upon its partners to provide technical assis- The Technical Review Panel ing funding from all sources.After tance and capacity-building support (TRP) is an independent body of in- the Global Fund approves a grant,the to current and potential grant recipi- ternational health and development CCM oversees implementation of ents.Bilateral agencies,businesses experts that assesses all grant pro- funded programs,reviews reports of and foundations,nongovernmental posals for technical and scientific Principal Recipients and ensures and multilateral organizations — merit based on global best practices. cross-sector coordination.CCMs are including UNAIDS,the World Members convene for two weeks in central to the Global Fund’s commit- Health Organization and the World Geneva to review the proposals sub- ment to local ownership and partici- Bank — work side by side with mitted for each funding round,and patory decision-making. Country Coordinating Mechanisms the TRP then makes recommenda- For each grant,at least one Princi- to develop high-quality proposals,to tions to the Board on proposals that pal Recipient (PR) is accountable for strengthen local capacity to manage deserve funding.The TRP also pro- the resources committed and dis- grants and to assist in the implemen- vides ongoing support to any pro- bursed by the Global Fund.The PR, tation of grant-funded programs. posal clarifications following Board which is nominated by the CCM and The World Health Organization pro- approval. approved by the Global Fund,super- vides international clinical standards Before a country applies to the vises program implementation,often for medical responses to AIDS,tuber- Global Fund for a grant,it normally with several sub-recipients.PRs work culosis and malaria,and plays an im- convenes a multisectoral Country with the Secretariat and sub-recipi- portant role in the prequalification of Coordinating Mechanism (CCM), ents to develop program goals,per- drugs for the three diseases.UNAIDS which represents public and private formance indicators and targets to be is playing an essential role in provid- sectors,including government,non- included in an initial two-year grant ing important technical support at governmental and faith-based or- agreement.At intervals specified in the country level and support and ganizations,people living with and the agreement,the PR requests dis- strategic advice for monitoring and affected by the diseases,bilateral and bursements from the Global Fund evaluation at local and national levels. multilateral development agencies, based on verified progress updates and academic institutions.The CCM and the cash requirements of the develops and submits grant propos- program.This is the foundation for als to the Global Fund based on na- the Global Fund’s system of perform- tional strategies,multi-stakeholder ance-based grant making and its priorities and identified gaps in exist- focus on tangible results.
10 Global Fund Annual Report 2004
World maps illustrating country coverage of Global Fund grants by disease
HIV/AIDS
Georgia Multi-country Uzbekistan *** Meso: Ghana Western Vietnam Belize, Costa Guatemala Pacific***** Yemen Rica, El Salvador, Guinea Myanmar Zambia Guatemala, Hon- Guinea-Bissau Namibia Zimbabwe duras, Nicaragua, Guyana Nepal Panama Haiti Nicaragua * CARICOM Honduras Niger Antigua & Barbuda, **** OECS: India Nigeria Bahamas, Barba- Antigua & Barbuda, Indonesia Pakistan dos, Belize, Do- Dominica, Grenada, Iran (Islamic Papua New Guinea minica, Dominican St. Kitts & Nevis, Republic of) Peru Republic, Grenada, St. Lucia, St. Vincent Jamaica Philippines Guyana, Haiti, & the Grenadines Jordan Romania Jamaica, St. Kitts Kazakhstan Russian Federation & Nevis, St. Lucia ***** Western Kenya Rwanda St. Vincent & Pacific: Kyrgyzstan Senegal the Grenadines, Cook Islands, Fiji, Lao PDR Serbia Suriname, Federated States of Lesotho Sierra Leone Trinidad & Tobago Micronesia, Liberia Somalia Kiribati, Niue, Macedonia, FYR South Africa ** CRN+: Palau, Samoa, Madagascar Sudan Antigua & Barbuda Solomon Islands, Afghanistan Bolivia Chile Djibouti Malawi Suriname Dominican Repub- Tonga, Tuvalu, Algeria Botswana China Dominican Republic Mali Swaziland lic, Grenada, Vanuatu Angola Bulgaria Colombia Ecuador Moldova Tajikistan Guyana, Haiti Argentina Burkina Faso Comores El Salvador Mongolia Tanzania Jamaica, St. Kitts Armenia Burundi Congo (Democratic Equatorial Guinea Morocco Tanzania/Zanzibar & Nevis, St. Lucia, Azerbaijan Cambodia Republic) Eritrea Mozambique Thailand St. Vincent & Bangladesh Cameroon Costa Rica Estonia CARICOM* Togo the Grenadines, Belarus Central African Cote d'Ivoire Ethiopia CRN+** Turkey Suriname, Trinidad Belize Republic Croatia Gabon Meso*** Uganda & Tobago Benin Chad Cuba Gambia OECS**** Ukraine
Tuberculosis Afghanistan Ethiopia Namibia Uganda Angola Georgia Nepal Uzbekistan Bangladesh Ghana Nicaragua Vietnam Benin Guinea-Bissau Pakistan Yemen Bhutan Guyana Panama Zambia Bolivia Haiti Paraguay Burkina Faso Honduras Peru * Western Pacific: Burundi India Philippines Cook Islands, Fiji, Cambodia Indonesia Romania Federated States Cameroon Kenya Russian Federation of Micronesia, Central African Kyrgyzstan Rwanda Kiribati, Niue, Palau, Republic Lao PDR Serbia Samoa, Chad Lesotho Serbia/Kosovo Solomon Islands, China Liberia Sierra Leone Tonga, Tuvalu, Congo (Democratic Madagascar Somalia Vanuatu Republic) Mali Sri Lanka Cote d'Ivoire Mauritania Sudan Dominican Republic Mongolia Swaziland East Timor Mozambique Tajikistan Ecuador Multi-country Tanzania/Zanzibar Egypt Western Pacific* Thailand El Salvador Myanmar Togo
Malaria Afghanistan Guinea Nigeria * RMCC: Angola Guinea-Bissau Pakistan Mozambique, South Benin Guyana Papua New Guinea Africa, Benin Haiti Philippines Swaziland Bhutan Honduras Rwanda Bolivia India Sao Tome ** Andean: Burkina Faso Indonesia & Principe Colombia, Ecuador Burundi Kenya Senegal Peru, Venezuela Cambodia Lao PDR Sierra Leone Cameroon Liberia Somalia *** Western Central African Madagascar Sri Lanka Pacific: Republic Malawi Sudan Cook Islands, Fiji, China Mali Suriname Federated States Comores Mauritania Swaziland of Micronesia, Congo (Democratic Mozambique Tanzania Kiribati, Niue, Palau, Republic) RMCC* Tanzania/Zanzibar Samoa, East Timor Andean** Thailand Solomon Islands, Eritrea Multi-country Togo Tonga, Tuvalu, Ethiopia Western Pacific*** Uganda Vanuatu Gabon Myanmar Uzbekistan Gambia Namibia Vietnam Georgia Nepal Yemen Ghana Nicaragua Zambia Guatemala Niger Zimbabwe COUNTRY PROFILE Global Fund Annual Report 2004 11 Moldova Free ARVs and targeted prevention for vulnerable groups
Disease(s) funded: HIV/AIDS, TB Approved Funding to date: US$ 11.7 million
By the end of 2004,ARVs had Mechanism (CCM) — by actively been provided to 115 people (109 involving Ministries as varied as Jus- When it became known that Ludmila U, adults and 6 children),with two tice,Labor and Education — has an obstetrician for 17 years, was HIV- health facilities supported to provide supported the government’s efforts positive, she lost her job, social network needed services.While the numbers to broaden its responses to may seem low in absolute terms,they HIV/AIDS,previously confined to and hope for a ‘normal’ life. Yet, seven represent an important start to scal- the health sector.It is also,within a years on, she has a second chance. ing up comprehensive care and sup- context of increasing external funds Free antiretroviral (ARV) treatment has port to the nearly 2,000 people re- and an urgent need for coordination, changed everything about living with ported to be living with HIV by the helping to streamline planning end of 2003.Direct procurement and among donors.This includes assum- HIV, rapidly improving her own health government negotiation of drug ing oversight for other major initia- and that of her friends. ‘Future’ has prices have resulted in reductions in tives in the country,including the returned to her vocabulary. When asked both overall treatment acquisition World Bank’s AIDS program (US$ what life would be like without ARVs, costs and per patient ARV costs. 5.5 million) and a USAID-funded As well as increasing access to TB project (US$ 4 million). Ludmila gives a sad smile and replies: treatment,the National Program and According to Dr.Oleg Barba,the “There would be no life.” its partners have also developed pre- Executive Secretary of the CCM,one vention strategies targeting groups of Moldova’s key lessons is that that are particularly vulnerable to in- HIV/AIDS and TB are promoted by The HIV/AIDS epidemic among fection.These include young people, poverty,injustice and discrimination, Moldova’s four million people was prisoners,truck drivers,commercial and their successful control will re- late to start but quick to take hold. sex workers,men who have sex with quire the involvement of a variety of While many infections were not re- men and injecting drug users sectors.In 2004,the CCM improved ported until after the mid–90s, (IDUs). its links with all constituencies,ap- prevalence escalated by nearly 10 Evidence is already beginning to pointed a Stakeholder Communica- percent in 2001–2003 alone,reaching emerge that this targeted approach is tion & Coordination Advisor and 0.2 percent among adults.As for tu- slowing the epidemic among some started work on revising its terms of berculosis,2002 saw some 98.1 noti- groups.With IDUs,for example,the reference and representation. This fied cases and 15.6 mortality per sharing of infected syringes had con- helped to strengthen coordination 100,000 people. tributed to HIV prevalence of 1.6 with NGOs,whose involvement as Providing free ARV treatment, percent in 2002.However,data now Global Fund grant sub-recipients is the first nation-wide initiative of its show that the number of new cases facilitated by the Soros Foundation. kind in a nation of the former Soviet among IDUs is stabilizing at a rela- Currently,28 sub-recipients support Union,is central to the country’s in- tively low level,and the proportion of some 11,000 people,mostly from tegrated response to the two diseases, IDUs among the country’s new infec- vulnerable populations. led by the National Programs for the tions has dropped from over 80 per- Progress was also made in two Prevention and Control of cent in 2000 to under 55 percent in other areas of HIV/AIDS work sup- HIV/AIDS/Sexually Transmitted In- 2003. ported by the Global Fund: voluntary fections and Tuberculosis.The work Another first for a state-run ini- counseling and testing,with 408,738 is enhanced by a Round One grant tiative in a former country of the So- people reached; and prevention of from the Global Fund,signed in viet Union was the introduction of mother-to-child transmission of March 2003.With the Ministry of HIV and TB prevention and diagno- HIV,with 35 women and 35 children Health’s Project Coordination,Im- sis,treatment and care for people in reached.While the start of planned plementation and Monitoring Unit prisons.HIV prevalence among de- activities targeting young people was (PCIMU) as the Principal Recipient, tainees was over 2 percent in 2002. delayed,plans were drawn up to take nearly US$ 5.03 ($5,026,861 as of Efforts supported by the Global Fund action in 2005,introducing a com- March 2005) million of the two-year have brought comprehensive services prehensive,life-skills based curricu- budget of US$ 5.3 million has been to four sites. lum as a mandatory subject in pre- disbursed to date. Moldova’s Country Coordinating university education. World map illustrating per capita health investment by the Global Fund
RUSSIAN FEDERATION
ESTONIA
BELARUS ROMANIA UKRAINE KAZAKHSTAN MOLDOVA UZBEKISTAN MONGOLIA GEORGIA BULGARIA KYRGYZSTAN ARMENIA CROATIA TAJIKISTAN ATLANTIC OCEAN SERBIA AZERBAIJAN MACEDONIA NEPAL CHINA MOROCCO IRAN
ALGERIA JORDAN BHUTAN CUBA THE BAHAMAS EGYPT BANGLADESH HAITI INDIA DOMINICAN REPUBLIC JAMAICA MAURITANIA PAKISTAN PACIFIC OCEAN BELIZE MALI NIGER AFGHANISTAN MYANMAR SENEGAL YEMEN LAOS HONDURAS CARIBBEAN CHAD THAILAND GUATEMALA ERITREA NICARAGUA CONSTITUENCY* GAMBIA SUDAN VIETNAM PHILIPPINES EL SALVADOR GUINEA BISSAU DJIBOUTI COSTA RICA GUINEA NIGERIA ETHIOPIA PANAMA VENEZUELA SIERRA LEONE GUYANA CENTRAL AFRICAN REP. LIBERIA CAMBODIA COLOMBIA SURINAME SOMALIA CAMEROON UGANDA SRI LANKA CÔTE D'IVOIRE INDONESIA PAPUA BURKINA FASO KENYA ECUADOR NEW GUINEA GHANA DEM. REP. RWANDA TOGO OF CONGO BURUNDI BENIN PERU TANZANIA EQUATORIAL GUINEA
GABON ANGOLA COMORES INDIAN WESTERN PACIFIC EAST TIMOR OCEAN ISLANDS ZAMBIA MALAWI
BOLIVIA ZIMBABWE MADAGASCAR PARAGUAY BOTSWANA MOZAMBIQUE PACIFIC NAMIBIA OCEAN SWAZILAND CHILE ARGENTINA LESOTHO SOUTH AFRICA
Under $1 * Caribbean Constiuency includes: CARICOM: Anguilla (territory), per capita Antigua & Barbuda, Bahamas, Barbados, Belize, British Virgin Islands (territory), Dominica, Dominican Republic, Grenada, Guyana, Haiti, Between $1–3 Jamaica, Montserrat (territory), St. Lucia, St. Kitts & Nevis, St. Vincent per capita & the Grenadines, Suriname, Trinidad & Tobago. OECS: Cook Islands, Over $3 Federated States of Micronesia, Fiji, Kirbati, Niue, Palau, Samoa, per capita Solomon Islands, Tonga, Tuvalu, Vanuatu 12 Global Fund Annual Report 2004 2004 The Year in Review
Executive Director Richard Feachem renewals,the appointment of new travels to Australia to meet with members to the Technical Review Prime Minister John Howard.Aus- Panel (TRP) in preparation for tralia uses this occasion to announce Round 4 and the creation of the JANUARY the country’s first pledge of AUS$ 29 Technical Evaluation Reference The United States confirms its pledge million (US$ 18 million). Group (TERG). of US$ 547 million for 2004,bringing the amount potentially available for Disbursements reach US$ 245 mil- Two countries,Niger and Yemen, Round 4 to US$ 900 million. lion across 72 countries. appeal the TRP’s decision on their proposals for Round 3.Both are The Global Fund is extensively dis- The International HIV/AIDS Al- successful in restructuring their pro- cussed during the World Economic liance is selected as a caretaker PR for posals in order to meet the technical Forum summit in Davos,Switzerland. a restructured Ukraine grant. standards required by the panel. The Asia Pacific Alternative Commu- MARCH The Global Fund holds its first re- nity Forum 2004,which brings to- Former Japanese Prime Minister gional meeting for the Middle East in gether representatives of community Yoshiro Mori,one of the founding Amman,Jordan.The regional meet- groups from throughout the region, supporters of the Global Fund at the ing is held to give CCM members an takes place in Bangkok.The Global Okinawa Summit of the G8 (2000), opportunity to ask questions,receive Fund organizes a one-day consulta- announces the launch of Friends of assistance and share best practices tion immediately after the Forum for the Global Fund,Japan.This partner with each other. civil society and nongovernmental organization is created to encourage organizations to look at ways of support for the Global Fund in World TB Day is held with the strengthening civil society participa- Japan,working closely with govern- theme,“Every breath counts – stop tion in Country Coordinating Mech- ment and civil society organizations. TB now!”The Global Fund expresses anisms (CCMs) and to gather input Mr.Tadashi Yamamoto,president of its support for the Stop TB Partner- on the preparations for the Global the Japan Center of International Ex- ship and the fight against TB. Fund’s First Biennial Partnership change (JCIE),is named director of APRIL Forum scheduled to take place in July. Friends of the Global Fund,Japan. After discussion with the Board,the In response to concerns about slow The Global Fund organizes a day- decision is made to allow reprogram- implementation and reports of seri- long induction program for new ming of existing malaria grants to in- ous management problems with Board members.About 25 members clude the purchase of new-genera- some of the Global Fund’s three of various delegations go through a tion drugs,artemisinin-based com- HIV/AIDS grants to Ukraine,a Sec- thorough orientation at the Secre- bination therapies (ACT) in those retariat mission is sent to Kiev.After tariat offices in Geneva,including countries where drug resistance has discussions with partners,stakehold- meetings with senior officers from reached levels of 15 percent or more. ers and the PRs,all three grants are every department,covering such Because ACT drugs are roughly fif- suspended and disbursed money not topics as grant agreements,opera- teen times more expensive than con- yet spent is asked to be returned. tional policies and CCM operations. ventional first-line treatments,this Right will require additional funds.The Village children FEBRUARY The Seventh Board Meeting is held in Thika, Kenya Board approves setting aside US$ 90 The Irish presidency of the European in Geneva.Key items on the agenda million for this purpose. Union organizes a conference in include: approval of the 2004 budget, Dublin.The theme of the meeting is replenishment of the Global Fund, “AIDS In Europe”. discussion on the process for Phase 2
Four of six siblings in an orphan-headed household in Swaziland fetch water at the end of the day. Global Fund financing covers school fees for these children and ensures that they receive food rations from the community’s grain stores.
A coordinated effort with UNAIDS MAY The TRP meets to review the and the World Bank leads to the an- Canada,one of the earliest supporters 173 eligible proposals submitted nouncement of the organizations of the Global Fund,announces that it for Round 4. jointly working to make the principle will double its pledge for 2004 to JUNE of the “Three Ones”a reality.(The CAD$ 70 million (US$ 50 million). The Eighth Board Meeting is held in “Three Ones”are one agreed Canada had initially pledged CAD$ Geneva.The first priority is the ap- HIV/AIDS action framework that 150 million (US$ 100 million) for the proval of the 69 grants for 50 coun- provides the basis for coordinating period 2002 to 2005,equally divided tries recommended by the TRP.Ap- the work of all partners; one national over the four years.In the same proved grants have a total value of AIDS coordinating authority,with a pledge,Canada also commits CAD$ US$ 2.9 billion over 5 years and US$ broad based multisectoral mandate; 35 million (US$ 25 million) for 2006. 968 million over two years. and one agreed country-level moni- The annual World Health Assembly toring and evaluation system.) Actor Rupert Everett travels to (WHO) is held in Geneva.This is the Cambodia to see work being done The next in the series of regional decision-making body for the World by Global Fund-financed programs meetings is held in Siam Reap,Cam- Health Organization,which gathers in support of the Global Fund’s par- bodia including recipients from the annually to review WHO policies ticipation in the XV International entire Asian region. and processes.The Global Fund pro- Conference on HIV/AIDS to be held vides a presentation to the delegates Work begins on developing an Early in Bangkok in July of the Assembly. Warning System,which will be used to The Global Fund publishes its first alert the Secretariat to potential prob- Responding to the rapid growth of procurement guide for use by CCMs lems with grant management or im- the Global Fund portfolio and work- and procurement staff working on plementation in recipient countries. load,the Secretariat undergoes a re- Global Fund-financed programs. organization in order to more effec- Africa Malaria Day is held with the tively align staffing resources with The Bill and Melinda Gates Founda- theme “A Malaria-Free Future”.The urgent requirements. tion and the Institute for Global central point of the celebration is the Health,University of California,San Matam region of Senegal,where The East African regional meeting Francisco,team up with the Global African musician Youssou N’Dour for CCM members is held in Fund to present on the theme of holds a large open-air concert. Nairobi,Kenya. “Scaling Up Health Investments in JULY bate medical,social and political is- Developing Countries: Lessons The Global Fund hosts the first Part- sues related to the fight against AIDS. About What Works”at a UK- nership Forum in Bangkok immedi- During the conference,the Bill and sponsored conference at Wilton Park. ately preceding the World AIDS Con- Melinda Gates Foundation an- ference.This biennial event forms nounces a new pledge of US$ 50 Working in partnership with the part of the governance structure of million to the Global Fund. WHO,the World Bank,UNICEF, the Global Fund and serves as an op- UNAIDS,USAID,the US Depart- The United Kingdom announces portunity for the Global Fund to in- ment of State and Department of a new pledge of an additional form a broad group of stakeholders Health and Human Services and the £154 million,effectively doubling of progress and challenges.More im- Centers for Disease Control,the the existing pledge for the period portantly,it also provides an oppor- Global Fund publishes The Monitor- 2005–2007. tunity for those who may not have a ing and Evaluation Toolkit, which direct voice on the Board to provide The Global Fund has disbursed US$ technical partners and CCMs can feedback and guidance. 430 million in 85 countries.This sum use as a guide for determining pro- represents 35% of the two-year grant gram indicators. A new report,A Force for Change: commitments for which disburse- The Global Fund at 30 Months, is Regional meetings are held for recip- ment has commenced. launched by the Global Fund at the ients in Sofia,Bulgaria and Oua- Partnership Forum in Bangkok.This VH1,a cable entertainment channel gadougou,Burkina Faso. report,which includes in-depth pro- which is part of the Viacom group of Friends of the Global Fight is files of Global Fund efforts in five companies,launches a national ad- launched in the United States with countries,sets out progress to date in vertising campaign on behalf of the former head of the Motion Pictures terms of grant agreements,disburse- Global Fund.This campaign,which Association of America,Jack Valenti, ments and milestones achieved. focuses on the theme “Join the as President.This NGO plans to raise Fight”,features a series of 30-second Thailand hosts the XV International awareness of and funds for the ads under the tag line,“Stopping AIDS Conference from 11–16 July. Global Fund in the USA. AIDS before it stops the world”.The Over 10,000 scientists,health-care spots,which run on average a hun- workers and activists from around dred times a month,are designed to the world gather to present and de-
16 Global Fund Annual Report 2004 Year in Review
raise public awareness of the Global The U.S.businessman Ted Turner The Global Fund signs a headquar- Fund and the threat of AIDS. launches an appeal to private donors ters agreement with the government in the United States in the hopes that of Switzerland,giving the Global AUGUST additional funds will allow the U.S. Fund privileges and immunities sim- USAID and the Centers for Disease to maximize its donation to the ilar to other international organiza- Control co-sponsor a conference in Global Fund. tions.The headquarters agreement Atlanta,Georgia on monitoring and enables the Global Fund to under- evaluation.This conference is a direct OCTOBER take a number of administrative outgrowth of the joint efforts by Disbursements reach US$ 628 mil- changes which will make the organi- these two agencies and several others lion in 98 countries. zation more effective and efficient. in conjunction with the Global Fund A regional meeting for CCM mem- to produce the Monitoring and Eval- World AIDS Day takes place on 1 bers is held in Fiji. uation Toolkit, which provides guid- December. ance for national M&E systems for The Netherlands,in response to the The Global Fund is represented at the HIV/AIDS,tuberculosis and malaria urgent appeal by Nelson Mandela, annual meeting of the International programs,and also coordinates the agrees to bring forward 5 million Confederation of Free Trade Unions reporting requirements of all donor (US$ 6 million) from their pledge for (ICFTU) in Tokyo. agencies in order to relieve the ad- 2005.This additional contribution in ministrative burden on recipient 2004 allows the United States to add Preparations are launched for Phase countries and their governments. another US$ 18 million to their total 2,the approval of continued funding contribution for 2004. for grants which have reached the SEPTEMBER two-year mark since their first dis- The Global Fund launches its first NOVEMBER bursement. public awareness campaign in France As a lead-up to its ninth Board meet- with pro bono support from the in- ing,the Global Fund organizes a se- At a meeting in Abuja,Nigeria,par- ternational advertising group Publi- ries of site visits for Board members ticipants discuss progress made on cis.The campaign,which includes to clinics,hospitals and other projects reaching the health-related Millen- print and television advertising,aims benefiting from Global Fund grants nium Development Goals to raise awareness of the Global Fund in Rwanda,Tanzania and Kenya. among the general public and to The ninth Board meeting is held in build support for government dona- Arusha,Tanzania — the first Board tions to the Global Fund.The Global meeting to be held in Africa.The Fund receives more than US$ 1.8 meeting opens with a high-level ses- million worth of free placement for sion addressed by the Presidents of both print and video advertisements Tanzania,Kenya and Uganda and a over a four-month period. representative of the President of The Technical Evaluation Reference Rwanda,as well as the UK Minister Group (TERG) is established. for International Development. In response to a plea by Nelson Man- The Board takes a unanimous deci- dela,Bono and Jack Valenti,the sion to launch Round 5 for approval United Kingdom announces an addi- in September 2005. tional pledge of £3 million (US$ 5.3 Sweden announces an additional million) to the Global Fund. contribution of SEK 16 million (US$ Together with the Global Alliance for 2.2 million) to the Global Fund in re- Vaccines and Immunization,the sponse to Mr.Mandela’s plea. Global Fund hosts the annual meet- DECEMBER ing of the European Foundations Germany announces that it will more Association in Geneva. than double its 2005 pledge from Nairobi,Kenya is the site of a Global 38 million to 82 million (US$ Fund conference,attended by 17 157 million),making Germany the countries,on the re-programming of fourth-largest donor to the Global Global Fund grants to allow for the Fund. purchase of third-generation ACT Executive Director Richard Feachem drugs for malaria. visits China and Japan.
COUNTRY PROFILE Global Fund Annual Report 2004 17 Burundi Providing holistic HIV/AIDS care against the odds
Disease(s) funded: HIV/AIDS, TB, malaria Approved Funding to date: US$ 24.3 million
Despite some initial delays,which most vulnerable and often marginal- postponed the start of most activities ized.It has also formalized the unique Stricken by ongoing political and social until the second year of the grant’s role of civil society organizations as the instability following an 11-year civil implementation,the program has interface between national strategies, war that claimed over 300,000 lives, begun to show concrete results.Over medical professionals and people at the 1,900 people had been provided with community level,improving both the and severely restricted by inadequate antiretroviral therapy and psychosocial quality and accessibility of prevention medical services, Burundi is making support by the end of 2004.Although and care for communities. remarkable progress in its efforts to this is only 58 percent of the program’s Burundi’s successes with these provide comprehensive HIV/AIDS target for its first two years,it represents grant-funded programs is indicative of important progress when measured the multisectoral collaboration — con- prevention and care. against the 2003 baseline of 600 people sidered by some to be unprecedented in reached and provides a solid founda- the country’s recent history — that has In Burundi,the HIV prevalence is 3.6 tion for the next phase.This founda- characterized its program management percent among the adult population tion,combined with decreasing drug and enabled it to achieve results despite (15 years and above).Life expectancy prices and increasing funding from a background of national turmoil.As has dropped to 40 years and some new donors,has resulted in the country Principal Recipient,the Executive Sec- 200,000 children have been orphaned. adjusting its overall treatment targets retariat of the National HIV/AIDS A Global Fund grant worth up to US$ upwards for the coming years. Council expanded its pool of sub-recip- 4.9 million over the first two years was By late 2004,results also began to ients from the originally budgeted six to signed with Burundi on 10 April 2003 emerge from the two other central eighteen,including several from civil for the scale-up of prevention and care. components of this Global Fund grant. society.Since the grant signing,several The three pillars of the grant are the In programs for the prevention of new donors have started to contribute holistic care of people living with mother-to-child transmission of HIV, to the country’s national HIV/AIDS HIV/AIDS,prevention of mother-to- antiretroviral prophylaxis was pro- strategy. The broadly representative child transmission of HIV and capac- vided to 335 pregnant women living Country Coordinating Mechanism is ity-building for the delivery of health with HIV/AIDS and 220 newborns, working with these donor partners and services.To date,US$ 4.9 million has representing 88 and 57 percent of the coordinating the efforts of development been disbursed to the Principal Recipi- program’s targets respectively.Based on stakeholders under one cohesive ent,the Executive Secretariat of the the National Action Plan for 2002–6, national disease strategy. National HIV/AIDS Council. the work had initially involved upgrad- The Global Fund’s support has par- ing a pilot site and extending services ticularly enhanced the government’s to two further sites,but has been efforts to provide comprehensive care, extended to 11 sites (Bujumbura and support and treatment for people living in-country).It also promoted Volun- with HIV/AIDS.These efforts have tary Counseling and Testing (VCT) in taken a complementary approach — prenatal consultations,extending serv- supplying not only antiretroviral ther- ices to entire family units,not just to apy and drugs for opportunistic infec- pregnant women. tions,but also providing psychosocial Grant-funded,capacity-building support to improve everyday well- efforts focused on integrating civil soci- being for patients and their families. ety into programs for health services Services are coordinated and delivered delivery by building on the experiences, by a broad range of stakeholders, skills and contacts of nongovernmental including hospitals,social workers, and community-based organizations community health centers,local and and networks of people living with international nongovernmental organ- HIV/AIDS.This has ensured that pre- izations,national reproductive health vention and care interventions are programs and government institutions, appropriate and accessible to commu- as well as private institutions. nity members,including those who are 18 Global Fund Annual Report 2004 Performance Measurement What the Global Fund Measures + How
the seven principles spelled out in its founding documents (see box on page 9).The measurement frame- work with its four levels — opera- tional performance,grant perform- ance,systems effects and impact — was developed under the oversight of the Technical Evaluation Reference Group (TERG) and the Monitoring and Evaluation,Finance and Audit (MEFA) Committee,and approved by the Board.
The four levels of the measurement framework (see Fig. 1, right) are as follows:
1. Operational performance This level measures the performance of the core functions of the Global Fund and its Secretariat,including resource mobilization,grant man- agement,proposal and grant signing, disbursements and Secretariat costs. BUILDING A PERFORMANCE- proved its first round of grants only In 2004,key performance indicators BASED FUNDING SYSTEM three months after its creation and for these areas were shown in a new In 2004,the Global Fund made sig- before any detailed architecture for management tool called the “Execu- nificant progress in designing and managing these grants and measur- tive Dashboard”.The monitoring of Above implementing transparent,rigorous ing performance had been designed. key performance indicators is sup- Improving laboratory facilities and consistent performance meas- The development of all aspects of its plemented by ad hoc studies under- in underserved urement systems for its own opera- functional architecture has taken taken to assess particular areas in regions and tions and for grant-funded programs place in parallel with the ongoing greater detail,such as the different training health care professionals in recipient countries.While per- management of existing grants. elements of the Global Fund’s basic in diagnosis and formance measurement has been architecture. treatment are part among the core principles of the GLOBAL FUND PERFORMANCE of China’s strategy to fight HIV/AIDS, Global Fund from its creation,build- MEASUREMENT: A FOUR-TIERED 2. Grant performance TB and malaria. ing a functional system to measure SYSTEM This level measures the performance performance and to provide the basis In 2004,The Global Fund established of grants and is the cornerstone of for funding decisions has been a a comprehensive measurement performance-based funding by the gradual process.Due to the urgency framework that evaluates its per- Global Fund.The system was defined of its mission,the Global Fund ap- formance at all levels and addresses and implemented in 2004 and covers Performance Measurement Global Fund Annual Report 2004 19
all aspects of the Global Fund grant build impact indicators (in addition remaining to be implemented in early process,including proposal develop- to coverage indicators) into all grant 2005.The measurement systems were ment,grant agreements,regular dis- extensions as grants reach the Phase put into practice in December 2004 bursements and Phase 2 evaluations. 2 funding stage. for review of the first 27 grants mak- Together with its primary technical ing application for extension into partners,the Global Fund developed The full implementation and roll-out their second,three-year phase of the the joint Monitoring and Evaluation of this system follows a phased ap- grant.(The Global Fund approves Toolkit, which defines simplified proach,as the Fund moves from grant proposals covering a period of evaluation frameworks and indica- grant signing and management to- up to five years.Funds are initially tors at all levels for the three diseases. wards broader systems effects and,ul- committed for the first two years of The Toolkit is designed to be of assis- timately,impact on the three diseases. the proposal period.Continued tance to those applying for Global At its ninth meeting in November funding to cover the remainder of the Fund grants in establishing univer- 2004,the Board approved perform- proposal period depends on satisfac- sally accepted targets and indicators ance indicators for the Executive Di- tory program performance and the for measuring proposed program rector and Secretariat and reviewed availability of resources.The exten- performance.In using the Toolkit, potential performance indicators for sion of a grant to cover remaining applicants can simplify their grant Board functions.Processes for evalu- years of an original proposal is re- designs by focusing on outputs ating and approving the continued ferred to as Phase 2 funding.) rather than on processes. funding of years three to five of grants While the indicators for the meas- that reach the two-year mark were urement of systems effects and impact 3. Systems effects also approved,providing an impor- were developed in 2004,their full im- This level measures the impact (posi- tant final piece of the grant perform- plementation and roll-out are priori- tive and negative) that the Global ance measurement system.Opera- ties for 2005,together with the prepa- Fund has on the existing systems tional and grant performance meas- ration of a thorough five-year evalua- through which it works,in particular urement systems were largely in place tion of the Global Fund in 2006. at the country level.In 2004,under by the end of 2004,with a few aspects the oversight of the TERG and the MEFA Committee of the Board and in conjunction with a wide range of partners and stakeholders,a set of in- dicators and measurement tools was developed to measure these effects with a particular focus on addition- ality of resources,long-term sustain- ability of efforts and harmonization between technical and donor agen- cies,as well as national partnerships under the guidance of CCMs.Mea- surement of these indicators will begin in 2005. Fig. 1: The Global Fund’s four-level measurement framework 4. Impact This level provides the means for measuring the impact of the Global Fund in the fight to turn the tide of the three diseases.Indicators for im- Impact pact measurement have been devel- oped to become part of the Global Fund’s grant management systems, System effects as it will ultimately be the impact that Global Fund grant-financed programs have on the contribution three diseases that will determine the Grant performance Global Fund’s success.While the basic indicators have been included in the joint Monitoring and Evalua- tion Toolkit, in 2005 it will be a prior- Operational performance ity to fully embed these in grant agreements as they are negotiated and signed.The first step will be to
In Bishkek, Kyrgyzstan, approximately 2,200 injecting drug users are reached with Global Fund-financed needle exchange services.
Global Fund Annual Report 2004 21 Operations + Results
22 Resource Mobilization, Communications + Advocacy 26 Pledges + Contributions to the Global Fund 28 Secretariat Management 30 Grant Management 36 Grant Performance
22 Global Fund Annual Report 2004 Operations + Results Resource Mobilization, Communications + Advocacy
decision will enable the Global Fund The Global Fund relies on donations from to establish a more systematic and predictable process securing the re- governments, foundations, corporations and quired resources for the programs it supports.The UN Secretary General, individuals to finance the fight against the Mr.Kofi Annan,and Mr.Sven Sand- ström,Director of the International three diseases, with the majority of funding Task Force on Global Public Goods, were nominated and confirmed as coming from the public sector. Chair and Vice-Chair of the Global Fund’s first replenishment meetings for 2005. Pledges are received on a continual larly communications to potential basis and can span any number of donors to educate them on the role, RESULTS: years.Resource mobilization activity results and needs of the Global Fund. RESOURCE MOBILIZATION is carried out by the Board,by a small Communications are also important In January 2004,the overall financing team within the Global Fund Secre- to ensure transparency for recipients need for the Global Fund was pro- tariat and by nongovernmental sup- and other stakeholders,and work is jected at around US$ 1.5 billion.This porters of the Global Fund,including increasingly underway by the Secre- included resources required to fully communities living with the diseases. tariat to meet a broader range of cover the Round 3 grants carried for- As trustee of the Global Fund,the needs for robust and responsive in- ward from 2003,renewals of existing World Bank manages contributions formation about the institutional ac- Round 1 programs and the financing to the Global Fund.To receive private tivity and grant progress of the of Round 4,the new round slated for contributions,the Global Fund relies Global Fund. approval in 2004.As of January 2004, upon the United Nations Foundation Efforts supported by partners to US$ 0.6 billion was forecast to be and its donors.The United Nations explore innovative,additional fi- available for Round 4.By the end of Foundation,a grant-making public nancing mechanisms for the Global the year,pledges for the year had charity established by philanthropist Fund accelerated during the year. reached US$ 1.6 billion,and a total of Ted Turner,receives private dona- These potential mechanisms in- US$ 1.4 billion had been con- tions in support of AIDS,TB and cluded debt conversion to finance tributed.This represented an in- malaria programs around the world Global Fund programs (for renewals crease of more than 50 percent com- on a pro bono basis and has chosen in a number of high-performing pared to the total contributions re- the Global Fund to be one of the pri- countries),the International Finance ceived for 2003.Outstanding pledges mary beneficiaries of such private Facility proposed by the Govern- for 2004 were expected to be con- contributions.The Foundation’s sta- ment of the United Kingdom and an tributed in early 2005. tus as a non-profit organization in introduction of global transaction A number of new donors pledged the United States affords contributors taxes to finance global public goods, for the first time to the Global Fund using this mechanism certain tax proposed by France. in 2004,including Australia,Hun- benefits in the United States. In 2004,the Global Fund’s Board gary,Iceland,the Republic of Korea, Fund-raising builds on broader approved the adoption of a periodic Singapore,Slovenia and Uganda, efforts to mobilize support,particu- replenishment funding model.This bringing the number of donor
In school in Tacoa, Honduras, children learn about malaria control.
24 Global Fund Annual Report 2004 Operations + Results
countries from 44 to 51.In addition, tions,the Global Fund also received for its resource needs.The Global Canada,the European Commission, a wide range of non-financial sup- Fund was represented in numerous Ireland,Luxembourg,New Zealand, port from private organizations and sessions coordinated by partners as Sweden,Switzerland,The Nether- individuals.In 2004,over US$ 7 mil- well as by the Global Fund,and re- lands,UK,the Bill and Melinda Gates lion worth of pro bono support — ceived positive press coverage Foundation and the Health Authori- ranging from staff secondments,to throughout.During the conference, ties of Taiwan pledged additional re- consulting projects to celebrity en- the Secretariat organized field visits sources in 2004.Hundreds of indi- gagements — was provided to the to Cambodia and Thailand with viduals from around the world also Global Fund. British actor Rupert Everett.The trip made donations to the Global Fund, produced extensive media coverage, and while those donations were rela- RESULTS: including a BBC documentary and tively small in magnitude (US$ 0.6 COMMUNICATIONS feature coverage in US-based maga- million),they point to a broadening + ADVOCACY zine Vanity Fair. base of support that is building In July,the Global Fund’s first sub- In 2004,two nongovernmental among the general public. stantive progress report,A Force organizations dedicated to raising Taken together,all pledges re- for Change: The Global Fund at 30 awareness of and advocating for in- sulted in a total amount of US$ 5.9 Months, was launched in Bangkok. creased support for the Global Fund billion through 2004.The average The report analyzed the results of the were launched in the United States rate of return on investment man- first 25 grants to reach the one-year and Japan. aged by the World Bank was 1.6 per- mark and profiled grants in four Friends of the Global Fund Japan cent in 2004,resulting in US$ 34.3 countries to give stakeholders an was launched in Tokyo in March at a million of investment income.This early impression of the quality and conference entitled “Human Security investment income covered nearly 78 results stemming from the Global Challenges of HIV/AIDS and Com- percent of the Global Fund’s operat- Fund grant process. municable Diseases in Asia”jointly ing expenses in 2004 (US$ 43.5 mil- The XV International AIDS Con- sponsored by the Asia Society of New lion),including the fees of Local ference,held in Bangkok in July,was York and the Japan Center for Inter- Fund Agents (US$ 12.2 million) and characterized by broad recognition national Exchange (JCIE).“Friends excluding services contributed in of how far the Global Fund had come Japan”was launched with the finan- terms of goods and services. in its first two years in terms of con- cial support of the Open Society Insti- In addition to financial contribu- crete results,and by strong support tute,the United Nations Foundation and Vodafone.Both the Chair and Vice- Chair of the Global Fund Board were present.The Director is Mr. Fig. 2: Funds Contributed Relative to Amount Tadashi Yamamoto,one of the leading Pledged for 2004 foreign policy experts of Japan and a long-time promoter of Japan’s in- creased international engagement. “Friends of the Global Fight”was 1,800,000 Affected communities 4% Other 5% launched in June in Washington,DC Other 6% Academic & educational Contributions as with a series of high-profile events at- Administration 7% 1,572,607 organizations 5% a percentage of tended by senior members of the Physical pledges = 91.6% Infastructure 6% Faith-based U.S.Congress,the administration organizations 5% 1,600,000 and other U.S.supporters and stake- Private sector 5% 1,439,786 holders.“Friends U.S.”was launched with the financial support and per- Drugs & sonal engagement of Edward Scott,a Physical Commodities Government Infastructure 1,400,000 49% 51% strong supporter of the Global Fund 13% in the United States.The NGO Human NGOs named as its president Jack Valenti, Resources 25% & Training the former head of the Motion Pic- 20% 1,200,000 ture Association of America. By the end of 2004,the activities of both Friends of the Fund in Japan and Friends of the Global Fight in the U.S. had already substantially strength- 1,000,000 Eastern Europe US $ '000s Pledges Made Contributions Received ened political support and general & Central Asia 7% Through Through awareness in these countries.A simi- 31 December 2004 31 December 2004 lar organization was initiated in Eu- Latin Tuberculosis rope with plans for a launch in 2005. America 13% 9%
East Asia, South East Asia, Oceania 18% Sub-Saharan Malaria HIV/AIDS Africa 61% 31% 56%
Impact
South Asia, Middle East System effects & North Africa 5% Global Fund contribution Grant performance
Operational performance
80%
70%
60%
50%
40%
30%
20%
10%
0% Overall Round 1 Round 2 Round 3
Operations + Results Global Fund Annual Report 2004 25
A major media outreach effort List of Pro Bono Services Contributed by the Private Sector in 2004 was launched in September 2004 to raise awareness of the Global Fund among the general public in key Booz Allen Hamilton donor countries.The campaign Review of Board & Committee structures started in Paris through a series of Celebrity: India Arie print and television advertisements Time and creative services in producing Global Fund documentary in Africa placed with support from the Publicis in partnership with VH1 Group.Media placements were pro- Celebrity: Rupert Everett vided on a pro bono basis with a Time and creative services in producing Global Fund documentary in Asia value of over 1.7 million.Following Celebrity: Tom Hanks the successful launch in France,the Creative services in providing voice-over for Global Fund video (US version) Publicis Group has begun to expand its already substantial commitment to Celebrity: Emma Thompson the Global Fund by making prepara- Creative services in providing voice-over for Global Fund video (European version) tions for similar campaigns in other McKinsey key markets. Development of Executive Director’s performance criteria In the U.S.,the Global Fund initi- Piper Rudnick ated a collaboration with the media Legal advice and staff expertise on various issues to develop the Global Fund’s risk group Viacom,which runs AIDS management system in 2005 and beyond awareness campaigns as a central Publicis Group and media partners part of its corporate social responsi- Advertising services and airtime/print space for Global Fund advertising bility program.This collaboration campaign in France has focused on the development of advertising and programming pro- Sidley, Austin, Brown & Wood moting the Global Fund on VH1,a Legal advice and preparatory work on registering the Global Fund name and satellite and cable channel reaching logo internationally 90 million U.S.households,as well as Sterling Group a substantial international audience. Marketing strategy consulting services to refine the external positioning for the Three ads were produced during the Global Fund and help the Fund better communicate with the key target audiences first half of 2004 and launched dur- The Bill and Melinda Gates Foundation ing the XV International AIDS Con- Cost of secondment of events coordinator from FHI to organize Partnership Forum ference in Bangkok in July.These ads UN Foundation were linked to the creation of a con- Sponsorship of Global Fund consumer website development, management sumer website,“investinginour- of private donor contributions to the Global Fund and dedicated staff to mobilize future.org”,which provides informa- partnerships and resources for the Global Fund tion about the Global Fund,about the fight against the three diseases VH1 (Viacom) and facilitates opportunities for do- Advertising services and airtime for Global Fund advertising campaign nations and local action in support of the fight.This website was created through assistance from “Friends U.S.”and the UN Foundation.The collaboration with VH1 and other Viacom properties,as well as increas- ing collaboration with the UN Foun- was used extensively by “Friends In 2004,the Global Fund’s website dation,Kaiser Family Foundation, U.S.”throughout the country.A sec- was visited about 500,000 times, the Global Business Coalition against ond,similar film was created for a doubling the site traffic of the previ- HIV/AIDS and others have placed broader,international audience.In ous year. the Global Fund in a position to addition,a set of four Public Service The Global Fund also received greatly expand its advocacy and indi- Announcements (PSAs),each star- extensive world press coverage,being vidual fund-raising activities in the ring a well-known African musician, mentioned 3,500 times in the main United States in 2005. were produced and shown exten- English language media,300 times in Other important promotional ac- sively on TV5,a European-based French,more than 200 times in tivities in 2004 included the produc- French-language satellite channel Spanish and about 200 times in the tion of two short films as an intro- with a global reach.Some of these German and Italian media.However, duction of the Global Fund to inter- PSAs were also shown during the an- these figures do not take into account ested audiences.One of the films was nual African Music Awards,known recipient countries’national press. produced for the U.S.market and as the Kora Awards.
26 Global Fund Annual Report 2004 Operations + Results Pledges + Contributions to The Global Fund
DONORS Contributions Received Through 31 Dec 2004 Pledges Made Through 31 Dec 2004 TOTAL For 2001–2003 For 2004 TOTAL Due in 2005 Due in 2006–
Governments Andorra 100 — 100 — — 100 Australia — 13’828 13’828 3’928 — 17’755 Austria 1’076 — 1’076 — — 1’076 Barbados 100 — 100 — — 100 Belgium 19’437 10’271 29’708 6’698 13’395 49’801 Brazil 50 — 50 50 — 100 Burkina Faso 75 — 75 — — 75 Cameroon — — — 100 — 100 Canada 50’000 50’006 100’006 59’322 — 159’328 China 2’000 2’000 4’000 2’000 4’000 10’000 Denmark 28’607 16’188 44’796 — — 44’796 European Comm 187’425 264’413 451’838 57’029 57’029 565’896 France 123’138 198’939 322’077 198’939 198’939 719’955 Germany 49’423 45’945 95’367 108’753 192’971 397’092 Greece — — — 332 — 332 Hungary — 10 10 — — 10 Iceland — 206 206 — — 206 Ireland 20’996 12’299 33’295 — — 33’295 Italy 215’160 — 215’160 265’252 — 480’412 Japan 160’394 104’726 265’120 — — 265’120 Kenya 8 — 8 — — 8 Korea (Repub of) — 500 500 — — 500 Kuwait 1’000 — 1’000 — — 1’000 Liberia — — — — 25 25 Liechtenstein 100 77 177 — — 177 Luxembourg 3’315 2’244 5’558 — — 5’558 Mexico — — — 100 — 100 Monaco 88 44 132 — — 132 Netherlands 51’678 54’345 106’022 61’008 — 167’030 New Zeland 734 625 1’359 — — 1’359 Niger — — — — 50 50 Nigeria 9’081 — 9’081 1’000 — 10’081 Norway 35’672 17’865 53’536 — — 53’536 Poland 20 10 30 — — 30 Portugal 400 600 1’000 — — 1’000 Russia 5’000 5’000 10’000 5’000 5’000 20’000 Rwanda — — — — 1’000 1’000 Saudi Arabia 2’500 2’500 5’000 2’500 2’500 10’000 Singapore — 200 200 200 600 1’000 Slovenia —66——6
All figures are in US$ 000s
Operations + Results Global Fund Annual Report 2004 27
Pledges + Contributions to The Global Fund
DONORS Contributions Received Through 31 Dec 2004 Pledges Made Through 31 Dec 2004 TOTAL For 2001–2003 For 2004 TOTAL Due in 2005 Due in 2006–
South Africa 2’000 — 2’000 — — 2’000 Spain 35’000 15’000 50’000 15’00 35’000 100’000 Sweden 33’858 48’033 81’892 — — 81’892 Switzerland 10’000 2’343 12’343 — — 12’343 Thailand 1’000 1’000 2’000 1’000 2’000 5’000 Uganda — 500 500 500 1’000 2’000 United Kingdom 118’248 60’033 178’581 91’195 193’711 463’487 United States 622’725 458’881 1’081’606 435’000 600’000 2’116’606 Zambia 25 — 25 — — 25 Zimbabwe 158 — 158 — — 158 Sub-Total 1’790’591 1’388’937 3’179’528 1’314’905 1’307’220 5’801’653 Support for Operating Expenses DFID — 219 219 — — 219 GTZ — 442 442 — — 442 Japan — 415 415 — — 415 Other — 42 42 — —42 Total Gov’ts 1’790’591 1’390’055 3’180’646 1’314’905 1’307’220 5’802’772
Private Sector Bill & Melinda Gates Fdn 100’000 50’000 150’000 — — 150’000 Hewlett Foundation — 200 200 — — 200 Novartis — 100 100 — — 100 Statoil — 100 100 — — 100 The United Nations Foundation and its donors Mr. Kofi Annan 100 — 100 — — 100 Amb. D. Fernandez 100 — 100 — — 100 Eni S.p.A. 500 — 500 — — 500 Heath Authorities of Taiwan 1’000 — 1’000 1’000 — 2’000 Int’l Olympic Committee 100 — 100 — — 100 Real Madrid Soccer Match 112 — 112 — — 112 Winterthur 1’044 — 1’044 — — 1’044 Other UNF Donors 425 634 1’059 — — 1’059 Other Private Sector Donors 20 140 160 — — 160 Sub-Total: Cash 103’402 51’389 154’791 1’000 — 155’791 In-kind — 7’265 7’265 — — 7’265 Total: Private Sector 103’402 58’654 162’056 1’000 — 163’056
Grand Total 1’893’993 1’448’709 3’342’703 1’315’905 1’307’220 5’965’828
28 Global Fund Annual Report 2004 Operations + Results Secretariat Management
reorganization in order to streamline In December 2004, the Global Fund operational processes and increase organizational efficiency.The move signed a headquarters agreement with to four “pillars”— Business Services, External Relations,Operations and the government of Switzerland, giving the Strategic Information & Evaluation — was made in response to the needs Global Fund privileges and immunities of the organization in its rapid growth to become a significant similar to other international organizations. grant-making institution in less than three years.The organizational de- velopment process is ongoing and The headquarters agreement will In 2002,the Global Fund designed reaches beyond the Secretariat’s enable the Global Fund to undertake and set in place the basic systems for structure to include its focus on con- a number of administrative changes negotiation and oversight of grant-fi- tinual learning and improvement, to make the organization more effec- nanced programs.In 2003,it tested formal and informal opportunities tive and efficient. its new structure and systems and for staff training,and the growth of As a young organization,the began to look at specific organiza- its organizational culture. Global Fund is continually making tional development processes to The Global Fund’s operating ex- adjustments to its systems and archi- complement its growth. penses in 2004 amounted to US$ tecture in response to lessons learned In May 2004,the Global Fund’s 43.5 million (excluding US$ 7.3 mil- and the demands of its core business. Secretariat underwent a structural lion worth of donated services).Of this,US$ 28.1 million went to run- ning the Secretariat,US$ 12.2 million was paid in fees to Local Fund Agents and US$ 3.2 million met the ex- Fig. 3: Secretariat expenses as a percentage of total expenditure in 2004 penses of the Board and Technical US$ millions Percentage of total expenditure Review Panel.These operating ex- Grants 854.4 95.2% penses represented 4.8 percent of Operating expenses total expenditures in 2004,with all excluding donated services the remainder going to grants.As the Secretariat expenses 28.1 3.1% size of the Global Fund’s grant port- LFA fees 12.2 1.4% folio increases substantially over the Board & TRP expenses 3.2 0.4% coming years,operating expenses are 43.5 4.8% expected to become a diminishing Total expenditure 897.9 100.0% part of total expenses,reaching less excluding donated services than two percent by the end of 2006. Donated services 7.2 In 2004,78 percent of operating ex- Total expenditure 905.1 penses were met by investment in- per the audited financial statements come on the Global Fund’s invest- ment portfolio.
In the slums of Nairobi, the Kenya Network of Women with AIDS provides treatment and care to children orphaned by HIV/AIDS.
30 Global Fund Annual Report 2004 Operations + Results Grant Management
ture disaster due to rapidly growing commodities with an open-ended infection rates.Nearly two-thirds are timeframe.As the need for a drastic countries classified by the World Bank expansion in the use of these prod- as low-income countries,while one- ucts — such as antiretrovirals and third are lower–middle-income coun- other drugs,condoms,diagnostic tries with severe disease burdens or equipment and insecticide-treated very high infection growth rates. bednets — became apparent,it also Three percent of the portfolio goes to became clear that developing coun- ten upper-middle-income countries tries would not be able to finance the with very high disease burdens or in- full cost of large-scale purchasing in fection growth rates. the short- or medium-term.The Despite the fact that there are no Global Fund was set up in part to fi- criteria for grant approval other than nance these purchases,and approxi- the technical quality of proposals,a mately 50 percent of committed persistent distribution pattern has funds are for the purchase of drugs emerged for grants over the four and other commodities.The rest is rounds.Sixty percent of the approved being used to strengthen infrastruc- funding is going to sub-Saharan ture and expand the training of Africa,while 23 percent is spent in health-care and other supporting Asia,the Middle East and North personnel. Africa,and the remaining 17 percent is Although the Global Fund is ded- shared between Latin America,the icated to the fight against the three PROPOSALS + APPROVALS Caribbean and Eastern Europe.Just diseases,it was designed and oper- The Global Fund finances grants over 56 percent of funding goes to ates with a view to strengthening through rounds of grant applica- fight HIV/AIDS,31 percent goes to overall healthcare delivery systems in tions.To date,four rounds have been malaria and 13 percent is allocated to funded countries.Wherever possible, approved and a fifth has been TB programs. it emphasizes the need for integra- launched and will come up for ap- Reflecting the breadth of Global tion and synergy with general health proval at the Eleventh Board Meeting Fund recipient partners at the country services and the importance of in September 2005. level,half of the principal recipients avoiding duplication or unnecessary Above Through its first four rounds,the are governments,while one-quarter “vertical”programming within the Education on Global Fund has approved a total of are nongovernmental organizations, health sector.In a number of coun- HIV prevention, counseling and US$ 3.1 billion over two years to 310 and the remaining quarter are faith- tries — in particular in sub-Saharan testing services, programs in 127 countries.The four based organizations,private sector Africa — HIV/AIDS,TB as an op- and condoms proposal rounds were approved in companies,academic institutions or portunistic co-infection with are provided to Roma squatters April 2002,January and October 2003, communities living with the diseases. HIV/AIDS,and malaria constitute in Romania. and June 2004.With a few exceptions, One of the major changes in de- an overwhelming burden on existing the countries benefiting from these velopment assistance for health over health services.A strengthening of grants comprise all those that are cur- the past few years has been the ac- health system capacity to deal with rently experiencing the most severe ceptance by donors of the necessity these diseases will strongly improve burdens of disease or are at risk for fu- to finance drugs and health-related overall health system performance.
Operations + Results Global Fund Annual Report 2004 31
The Global Fund’s grant-making process in brief
Step 1 Step 7 Global Fund Secretariat announces The Secretariat and PR negotiate a a call for proposals. grant agreement, which identifies specific, measurable results, to be Step 1 tracked using a set of key indicators. Country Coordinating Mechanism (CCM) prepares proposal based on Step 8 local needs and financing gaps. The grant agreement is signed. As part of the proposal, the CCM Based on a request from the Secre- nominates one or more Principal tariat, the World Bank makes the Recipients (PR). In many cases, initial disbursement to the PR. The development partners assist in the PR makes disbursements to sub- preparation of the proposal. recipients for implementation, as called for in the proposal. Step 3 The Secretariat reviews proposals to Step 9 PACE OF GRANT ensure they meet eligibility criteria Program and services begin. As the MANAGEMENT and forwards all eligible proposals coordinating body at the country From its inception,the Global Fund to the Technical Review Panel (TRP) level, the CCM oversees and moni- had a rapid start-up,signing its first for consideration. tors progress during implementa- tion. grant agreements while still develop- Step 4 ing operational procedures and The TRP reviews all eligible propos- Step 10 guidelines.One of the consequences als for technical merit and makes The PR submits periodic disburse- of this parallel process was that early one of four recommendations to the ment requests with updates on pro- grant agreements were signed before Global Fund Board: (1) fund; (2) grammatic and financial progress. necessary assessments of principal fund if certain conditions are met; The LFA verifies information submit- recipients’financial and procurement (3) encourage resubmission; and ted and recommends disburse- capacities had been completed.This (4) do not fund. ments based on demonstrated often slowed down grant implemen- progress. Lack of progress triggers a Step 5 tation,since weaknesses were discov- request by the Secretariat for cor- The Board approves grants based ered and had to be rectified before rective action. any substantial grant activities could on technical merit and availability begin.Another consequence was that of funds. Step 11 The PR submits a fiscal year early grants were signed without tar- Step 6 progress report and an annual audit gets that measured core activities of The Secretariat contracts with one of program financial statements to funded programs,instead often in- Local Fund Agent (LFA) per country. the Secretariat through the LFA. cluding targets that measured related The LFA certifies the financial man- but not core activities. agement and administrative capac- Step 12 From Round Three onwards,the ity of the nominated PR(s). Based on Regular disbursement requests and Global Fund’s Secretariat has given the LFA assessment, the PR may program updates continue, with particular attention to improving the require technical assistance to future disbursements tied to ongo- quality of the grant agreements strengthen capacities. Development ing progress. signed.It is working with its partners partners may provide or participate Step 13 to ensure that all grants have clear in such capacity-building activities. The CCM requests funding beyond performance targets that show the The strengthening of identified the initially approved two-year coverage of their grant activities — capacity gaps may be included as period. The Global Fund approves in other words,targets that reflect conditions precedent to disburse- continued funding based on people reached with interventions, ment of funds in the grant agree- progress and availability of funds. service points supported and people ment between the Global Fund and trained within defined service deliv- the PR. ery areas.The Secretariat also now requires that all assessments when appropriate are completed before the grants are signed in order to reduce the number of conditions precedent to grant signing.This will lead to faster disbursement in the future.
32 Global Fund Annual Report 2004 Operations + Results
1,800,000 Affected communities 4% Other 5% Finally,proposal formats for future Fig. 4: DistributionOther 6% of the Global Fund grant portfolio by type Academic & educational rounds have been improved to en- Contributions as of Administrationexpenditure, 7% by type of Principal Recipient, by region and by disease 1,572,607 organizations 5% sure that they are more user-friendly a percentage of Physical pledges = 91.6% Infastructure 6% Faith-based and that all critical information re- organizations 5% 1,600,0001,800,000 quired for the Technical Review PrivateAffected sector communities 5% 4% Other 5% Other 6% Panel is included in the proposal. 1,439,786 Academic & educational Contributions as Administration 7% Most grants are at an early stage, 1,572,607 organizations 5% a percentage of Physical building the capacity to reach more Drugs & pledges = 91.6% InfastructurePhysical 6% Faith-based Commodities Government Infastructure organizations 5% people in the near future.The aver- 1,400,000 49% 51% 1,600,000 13% Private sector 5% age age of a Global Fund grant at the 1,439,786 Human NGOs end of 2004 was eleven months. Resources 25% & Training As of 31 December 2004,the 20% Drugs & Physical Global Fund had signed 67 grant Commodities Government 1,200,000 Infastructure 1,400,000 49% 51% agreements for Round One out of a 13% total of 69.One grant to the Democ- Human NGOs Resources 25% ratic People’s Republic of Korea had & Training 20% been cancelled and one grant to 1,000,000 Eastern Europe Zimbabwe was being negotiated.For 1,200,000 & Central Asia 7% US $ '000s Pledges Made Contributions Received Round Two,96 grant agreements had Through Through 31 December 2004 31 December 2004 been signed out of a total of 100. Latin Tuberculosis Sixty-three grant agreements had America 13% 9% been signed out of a total of 72 for 1,000,000 Eastern Europe US $ '000s Pledges Made Contributions Received & Central Asia 7% Round 3.Of the remaining Round 3 Through Through East Asia, grants,a grant for the Democratic 31 December 2004 31 December 2004 South East Asia, Oceania 18% Sub-Saharan Malaria HIV/AIDS People’s Republic of Korea was can- 56% Latin Africa 61% 31% Tuberculosis America 13% celled,as was a grant for Iran,and ne- 9% gotiations were in progress for a Impact Multi-Country Americas grant and a East Asia, South East Asia, grant for Yemen.Round 4 was ap- Oceania 18% Sub-Saharan Malaria HIV/AIDS Africa 61% 31% 56% proved at the end of June 2004 and South Asia, Middle East System effects & North Africa 5% 13 grant agreements out of a total of 73 had been signed by the end of the Impact Global Fund contribution year.Grant signing for remaining Round 4 grants will increase rapidly Grant performance in the first half of 2005. South Asia, Middle East System effects & North Africa 5% Global Fund DISBURSEMENT Operational performance contribution The rate at which the Global Fund Grant performance disbursed money to grant recipients accelerated in 2004 and reached a cu- mulative total amount disbursed of Fig. 5: Disbursements compared to life of grants elapsed US$ 860 million by 31 December Operational performance 2004,out of a total commitment in 80% signed grant agreements of US$ 2.1 billion.Of funds disbursed to that 70% time,52.3 percent was disbursed to sub-Saharan Africa,17.3 percent to 60% East Asia and the Pacific,13.3 percent 50%80% to Latin America and the Caribbean, 9.6 percent to Eastern Europe and 70% 40% Central Asia,3.5 percent to North Africa and the Middle East,and 4 30%60% percent to South Asia. 20%50% To evaluate whether disburse- ments are on track,the Global Fund 40% 10% compares disbursed funds as a per- 0%30% centage of all committed funds with Overall Round 1 Round 2 Round 3 the proportion of time elapsed since 20% the grant agreements were signed. 10%
0% Overall Round 1 Round 2 Round 3
Operations + Results Global Fund Annual Report 2004 33
Fig. 6: Grant agreements signed as a proportion of total grants approved by the Board
2002 2003 2004 Total No. % Q1 Q2 Q3 Oct Nov Dec to Date Approved Signed
No. of Grants Signed Round 1 9 57 1 — — — — — 67 68 99% Round 2 — 69 9 9 4 2 3 — 96 100 96% Round 3 — — 4 12 30 17 — — 63 72 88% Round 4 — — — — 1 1 3 8 13 73 18% All rounds 9 126 14 21 35 20 6 8 239 313 76%
Funds 52 1’040 93 206 314 165 44 55 1’970 $ million Committed ($ m) Funds 1 225 58 139 165 47 50 174 860 $ million Disbursed ($ m) 86% of $1 billion goal by end of 2004
* Includes total number of prospective grants approved (i.e. including components where more than one grant will be assigned) and grants for which funding was formerly provided (i.e. suspended grants)
Applying this technique,the dis- • with many,absorption capacity requests vary according to the bursement record is described in Fig- will grow over time as grant types of activities planned for ure 7 below for each funding round funding,partner involvement or the disbursement period — and for the portfolio as a whole. a broadened sub-recipient for example,drug procurement Of the total amount of disburse- base result in an increase in requires more money than the ments to 31 January 2005,82 percent absorptive capacity; training of staff. was disbursed to Rounds 1 and 2 • the level of verifiable program- grants,16 percent to Round 3 grants matic performance — a lack of Nongovernmental principal recipi- and 2 percent to Round 4 grants. progress on the part of the PR ents have performed well in absorb- Round 3 and 4 grants,which are or evidence that the PR is ing funds,with an average disburse- younger,have disbursed in excess of not disbursing to sub-recipients ment rate of 91 percent of expected grant time elapsed because the first causes recipients to receive disbursement,as compared to an av- disbursement to recipients is usually money at a slower rate; erage of 79 percent for governmental larger than average.Over time,ex- • the amounts of disbursement principal recipients. penditure lines up more closely with time elapsed.From 2005,Rounds 3 and 4 grants will receive increasing disbursements and therefore con- tribute much more significantly to Fig. 7: Approvals, commitments and disbursements by funding round results.Overall,disbursements are roughly on track relative to the time Round Approved 2-year 2-year 2-year Mean % Mean time approved1 signed2 disbursed3 of 2-yr amt elapsed4 elapsed for signed grants. disbursed4 While comparing the rate of dis- bursement with time elapsed since Round 1 Apr-02 $ 555 $ 545 $ 370 70% 77% grant agreement signing is an impor- Round 2 Jan-03 $ 859 $ 810 $ 336 46% 50% tant way to evaluate whether or not Round 3 Oct-03 $ 635 $ 543 $ 136 33% 16% disbursements are on track overall, Round 4 Jun-04 $ 1,038 $ 72 $ 18 32% 6% the disbursement rate for any single Total $ 3,087 $ 1,970 $ 860 49% 48% grant is never constant.Disburse- ment rates may vary for a number of Disbursements by funding round $ figures in millions, as of 31 December 2004 reasons: 1. Proposals approved for funding by the Board (initially for two years, with an extension to five years • some grants absorb money where approved) more slowly than others due to 2. Grant agreement signed by the Secretariat, committing funds for 2-year term of grant 3. Amount transferred to recipients – disbursed incrementally based on performance limited capacity; 4. Calculations based on grants which have received one or more disbursements
34 Global Fund Annual Report 2004
Local Fund Agents by country during 2004
PWC Afghanistan (PWC) Cote D’Ivoire (PWC) Guinea-Bissau (PWC) Mongolia (UNOPS) Panama (PWC) Togo (PWC) Algeria (PWC) Congo DR (PWC) Guyana (DTT) Morocco (PWC) Paraguay (PWC) Turkey (PWC) Angola (PWC) Costa Rica (PWC) Haiti (KPMG) Mozambique (DTT) Peru (PWC) Uganda (PWC) KPMG Argentina (PWC) Croatia (KPMG) Honduras (PWC) Multi Country CARI- Philippines (PWC) Ukraine (PWC) Armenia (KPMG) Cuba (PWC) Indonesia (PWC) COM (DTT) Romania (KPMG) Uzbekistan (PWC) UNOPS Azerbaijan (UNOPS) Djibouti (STI) India (UNOPS) Multi Country OECS Russian Federation Vietnam (KPMG) Bangladesh (DTT) Dominican Republic Iran (KPMG) (DTT) (PWC) Yemen (KPMG) Belarus (KPMG) (DTT) Jamaica (PWC) Multi Country CRN+ Rwanda (Crown Zambia (PWC) STI Belize (KPMG) Dominican Republic Jordan (PWC) (DTT) Agents) Zanzibar (PWC) Benin (PWC) (PWC) Kazakhstan (KPMG) Multi Country Africa Sao Tome and Zimbabwe (PWC) DTI Bhutan (KPMG) East Timor (PWC) Kenya (KPMG) (PWC) Principe (STI) Bolivia (PWC) East Timor (UNOPS) Korea DPR (KPMG) Multi Country Andean Senegal (KPMG) Botswana (PWC) Ecuador (PWC) Kosovo (UNOPS) Region (PWC) Serbia (UNOPS) CROWN Bulgaria (KPMG) Egypt (PWC) Kyrgyzstan (PWC) Multi Country Meso Sierra Leone (PWC) Burkina Faso (STI) El Salvador (KPMG) Laos (KPMG ) Americas (PWC) Somalia (PWC) Burundi (PWC) Equatorial Guinea (STI) Lesotho (PWC) Multi Country Western South Africa (KPMG) Cambodia (KPMG) Eritrea (KPMG) Liberia (PWC) Pacific Islands Sri Lanka (PWC) Cameroon (PWC) Estonia (PWC) Lutheran World (KPMG) Swaziland (PWC) Central African Ethiopia (KPMG) Federation (DTT) Myanmar (KPMG) Sudan North (KPMG) Republic (PWC) Gabon (PWC) Macedonia (UNOPS) Namibia (PWC) Sudan South (KPMG) Chad (STI) Gambia (PWC) Madagascar (PWC) Nepal (PWC) Suriname (PWC) Chile (PWC) Georgia (KPMG) Malawi (PWC) Nicaragua (PWC) Tajikistan (PWC) China (UNOPS) Ghana (PWC) Mali (KPMG) Niger (STI) Tanzania (PWC) Colombia (PWC) Guatemala (DTT) Mauritania (PWC) Nigeria (KPMG) ThailandPWC (PWC) Comoros (PWC) Guinea (PWC) Moldova (PWC) Pakistan (KPMG) ThailandKPMG (KPMG) UNOPS
STI DTT
CROWN
MANAGING UNDER- ents better by devoting more re- to define and monitor appropriate PERFORMING GRANTS sources to particular issues before steps to be taken by the Secretariat in Over the first 18 months of the they turn into serious problems and coordinated action with partners. Global Fund’s existence,a portfolio to better manage the Global Fund’s manager handled all of the issues as- risk exposure. LOCAL FUND AGENTS sociated with each of their grants.As The support unit was tasked with The decision not to have a Global the implementation of some grants generating several tools to aid prob- Fund presence outside Geneva,and faced more obstacles than others, lem-solving strategies.Tools whose instead secure the services of in- portfolio managers quickly found development was begun in 2004 in- country Local Fund Agents (LFAs),is that a few grants took up most of clude an early warning system to flag among the most innovative elements their time,leaving little time to sup- problems with grants at early stages of the Global Fund’s grant manage- port their remaining grants.In May of development.This system would ment structure. 2004,the Global Fund created a sup- respond to a wide variety of triggers, LFAs are contracted to assess the port unit,Operational Partnerships of varying urgency and type,such as capacity of nominated Principal Re- and Country Support,whose re- time-sensitive factors or disburse- cipients (PRs) to administer grant sponsibility it is to assist slow-mov- ment information,and would also funds and,beyond grant signature,to ing grants,leaving the portfolio man- respond to the computerized Grant report on financial and program- agers free to continue routine sup- Management Tool.A related diag- matic progress and challenges to pro- port of higher-functioning grants. nostic tool would simultaneously gram success.During grant imple- This process has enabled the Secre- help define the nature of the prob- mentation,LFAs also ascertain tariat to simultaneously serve recipi- lem,while a system is being created whether PRs are undertaking
Operations + Results Global Fund Annual Report 2004 35
product and other procurement con- peated use of the same PRs,the role order to align CCMs with the UN- sistent with the Global Fund’s guide- of LFAs in such cases will inevitably AIDS principle of“The Three Ones”: lines.In addition,LFAs verify a PR’s change,especially where the need for one agreed HIV/AIDS Action periodic disbursement requests, comprehensive assessment is ren- Framework that provides the basis progress updates and review annual dered unnecessary. for coordinating the work of all part- audit reports.From late 2004,the An LFA officer position was cre- ners; one National AIDS Coordinat- scope of LFA services has expanded ated to oversee the Global Fund’s re- ing Authority with a broad-based to provide critical objective input into lationship with LFAs and ensure the multisectoral mandate; one agreed the Phase 2 grant renewal process. delivery of optimal LFA services.By country-level Monitoring and Evalu- Although the idea behind the the end of 2004,this position had not ation System.The CCM is a mecha- Local Fund Agent (LFA) model is not yet been filled. nism which should be flexible unique,no other major development enough to be fully aligned with other finance mechanism has so far made COUNTRY COORDINATING decision bodies where appropriate. use of outside assessment and verifi- MECHANISMS Improving CCMs is among the cation of the type and scale of the Over the past 18 months,the Global Global Fund’s most central priorities. Global Fund’s LFA system.The lack Fund Secretariat has undertaken a The conclusions of this analysis of previous experience and best prac- comprehensive analysis of the early led to a set of revised requirements tices in this field means there is a con- experiences of CCMs based on case and recommendations for CCMs, stant need to assess and seek ways of studies from 17 countries,a particu- covering areas such as membership, improving performance of the LFA larly in-depth study of CCMs in four representation and process,and system.A thorough review of the ef- countries,two multi-country studies which were adopted by the Board in fectiveness,benefits and weaknesses of NGO involvement in CCMs,a November 2004.The analysis also re- of individual LFAs and the system of multi-country study on the involve- sulted in a set of performance criteria outsourced oversight in general was ment of People Living with for CCMs to be implemented in carried out in 2004.The review in- HIV/AIDS,an International Labour 2005.Other results of the analysis in- cluded 13 in-depth case studies of Organization review of private sector clude a series of workshops to be car- LFA performance and an independ- participation,and two studies of ried out in 2005 to build capacity in ent overall report on the effectiveness faith-based organizations’integra- common areas of weakness,includ- and value-for-money of existing LFA tion into Global Fund processes,as ing project management and basic contracts and working arrangements. well as feedback from regional meet- business skills,and an expansion of From this review came a number of ings and Secretariat staff. the Global Fund’s mailing list for recommendations which are now These assessments all stress the CCM communications to include being implemented through changed value and benefits of the CCMs, not only Chairs and Vice-Chairs but work procedures and revised terms pointing out that CCMs have taken also all other CCM members. for future contracts. inclusiveness and multisectoral col- As part of the systems effects Among the revisions that were laboration a step forward in the framework development,the Global made to the LFA system during 2004 health sectors of many developing Fund has developed a simple CCM was a more fully defined day-to-day countries. checklist which was approved by the role of the LFA,with quality control However,they point to a variety Board in November 2004.This and assurance services continuing to of problems which are hampering checklist will serve as a tool for yearly be provided by central teams with the CCM’s performance and there- self-assessments of CCM composi- whom the Global Fund directly con- fore are negatively affecting the over- tion and functioning and as a basis tracts.Contracts were re-negotiated, all Global Fund process.Some of the for regular sample audits.The Global moving from a “fee for service” problems facing CCMs are due to Fund has initiated a study that will framework,to one focused on “deliv- practical limitations; travel costs,lan- develop a baseline for all CCMs by ery of performance-based verifica- guage barriers,lack of organization June 2005. tion of implementation services”.In among constituencies and scarce re- the negotiation of contracts,the sources for administration have hin- Global Fund has been moving away dered the smooth functioning of from a “one size fits all”model by re- some CCMs.In others,the govern- ducing LFA oversight in well-per- ment has not been willing to fully in- forming countries,and enhancing all clude nongovernmental groups in forms of grant oversight in countries decision-making processes and over- where greater challenges exist.It has sight functions,and this has reduced also introduced a systemic approach genuine multisectoral participation. to program verification tied to per- In addition,in many countries, ceived programmatic risks.As in- the role of the CCM vis-à-vis other creasing numbers of country grants forums for health planning and coor- made at new rounds involve the re- dination needs to be clarified in
36 Global Fund Annual Report 2004 Operations + Results Grant Performance
Overall Targets + Results Each Global Fund grant sets a target for the number of people it aims to reach with key interventions over the five-year lifetime of the grant. When the targets for all grants in the first four funding rounds are tallied, a cumulative set of global targets is reached:
Fig. 8: Expected outcomes for Rounds 1-4 after five years
HIV/AIDS TUBERCULOSIS MALARIA
1.6 million people on 3.5 million additional TB cases 108 million bednets to protect antiretroviral treatment treated successfully under the families from transmission of DOTS treatment strategy malaria 52 million people reached with voluntary counseling and testing More than 12,000 new treatments 145 million artemisinin-based for HIV for multidrug-resistant tuberculosis, combination treatments for quadrupling current numbers on drug-resistant malaria More than one million treatment orphans supported through medical services, education and community care
These are rolling targets,as they Since they include Round Four last batch by early 2010.Long before will increase as new rounds are in- grants which have yet to start imple- then,however,there will be more cluded and because the five-year tar- mentation,the first batch of grants grants approved in successive fund- get refers to the lifetime of each grant contributing to these targets will ing rounds,so these targets will in- and not to a fixed calendar period. reach their targets by 2007 and the crease with each new round.
Operations + Results Global Fund Annual Report 2004 37
By the end of 2004,the average 2004 were as follows (no significant targets predominantly stem age of Global Fund grants was 11 results for HIV orphans and mul- from grants that are too young to months. Cumulative results for the tidrug-resistant tuberculosis cases show results). grant portfolio as of 31 December have been recorded yet, as these
Fig. 9: Cumulative results for grant portfolio at end of 2004
HIV/AIDS TUBERCULOSIS MALARIA
130,000 people on antiretroviral 385,000 TB cases treated under More than 1.35 million families treatment the DOTS strategy* with insecticide-treated bednets to prevent malaria. More than 1 million people * Some of these treatments are reached with voluntary counseling not yet completed and can More than 300,000 people receiv- and testing services for HIV therefore not yet be proven ing highly effective artemisinin “successful” combination treatment for malaria
In addition,an estimated tens of bers show steady growth rates,with ture,national governments,NGOs millions have been reached through a results increasing by 52 percent be- and other program implementers are wide range of prevention programs, tween the 12-month and 18-month working hard with the assistance of including behavior-change cam- marks.These results reflect the chal- bilateral and multilateral partners to paigns,community outreach pro- lenges faced in scaling up ARV treat- improve procurement systems,train grams,condom distribution,targeted ment access in settings where train- staff and build clinics. support for injecting drug users,sex ing,testing,and diagnostic facilities The results of Global Fund fi- workers and mobile populations, are inadequate and where capacity- nancing are the results of the work of school programs,and awareness-rais- building issues are more complex. a broad range of implementing part- ing for communities and the media. ners.The Global Fund disburses Another indication of the pace of CAPACITY-BUILDING grant funding to a wide selection of progress is to look at the growth and As important as the Global Fund’s principal recipients,including gov- acceleration of grant achievements “headline”results is the way grants ernment ministries,nongovernmen- between their one-year mark and are building human resource capac- tal organizations,private sector busi- their 18-month mark.In comparing ity and physical infrastructure in nesses,faith-based organizations,ac- the June and December 2004 results order to accelerate the scale-up of ademic institutions and organiza- of the earliest 15 grants,a steady prevention and treatment services in tions representing people living with growth and in some cases an acceler- the near future and to ensure that the or affected by the diseases. ation of results is apparent during the quality of services provided is high. However,it is important to re- first half of the second year.The The grants have made important in- member that these principal recipi- number of people reached with TB vestments in country capacity as the ents further distribute funds to sub- treatment under DOTS increased by basis for future scale-up.Over recipients.In Zambia,for example, 70 percent between June and Decem- 350,000 people — from ministries of sub-recipients include health dis- ber 2004,and the distribution of in- health to community organizations tricts,faith-based organizations and secticide-treated bednets increased and peer educators — were trained nongovernmental organizations; in by 103 percent during the same time to fight HIV,TB and malaria in 2004. China,there are several thousand period.The acceleration of TB and Of Global Fund grants approved to sub-recipients at every level of gov- malaria programs is not surprising, date,20 percent is being spent on ernment right down to district level. given that the first year of a grant is human resources and 13 percent on Results to date are the culmination of predominantly spent on logistical is- physical infrastructure. their efforts in the fight against sues,physical infrastructure,pro- In many countries,Global Fund HIV/AIDS,TB and malaria.It is the curement and training,and that grants are being used to scale up ex- people at all of these levels — princi- these lay the ground for an accelera- isting efforts and to pilot new or ex- pal recipients,sub-recipients and tion of services in the grants’second panding programs; in other coun- sub-sub-recipients — and from the year.Antiretroviral treatment num- tries with little capacity or infrastruc- entire spectrum of public and private
38 Global Fund Annual Report 2004
sectors that carry out the implemen- ing clarifications on their proposals. tation of funded programs to fight WHO’s Intensified Support and Ac- the three diseases. tion Countries initiative is support- ing 17 Global Fund recipients in WORKING WITH PARTNERS order to achieve more rapid and The Global Fund has no presence in more effective program implementa- the countries it funds,and as a fund- tion.Stop TB is also supporting ing mechanism it plays no part in about 50 countries,including previ- program implementation or provid- ously unsuccessful applicants in ing technical assistance.However,as Round Four,in developing their ap- part of a dynamic network of devel- plications for Round Five,which the opment partners working to achieve Global Fund will approve in time for greater combined results towards the June 2005 deadline.Finally,the common goals,the Global Fund re- Global TB Drug Facility is working lies on its partners to provide techni- with recipients in eight priority cal expertise to grant recipients.The countries to identify bottlenecks in Global Fund’s network includes a their procurement and supply man- large and varied group of technical agement systems and to implement partners that carry out invaluable solutions. work to provide input to and build Similarly,close collaboration is recipient-country capacity for pro- taking place with the WHO’s posal writing,program implementa- HIV/AIDS Department and the “3 by tion,problem-solving,harmoniza- 5”initiative to put three million peo- tion with existing systems and per- ple on antiretroviral treatment by the formance evaluation. end of 2005.A joint effort is under- Over the past two years,much ef- way to develop comprehensive tech- fort has been made to both nical support plans for accelerating strengthen and systematize the the scale-up of antiretroviral therapy Global Fund’s collaboration with and prevention services in 15 to 20 technical partners,and to broaden its priority countries.The support of the partner network for country-level “3 by 5”team in speeding up pro- technical support throughout the life posal clarifications on approved cycle of each grant.UNAIDS is cen- Round Four grants,like that of the tral within this network,and over the Stop TB Department,has also been past year,the Global Fund’s collabo- invaluable.In addition,WHO is ration with UNAIDS has intensified strengthening its capacity to provide in various areas.UNAIDS is provid- assistance to countries in procure- ing critical support to CCMs in ment and supply-chain management. preparing grant performance reports, In 2004,the collaboration with also working to accelerate the roll- leveraging about 30 new monitoring WHO’s Roll Back Malaria (RBM) out of a new generation of long-last- and evaluation officers who are being Department was close and comple- ing mosquito nets,which have posted in various countries.In addi- mentary,specifically with regards to proven highly effective. tion,UNAIDS is scaling up its in- the ongoing effort to reprogram ex- The Global Fund has intensified volvement and staffing levels to inten- isting Global Fund grants to use new, dialogue on coordination,informa- sify its capacity-building support. more effective malaria treatments tion exchange and assistance in pro- Another central partner is the that use an artemisinin-based com- gram countries with bilateral part- World Health Organization (WHO), bination therapy (ACT).So far 26 ners.It draws on substantial support and the Global Fund is working countries have been directly assisted from American,British,Canadian, closely to expand and intensify its in this process,and a number of French,German and Swedish bilater- collaboration with WHO at all levels. other countries will be assisted in als and others that are providing In 2004,the Stop TB Department,in producing grant proposals for the training and technical support for collaboration with the Global Stop next funding round that cover the the Global Fund application and im- TB Partnership,increased its provi- cost of changing national drug pro- plementation processes in recipient sion of the technical support re- tocols to include ACT.RBM has pro- countries,and improving participa- quired by countries during the devel- vided valuable support to assist tion in CCMs. opment of applications to the Global funded countries in accelerating im- The Global Fund is broadening Fund and is providing significant plementation where progress on and deepening its collaboration with support to countries that were ap- malaria programs has proven too NGO partners and the private sector proved for Round 4 TB grants pend- slow.The Global Fund and RBM are based on lessons learned over the
past two years.In a number of coun- ing with the private sector,the Global Niger,the Global Fund has been tries,the French-led ESTHER initia- Fund is making a substantial effort to working with European members of tive supports Global Fund processes accelerate engagement through dis- the Global Business Coalition Against through technical assistance on high- cussions on co-investment opportu- HIV/AIDS to allow local branches of quality treatment and care for people nities with corporations that have these companies to associate them- living with HIV/AIDS.The Interna- operations and expertise in develop- selves with recipients of Global Fund tional Council of AIDS Service Orga- ing countries. grants.Discussions have also been ini- nizations (ICASO) is providing sup- tiated in China and in India to seek port in translating CCM guidelines CO-INVESTMENT greater involvement of the private sec- and working to increase civil society The co-investment approach seeks to tor in the Global Fund process at the and community involvement in ensure that,in addition to efforts the country level.It is expected that a CCMs.A constructive dialogue is corporations are making to provide number of such proposals will be maintained with Médecins Sans services to their employees and their made in Round 5 in India.In June Frontières on important in-country dependents,broader communities 2005,the Global Fund,in association Above issues,in particular concerning will also benefit from quality services with the Global Business Coalition TB patients sit outside a district malaria and TB drugs.The Global through the reinforcement of public and GTZ,will be organizing the next health center in Fund has also developed a plan for health services or collaboration with meeting on co-investment,bringing Yangon, Myanmar. collaboration on drug prices and NGOs receiving Global Fund grants. together bilateral organizations,in- other areas of support with the Clin- Since the last Board meeting,several cluding the UK’s Department for In- ton Foundation for a number of sub- proposals for co-investment have ternational Development (DFID), Saharan African countries.In work- been initiated.In Kenya,Gabon and France’s Agence Française de
40 Global Fund Annual Report 2004 Operations + Results
Developpement (AFD),the Presi- monitoring and evaluation, tween the Global Fund and other dent’s Emergency Plan for AIDS Relief and progress achieved at each donors,in particular the U.S.Presi- (PEPFAR),the United Nations,the disbursement period. dent’s Emergency Plan for AIDS Re- World Economic Forum – Global • Key performance and country lief (PEPFAR),in program coun- Health Initiative (WEF-GHI),the In- contextual information tries.An example of this kind of col- ternational Finance Corporation This summarizes the perform- laboration was the joint calculation (IFC),expert groups such as Abt ance data by showing the and announcement of antiretroviral Associates,Merck and Co,as well as percentage of targets met treatment figures in January 2005 by ESTHER (Ensemble pour une Soli- for key service delivery areas. the Global Fund and PEPFAR,re- darité Thérapeutique Hospitalière En Contextual information of flecting the fact that the two mecha- Réseau),in order to come to a greater relevance to the interpretation nisms often finance different ele- understanding of roles and responsi- of grant progress and perform- ments within the same national bilities for building public-private ance is also included,such as treatment programs. partnerships at the country level. levels of conflict in a country, Finally,it will be the impact natural disasters,etc. Global Fund financing has in reduc- PHASE 2 FUNDING RENEWALS ing the burden of the three diseases Periodic performance evaluation in All of this information is put into a that will determine its ultimate suc- the first two years of a grant’s life Grant Performance Report which is cess or failure.Until now,one can builds to a formal assessment at the posted on the Global Fund’s website only infer a very modest global im- two-year mark for Phase 2 funding to as a public document. pact against the three diseases from cover the remaining years of the ap- Based on the performance and the results achieved to date.From proved grant period.The first Global contextual factors provided,the Sec- Round Five onwards,all grants will Fund grants were approaching the retariat makes a recommendation on have a set of impact indicators as end of their first two years at the end each Phase 2 funding applicant to the part of their overall set of results of 2004.As a result,one key area of Board.The Board makes the final de- measurement built into their Phase work in 2004 was the development of cision on whether or not to provide One grant agreements,and all Phase policies and procedures in prepara- continued funding to grantees.More Two grant extensions will have im- tion for the first tranche of Phase 2 than 100 grants will be eligible for pact indicators as they begin to be funding applicants. Phase 2 funding in 2005.Lessons negotiated and signed in early 2005. When grants reach 16 months,the learned by the Secretariat and grant The data gathered through these Global Fund Secretariat invites the recipients will be reviewed in 2005 processes will make an important grantee to apply for Phase 2 funding. and incorporated in the performance- contribution to the measurement of Performance and contextual factors based funding system going forward. Global Fund impact. contribute to a broad range of infor- mation that is used to make the Phase SYSTEMS EFFECTS + IMPACT 2 funding decision.They include: No systematic data exist yet on the extent to which the Global Fund in- • General grant information teracts with and affects its immediate and program objectives environment.The Global Fund,with This captures the major ele- relevant partners,has developed a set ments of the proposal,goals,im- of core indicators for systems effects pact indicators and key dates. and impact and putting them into • Program results compared operation over the course of 2005 is a to country-set targets priority.However, despite the lack of These measure the services that numerical data,events over the past were delivered and the progress three years suggest that the Global made over time against the Fund has influenced and adapted to targets that were set out in the the existing environment in which it grant agreement. Indicators operates.One clear example is with measure the numbers of people CCMs,which have now been estab- reached,the growth in capacity lished in more than 120 countries and the supporting environ- and which have,in many cases,in- ment of the grant. creased civil society involvement in • In-country assessments of the planning and decision-making Global Fund grants by Local processes for national programs to Fund Agents fight AIDS,TB and malaria. This includes assessments Another example is the increas- made through the grant’s first ingly close collaboration and infor- two years of procurement, mal work-sharing taking place be-
COUNTRY PROFILE Global Fund Annual Report 2004 41 Morocco Initiating a first national HIV/AIDS communication campaign
Disease(s) funded: HIV/AIDS Approved funding to date: US$ 9.2 million
strategies such as abstinence and fi- ness-raising events,27,800 from edu- delity and also,for the first time in cation initiatives and 2,200 commer- Among large sections of Moroccan the country’s history,publicly pro- cial sex workers and female workers society, it remains taboo to mention sex mote the use of condoms.Aspects of from outreach activities.During the in public. Yet with strong leadership, the campaign are targeted to young year,a total of 1,120 peer educators people and women,two groups par- were trained to support vulnerable spearheaded by the King and the Prime ticularly vulnerable to HIV infection groups,including sex workers,young Minister, things are beginning to change. in Morocco. people (both in and out of educa- The campaign has benefited tional settings) and women. enormously from the country’s in- The support of the Global Fund In 2004,one of the clearest signs of creasingly strong national leadership also strengthened voluntary counsel- this was the launch of the country’s and political commitment in relation ing and testing (VCT) and the provi- first national communication cam- to HIV/AIDS,including from the sion of care and treatment for people paign on HIV/AIDS.Unprecedented King,who has visited people living living with HIV/AIDS.Antiretrovi- in North Africa,it is bringing power- with HIV/AIDS in hospital,as well as rals (ARVs) and monitoring were ful messages about prevention and the involvement of the Prime Minis- made universally freely available to care to people’s homes,workplaces ter and the Ministry of Habous and all those who are eligible for treat- and social environments. Islamic Affairs.It has also been ment,706 people were provided with HIV prevalence remains very low greatly aided by a Media for AIDS ARV treatment,and services were among Morocco’s 31 million people, Charter,signed by the Ministries of decentralized,and made available at an estimated 0.1 per cent in 2003. Health and Communications and the through five regional referral centers. Yet with high levels of sexually trans- Directors General of two national tel- Thanks to reduced drug prices,con- mitted infections (600,000 new cases evision channels and two radio chan- siderable savings were made from the were registered in one recent year nels,as well as the President of the efficient procurement of ARVs. alone) and HIV prevalence increas- Federation of Print Media.By the The initiatives supported by the ing more than two-fold in the 1990s, end of 2004,the campaign had al- Global Fund are coordinated by a there is little room for complacency. ready disseminated 308 national tele- Country Coordinating Mechanism The Ministry of Health has devel- vision spots,450 radio spots in four (CCM) that reflects the dynamic, oped a comprehensive national strat- dialects,100 press releases and 125 multi-sectoral nature of Morocco’s egy,whose implementation is partly city billboards,as well as a mobile national response.In 2004,the group funded by the Global Fund.The pro- unit which travelled 4,000 km across was joined by the Ministry of gram was submitted to the Global the country to provide information Habous and Islamic Affairs on a col- Fund in Round One and the grant on HIV/AIDs. laborative NGO project to involve agreement was signed in March 2003 Other key areas of work sup- imams in HIV/AIDS initiatives.New for a two-year budget of US$ 4.7 mil- ported by the Global Fund include CCM members in 2004 included lion with the National AIDS Program HIV prevention with vulnerable representatives of other ministries as the Principal Recipient . communities such as commercial sex (Communications,Penitentiaries, 2004 saw the launch of a key ele- workers,among whom prevalence Justice),the private sector (Federa- ment of the work supported by the was over 2 per cent in 2003.Here,the tion of Moroccan Businesses and Global Fund: a national communica- work is largely implemented by NGO Moroccan Association of Pharma- tion campaign on HIV/AIDS.The partners and includes information ceutical Industries) and NGOs (Mo- campaign is walking a social and po- on prevention, the provision of con- roccan Red Crescent and Moroccan litical tightrope,showing respect for doms and information and STI diag- Family Planning Association).The the diversity and sensitivity of Mo- nosis and treatment.In 2004,this CCM continued to promote trans- rocco’s culture and traditions while component of the program either parency and created a website addressing the reality of a disease met or exceeded all of its key targets. (www.programmesida.org.ma) to that,in at least 76 percent of cases,is Over 1.9 million condoms were dis- publicly share information on its transmitted through heterosexual tributed in the target area,while composition and function,goals, sex,both in and outside of marriage. 172,000 young people and women monitoring and evaluation plan,and Some of its messages emphasize benefited from HIV/AIDS aware- Principal and Sub-Recipients.
Global Fund Annual Report 2004 43 Approved Grants + the Organization
44 Approved Grants 54 List of Board Members 2004 56 Technical Review Panel 2004 58 The Global Fund Secretariat
44 Global Fund Annual Report 2004 Approved Grants
The principal work of the Global Fund is accomplished by rewarding EAST ASIA + THE PACIFIC and managing grants to finance the battle against the world’s three great health pandemics: HIV/AIDS, tuberculosis and malaria. Cambodia HIV/AIDS,Malaria and Tuberculosis Following approval of programs by the Board, grant agreements Rounds 1,2 and 4 commit funds for an initial two-year period, and periodic 38’147’845 disbursements are made on the basis of requests and performance. 24’131’619 The list that follows details funding approved by the Board after 12’003’743 Local Fund Agent three proposal rounds, by region, country, disease target, and round. KPMG The total sum authorized by Board approval is specified and is Principal Recipent(s) followed by the sum committed as a result of signed grant The Ministry of Health and TBC agreements as of 31 December 2004 and then by the amount ———————— China disbursed as of that same date. HIV/AIDS,Malaria and Tuberculosis Principal Recipients are listed for all grant agreements signed Rounds 1,3 and 4 by 31 December 2004. In all other cases, these are shown as “To Be 112’843’130 Confirmed”. This is also the case for Local Funding Agents. 61’016’212 40’320’012 For current and detailed information regarding the grant portfolio Local Fund Agent of the Global Fund, please refer to the Global Fund website at United Nations Office for Project www.theglobalfund.org. Services Principal Recipent(s) The Chinese Centre for Disease Control and Prevention and TBC ———————— East Timor Malaria and Tuberculosis Key Rounds 2 and 3 3’268’394 REGION 3’268’394 1’364’450 Country Local Fund Agent Program(s) Approved for Funding Pricewaterhouse Coopers Round(s) of Approval Principal Recipent(s) Total Funds Approved (in US$) The Ministry of Health Funds Committed by Grant Agreement(s) (in US$) Funds Disbursed at 31 December 2004 (in US$) Local Fund Agent Principal Recipient(s)
Approved Grants Global Fund Annual Report 2004 45
Indonesia Papua New Guinea Azerbaijan HIV/AIDS,Malaria and Tuberculosis HIV/AIDS and Malaria HIV/AIDS Rounds 1 and 4 Rounds 3 and 4 Round 4 67’921’801 14’598’802 6’553’600 36’792’183 6’106’557 — 24’207’542 2’185’723 — Local Fund Agent Local Fund Agent Local Fund Agent Pricewaterhouse Coopers KPMG TBC Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Ministry of Health and TBC The Department of Health and TBC TBC ———————— ———————— ———————— Lao PDR Philippines Belarus HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis HIV/AIDS Rounds 1,2 and 4 Rounds 2 and 3 Round 3 13’470’615 14’176’114 6’818’796 5’987’154 14’176’114 6’818’796 4’665’882 10’038’851 1’254’445 Local Fund Agent Local Fund Agent Local Fund Agent KPMG Chemonics KPMG Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Ministry of Health and TBC Tropical Disease Foundation,Inc. The United Nations Development ———————— ———————— Programme Mongolia Thailand ———————— HIV/AIDS and Tuberculosis HIV/AIDS,Malaria and Tuberculosis Bulgaria Rounds 1,2 and 4 Rounds 1,2 and 3 HIV/AIDS 3’873’882 61’197’279 Round 2 1’915’623 61’197’279 6’894’270 1’835’792 36’948’766 6’894’270 Local Fund Agent Local Fund Agent 2’691’090 United Nations Office KPMG Local Fund Agent for Project Services Principal Recipent(s) KPMG Principal Recipent(s) The Ministry of Public Health and Principal Recipent(s) The Ministry of Health and TBC RAKS Thai Foundation The Ministry of Health ———————— ———————— ———————— Multi-country Western Pacific Viet Nam Croatia HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis HIV/AIDS Round 2 Rounds 1 and 3 Round 2 7’151’950 23’388’402 3’363’974 7’151’950 23’388’402 3’363’974 5’392’219 7’626’978 1’468’709 Local Fund Agent Local Fund Agent Local Fund Agent KPMG KPMG KPMG Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Secretariat of the Pacific The Ministry of Health The Ministry of Health Community and Social Welfare ———————— ———————— Myanmar EASTERN EUROPE + Estonia HIV/AIDS,Malaria and Tuberculosis CENTRAL ASIA HIV/AIDS Rounds 2 and 3 Round 2 35’680’724 Armenia 3’908’952 6’997’137 HIV/AIDS 3’908’952 2’404’656 Round 2 2’796’271 Local Fund Agent 3’166’641 Local Fund Agent KPMG 3’166’641 Pricewaterhouse Coopers Principal Recipent(s) 1’843’839 Principal Recipent(s) The United Nations Development Local Fund Agent The National Institute for Health Programme and TBC KPMG Development of the Ministry Principal Recipent(s) of Social Affaires World Vision International – Armenia Branch
46 Global Fund Annual Report 2004 Approved Grants
Georgia Moldova Tajikistan HIV/AIDS,Malaria and Tuberculosis HIV/AIDS and Tuberculosis HIV/AIDS and Tuberculosis Rounds 2,3 and 4 Round 1 Rounds 1,3 and 4 7’099’810 5’257’941 5’284’725 4’664’032 5’257’941 5’284’725 1’171’271 2’976’861 3’534’233 Local Fund Agent Local Fund Agent Local Fund Agent KPMG Pricewaterhouse Coopers Pricewaterhouse Coopers Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Georgia Health and Social Projects The Project Coordination, Project HOPE and The United Nations Implementation Center and TBC Implementation and Monitoring Development Programme ———————— Unit of the Ministry of Health ———————— Global (LWF) ———————— Turkey HIV/AIDS Romania HIV/AIDS Round 1 HIV/AIDS and Tuberculosis Round 4 485’000 Round 2 3’891’762 485’000 38’671’000 — 348’000 38’671’000 — Local Fund Agent 21’474’170 Local Fund Agent DTT Emerging Markets Local Fund Agent TBC Principal Recipent(s) KPMG Principal Recipent(s) The Lutheran World Federation Principal Recipent(s) TBC ———————— The Ministry of Health and Family ———————— Kazakhstan ———————— Ukraine HIV/AIDS Russian Federation HIV/AIDS Round 2 HIV/AIDS and Tuberculosis Round 1 6’502’000 Rounds 3 and 4 17’296’598 6’502’000 125’614’264 17’296’598 3’419’670 37’903’176 17’296’598 Local Fund Agent 12’661’235 Local Fund Agent KPMG Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) Pricewaterhouse Coopers Principal Recipent(s) The Republican Center for Principal Recipent(s) The International HIV/AIDS Alliance, Prophylactics and Control of AIDS The Open Health Institute, The Ministry of Health,The Ukrainian ———————— Partners In Health and TBC Fund to Fight HIV Infection and AIDS Kyrgyzstan ———————— and the United Nations Development HIV/AIDS and Tuberculosis Serbia + Montenegro Programme Round 2 HIV/AIDS and Tuberculosis ———————— 6’170’873 Rounds 1 and 3 Uzbekistan 6’170’873 5’147’700 HIV/AIDS,Malaria and Tuberculosis 2’195’940 5’147’700 Rounds 3 and 4 Local Fund Agent 2’342’301 12’160’743 Pricewaterhouse Coopers Local Fund Agent 4’760’755 Principal Recipent(s) United Nations Office for Project 407’181 The National AIDS Center Services Local Fund Agent and National Center of Phtisiology Principal Recipent(s) Pricewaterhouse Coopers ———————— The Economics Institute in Belgrade Principal Recipent(s) Macedonia, FYR and The Ministry of Health The National AIDS Center of the HIV/AIDS ———————— Ministry of Health and TBC Round 3 Serbia + Montenegro (Kosovo) 4’348’599 Tuberculosis 4’348’599 Round 4 1’240’413 2’122’441 Local Fund Agent — United Nations Office for Project — Services Local Fund Agent Principal Recipent(s) TBC The Ministry of Health Principal Recipent(s) TBC
Approved Grants Global Fund Annual Report 2004 47
LATIN AMERICA + Costa Rica Guatemala THE CARIBBEAN HIV/AIDS HIV/AIDS and Malaria Round 2 Rounds 3 and 4 Argentina 2’279’501 18’137’660 HIV/AIDS 2’279’501 8’423’807 Round 1 1’486’604 1’532’478 12’177’200 Local Fund Agent Local Fund Agent 12’177’200 Pricewaterhouse Coopers DTT Emerging Markets 8’123’197 Principal Recipent(s) Principal Recipent(s) Local Fund Agent The Consejo Técnico de Asistencia Fundación Visión Mundial Guatemala Pricewaterhouse Coopers Médico Social (CTAMS) and TBC Principal Recipent(s) ———————— ———————— The United Nations Development Cuba Guyana Programme HIV/AIDS HIV/AIDS,Malaria and Tuberculosis ———————— Round 2 Rounds 3 and 4 Belize 11’465’129 11’663’649 HIV/AIDS 11’465’129 10’937’361 Round 3 11’465’129 — 1’298’884 Local Fund Agent Local Fund Agent 1’298’884 Pricewaterhouse Coopers DTT Emerging Markets 342’578 Principal Recipent(s) Principal Recipent(s) Local Fund Agent The United Nations Development The Ministry of Health and TBC KPMG Programme ———————— Principal Recipent(s) ———————— Haiti Belize Enterprise for Sustainable Dominican Republic HIV/AIDS,Malaria and Tuberculosis Technology HIV/AIDS and Tuberculosis Rounds 1 and 3 ———————— Rounds 2 and 3 40’222’156 Bolivia 17’335’590 40’222’156 HIV/AIDS,Malaria and Tuberculosis 17’335’590 29’136’244 Round 3 1’067’253 Local Fund Agent 14’500’232 Local Fund Agent KPMG 14’500’232 Pricewaterhouse Coopers Principal Recipent(s) 3’404’860 Principal Recipent(s) Fondation SOGEBANK and The United Local Fund Agent Asociación Dominicana Pro-Bienestar Nations Development Programme Pricewaterhouse Coopers de la Familia (PROFAMILIA) and ———————— Principal Recipent(s) Consejo Presidencial del SIDA Honduras Centro de Investigación,Educación (COPRESIDA) HIV/AIDS,Malaria and Tuberculosis y Servicios (CIES) ———————— Round 1 ———————— Ecuador 20’470’016 Chile HIV/AIDS and Tuberculosis 20’470’016 HIV/AIDS Rounds 2 and 4 13’679’285 Round 1 16’355’435 Local Fund Agent 13’574’098 7’453’979 Pricewaterhouse Coopers 13’574’098 — Principal Recipent(s) 11’283’052 Local Fund Agent The United Nations Development Local Fund Agent Pricewaterhouse Coopers Programme Pricewaterhouse Coopers Principal Recipent(s) ———————— Principal Recipent(s) The Ministry of Public Health and TBC Jamaica Consejo de las Américas ———————— HIV/AIDS ———————— El Salvador Round 3 Colombia HIV/AIDS and Tuberculosis 7’560’365 HIV/AIDS Round 2 7’560’365 Round 2 14’775’073 2’227’456 3’482’636 14’775’073 Local Fund Agent 3’482’636 6’080’398 Pricewaterhouse Coopers 514’282 Local Fund Agent Principal Recipent(s) Local Fund Agent KPMG The Ministry of Health Pricewaterhouse Coopers Principal Recipent(s) Principal Recipent(s) The United Nations Development The International Organization Programme for Migration (IOM)
48 Global Fund Annual Report 2004 Approved Grants
Multi-country Americas (Andean) Nicaragua NORTH AFRICA + Malaria HIV/AIDS,Malaria and Tuberculosis THE MIDDLE EAST Round 3 Round 2 15’909’000 8’702’180 Algeria — 8’702’180 HIV/AIDS — 4’197’622 Round 3 Local Fund Agent Local Fund Agent 6’185’000 TBC Pricewaterhouse Coopers 6’185’000 Principal Recipent(s) Principal Recipent(s) 1’561’251 TBC Federación NICASALUD Local Fund Agent ———————— ———————— Pricewaterhouse Coopers Multi-country Americas Panama Principal Recipent(s) (CARICOM) Tuberculosis The Ministry of Health,Population and HIV/AIDS Round 1 Hospital Reform Round 3 440’000 ———————— 6’100’900 440’000 Chad 6’100’900 362’973 HIV/AIDS and Tuberculosis 2’188’108 Local Fund Agent Rounds 2 and 3 Local Fund Agent Pricewaterhouse Coopers 8’644’119 DTT Emerging Markets Principal Recipent(s) 8’644’119 Principal Recipent(s) The United Nations Development 1’580’169 The Caribbean Community Secretariat Programme Local Fund Agent ———————— ———————— Swiss Tropical Institute \Multi-country Americas (CRN+) Paraguay Principal Recipent(s) HIV/AIDS Tuberculosis Fonds de Soutien aux Activités Round 4 Round 3 en matière de Population 1’947’094 1’194’902 ———————— — 1’194’902 Djibouti — 433’926 HIV/AIDS Local Fund Agent Local Fund Agent Round 4 TBC Pricewaterhouse Coopers 7’271’400 Principal Recipent(s) Principal Recipent(s) — TBC Alter Vida – Centro de Estudios y — ———————— Formación para el Ecodesarrollo Local Fund Agent Multi-country Americas (Meso) ———————— TBC HIV/AIDS Peru Principal Recipent(s) Round 4 HIV/AIDS and Tuberculosis TBC 2’181’050 Round 2 ———————— — 35’872’172 Egypt — 35’872’172 Tuberculosis Local Fund Agent 13’939’472 Round 2 TBC Local Fund Agent 2’480’219 Principal Recipent(s) Pricewaterhouse Coopers 2’480’219 TBC Principal Recipent(s) 354’112 ———————— CARE Peru Local Fund Agent Multi-country Americas (OECS) ———————— Chemonics HIV/AIDS Suriname Principal Recipent(s) Round 3 HIV/AIDS and Malaria National Tuberculosis Control 2’553’861 Rounds 3 and 4 Program of the Ministry of Health — 5’152’382 ———————— — 2’963’950 Jordan Local Fund Agent — HIV/AIDS TBC Local Fund Agent Round 2 Principal Recipent(s) Pricewaterhouse Coopers 1’778’600 TBC Principal Recipent(s) 1’778’600 Medische Zending – Primary Health 1’497’206 Care Suriname and TBC Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) The Ministry of Health of the Government
Approved Grants Global Fund Annual Report 2004 49
Mauritania Yemen India Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis Round 2 Rounds 2,3 and 4 Rounds 1,2,3 and 4 1’928’786 12’239’211 114’128’775 1’928’786 4’159’632 41’514’345 959’591 1’661’532 11’166’268 Local Fund Agent Local Fund Agent Local Fund Agent Pricewaterhouse Coopers KPMG United Nations Office for Project Principal Recipent(s) Principal Recipent(s) Services and The World Bank The United Nations Development The National Malaria Programme Principal Recipent(s) Programme at the Ministry of Public Health and The Department of ———————— Population and TBC Economic Affairs and TBC Morocco ———————— HIV/AIDS Iran (Islamic Republic of) Round 1 SOUTH ASIA HIV/AIDS 4’738’806 Rounds 2 and 3 4’738’806 Afghanistan 9’698’000 3’909’772 HIV/AIDS,Malaria and Tuberculosis — Local Fund Agent Rounds 2 and 4 — Pricewaterhouse Coopers 5’469’995 Local Fund Agent Principal Recipent(s) 3’125’605 TBC The Ministry of Health 1’687’514 Principal Recipent(s) ———————— Local Fund Agent TBC Niger Pricewaterhouse Coopers ———————— HIV/AIDS and Malaria Principal Recipent(s) Nepal Rounds 3 and 4 The Ministry of Health and TBC HIV/AIDS,Malaria and Tuberculosis 24’548’394 ———————— Rounds 2 and 4 13’290’406 Bangladesh 10’343’005 5’104’204 HIV/AIDS and Tuberculosis 6’988’925 Local Fund Agent Rounds 2 and 3 948’513 Swiss Tropical Institute 22’653’213 Local Fund Agent Principal Recipent(s) 22’653’214 Pricewaterhouse Coopers The Centre of International 9’349’622 Principal Recipent(s) Cooperation in Health and Local Fund Agent The Ministry of Health and TBC Development (CCISD), DTT Emerging Markets ———————— The National Multi-sectoral Principal Recipent(s) Pakistan Coordination Unit for the Fight Bangladesh Rural Advancement HIV/AIDS,Malaria and Tuberculosis Against HIV/AIDS/STI and TBC Committee (BRAC) and The Economic Rounds 2 and 3 ———————— Relations Division of the Ministry of 17’632’567 Somalia Finance 17’632’567 HIV/AIDS,Malaria and Tuberculosis ———————— 6’596’026 Rounds 2,3 and 4 Bhutan Local Fund Agent 24’496’356 Malaria and Tuberculosis KPMG 14’491’712 Round 4 Principal Recipent(s) 6’951’128 1’561’525 The National AIDS Control Programme Local Fund Agent — on the Behalf of the Ministry of Health Pricewaterhouse Coopers — ———————— Principal Recipent(s) Local Fund Agent Sri Lanka The United Nations Children’s Fund, TBC Malaria and Tuberculosis World Vision – Somalia and TBC Principal Recipent(s) Rounds 1 and 4 ———————— TBC 10’261’140 Sudan 8’057’620 HIV/AIDS,Malaria and Tuberculosis 5’419’444 Rounds 2,3 and 4 Local Fund Agent 49’595’585 Pricewaterhouse Coopers 18’698’422 Principal Recipent(s) 6’969’278 Lanka Jatika Sarvodaya Shramadana Local Fund Agent Sangamaya,The Ministry of Health KPMG and TBC Principal Recipent(s) The United Nations Development Programme and TBC
50 Global Fund Annual Report 2004 Approved Grants
SUB-SAHARAN AFRICA Cameroon Equatorial Guinea HIV/AIDS,Malaria and Tuberculosis HIV/AIDS Angola Rounds 3 and 4 Round 4 HIV/AIDS,Malaria and Tuberculosis 40’913’717 4’402’427 Rounds 3 and 4 40’913’717 — 60’280’400 11’078’036 — — Local Fund Agent Local Fund Agent — Pricewaterhouse Coopers TBC Local Fund Agent Principal Recipent(s) Principal Recipent(s) TBC CARE International and The Ministry TBC Principal Recipent(s) of Public Health ———————— TBC ———————— Eritrea ———————— Central African Republic HIV/AIDS and Malaria Benin HIV/AIDS,Malaria and Tuberculosis Rounds 2 and 3 HIV/AIDS,Malaria and Tuberculosis Rounds 2 and 4 10’742’543 Rounds 1,2 and 3 25’520’634 10’742’543 17’294’520 14’927’818 4’811’220 17’294’520 6’782’857 Local Fund Agent 9’929’522 Local Fund Agent KPMG Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) Pricewaterhouse Coopers Principal Recipent(s) The Ministry of Health Principal Recipent(s) The United Nations Development ———————— Africare and The United Nations Programme and TBC Ethiopia Development Programme ———————— HIV/AIDS,Malaria and Tuberculosis ———————— Comores Rounds 1,2 and 4 Botswana HIV/AIDS and Malaria 149’350’582 HIV/AIDS Rounds 2 and 3 104’261’422 Round 2 2’220’231 45’739’466 18’580’414 2’220’231 Local Fund Agent 18’580’414 1’019’768 KPMG 9’019’119 Local Fund Agent Principal Recipent(s) Local Fund Agent Pricewaterhouse Coopers The Federal Ministry of Health, Pricewaterhouse Coopers Principal Recipent(s) The HIV/AIDS Prevention Principal Recipent(s) Association Comorienne pour le and Control Office and TBC The Ministry of Finance and Bien-Etre de la Famille (ASCOBEF) ———————— Development Planning ———————— Gabon ———————— Congo (Democratic Republic) HIV/AIDS and Malaria Burkina Faso HIV/AIDS,Malaria and Tuberculosis Rounds 3 and 4 HIV/AIDS,Malaria and Tuberculosis Rounds 2 and 3 10’574’124 Rounds 2 and 4 66’175’203 10’574’124 22’135’793 66’175’203 2’219’758 22’135’793 10’468’928 Local Fund Agent 7’522’237 Local Fund Agent Pricewaterhouse Coopers Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) Chemonics Principal Recipent(s) The United Nations Development Principal Recipent(s) The United Nations Development Programme The United Nations Development Programme ———————— Programme ———————— Gambia ———————— Côte d’Ivoire HIV/AIDS and Malaria Burundi HIV/AIDS and Tuberculosis Round 3 HIV/AIDS,Malaria and Tuberculosis Rounds 2 and 3 11’907’243 Rounds 1,2 and 4 21’993’054 11’907’243 20’556’301 21’993’054 2’723’624 18’669’126 7’948’437 Local Fund Agent 10’459’514 Local Fund Agent Pricewaterhouse Coopers Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) Pricewaterhouse Coopers Principal Recipent(s) The Department of State for Health Principal Recipent(s) CARE Côte d’Ivoire and The United and The National AIDS Secretariat Conseil National de Lutte Contre le Nations Development Programme SIDA (National AIDS Council), The Ministry of Public Health and TBC
Approved Grants Global Fund Annual Report 2004 51
Ghana Liberia Multi-country Africa (RMCC) HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis Malaria Rounds 1,2 and 4 Rounds 2 and 3 Round 2 30’459’896 24’333’125 7’090’318 11’898’529 24’333’125 7’090’318 8’127’193 5’061’000 4’997’501 Local Fund Agent Local Fund Agent Local Fund Agent Pricewaterhouse Coopers Pricewaterhouse Coopers Pricewaterhouse Coopers Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Ministry of Health and TBC The United Nations Development The Medical Research Council ———————— Programme ———————— Guinea ———————— Namibia HIV/AIDS and Malaria Madagascar HIV/AIDS,Malaria and Tuberculosis Round 2 HIV/AIDS,Malaria and Tuberculosis Round 2 11’698’205 Rounds 1,2,3 and 4 30’707’125 11’698’205 47’463’190 30’707’125 2’784’814 28’159’130 1’168’462 Local Fund Agent 14’617’790 Local Fund Agent Pricewaterhouse Coopers Local Fund Agent Pricewaterhouse Coopers Principal Recipent(s) Pricewaterhouse Coopers Principal Recipent(s) The Ministry of Public Health Principal Recipent(s) The Ministry of Health ———————— Catholic Relief Services,Population and Social Services Guinea-Bissau Services International,Sécrétariat ———————— HIV/AIDS,Malaria and Tuberculosis Exécutif du Comité National Nigeria Rounds 3 and 4 de Lutte Contre le VIH/SIDA, HIV/AIDS and Malaria 4’556’179 UGP-CRESAN and TBC Rounds 1,2 and 4 4’556’179 ———————— 69’629’535 808’095 Malawi 69’629’535 Local Fund Agent HIV/AIDS and Malaria 11’677’006 Pricewaterhouse Coopers Rounds 1 and 2 Local Fund Agent Principal Recipent(s) 62’623’500 KPMG The United Nations Development 41’751’500 Principal Recipent(s) Programme 26’253’844 National Action Committee on AIDS ———————— Local Fund Agent and The Yakubu Gowon Center for Kenya Pricewaterhouse Coopers National Unity and International HIV/AIDS,Malaria and Tuberculosis Principal Recipent(s) Cooperation Rounds 1,2 and 4 The Registered Trustees of the National ———————— 137’021’819 AIDS Commission Trust and TBC Rwanda 55’049’108 ———————— HIV/AIDS,Malaria and Tuberculosis 36’403’313 Mali Rounds 1,3 and 4 Local Fund Agent HIV/AIDS,Malaria and Tuberculosis 42’261’643 KPMG Rounds 1 and 4 42’261’643 Kenya Network of Women With AIDS, 28’249’252 23’111’551 Principal Recipent(s) 2’023’424 Local Fund Agent The Ministry of Finance,Sanaa Art 945’120 Crown Agents Promotions and TBC Local Fund Agent Principal Recipent(s) ———————— KPMG The Ministry of Health Lesotho Principal Recipent(s) ———————— HIV/AIDS and Tuberculosis The Ministry of Health and TBC Sao Tome & Principe Round 2 ———————— Malaria 12’557’000 Mozambique Round 4 12’557’000 HIV/AIDS,Malaria and Tuberculosis 1’941’359 5’365’581 Round 2 — Local Fund Agent 51’112’173 — Pricewaterhouse Coopers 51’112’173 Local Fund Agent Principal Recipent(s) 16’384’567 TBC The Ministry of Finance and Local Fund Agent Principal Recipent(s) Development Planning DTT Emerging Markets TBC Principal Recipent(s) The Ministry of Health and The National AIDS Council (CNCS)
52 Global Fund Annual Report 2004 Approved Grants
Senegal Tanzania Zambia HIV/AIDS and Malaria HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis Rounds 1 and 4 Rounds 1,3 and 4 Rounds 1 and 4 34’030’997 198’703’195 121’995’782 10’285’714 41’310’110 74’945’056 4’669’629 14’468’386 52’896’603 Local Fund Agent Local Fund Agent Local Fund Agent KPMG Pricewaterhouse Coopers Pricewaterhouse Coopers Principal Recipent(s) Principal Recipent(s) Principal Recipent(s) The Ministry of Health,The National The Ministry of Finance,The Ministry The Central Board of Health, AIDS Council and TBC of Health and TBC The Churches Health Association ———————— ———————— of Zambia,The Ministry of Finance, Sierra Leone Tanzania (Zanzibar) Zambia National AIDS Network HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis and TBC Rounds 2 and 4 Rounds 1,2,3 and 4 ———————— 23’240’195 7’946’063 Zimbabwe 2’569’103 7’946’063 HIV/AIDS and Malaria 1’800’067 4’955’405 Round 1 Local Fund Agent Local Fund Agent 17’016’250 Pricewaterhouse Coopers Pricewaterhouse Coopers 6’716’250 Principal Recipent(s) Principal Recipent(s) 1’415’000 The Sierra Leone Red Cross Society The Ministry of Health and Social Local Fund Agent and TBC Welfare and Zanzibar AIDS Pricewaterhouse Coopers ———————— Commission Principal Recipent(s) South Africa ———————— The Ministry of Health and Child HIV/AIDS and Tuberculosis Togo Welfare and TBC Rounds 1,2 and 3 HIV/AIDS,Malaria and Tuberculosis 65’030’986 Rounds 2,3 and 4 56’616’986 37’762’054 28’876’905 19’417’956 Local Fund Agent 11’062’168 KPMG Local Fund Agent Principal Recipent(s) Pricewaterhouse Coopers The National Treasury,The Provincial Principal Recipent(s) Health Department of the Western Cape The United Nations Development and TBC Programme and TBC ———————— ———————— Swaziland Uganda HIV/AIDS,Malaria and Tuberculosis HIV/AIDS,Malaria and Tuberculosis Rounds 2,3 and 4 Rounds 1,2,3 and 4 48’356’500 201’007’993 31’959’700 134’575’845 8’768’790 37’965’273 Local Fund Agent Local Fund Agent Pricewaterhouse Coopers Pricewaterhouse Coopers Principal Recipent(s) Principal Recipent(s) The National Emergency Response The Ministry of Finance,Planning and Council on HIV/AIDS and TBC Economic Development and TBC
Fifteen-year old Venda Mamba is now the head of this family of six children who lost their parents to AIDS- related illnesses.
54 Global Fund Annual Report 2004 List of Board Members 2004
An international, multi-sectoral, Eastern Europe (Romania) France (Luxemburg, Spain) 23-member Board (18 voting and Dr.Ovidiu Brinzan Mrs.Mireille GUIGAZ five non-voting) governs the Minister of Health Ambassadeur en mission pour Romania la lutte contre Global Fund, approves grants and ———————— le VIH/sida et les maladies mobilizes external resources to meet Eastern Mediterranean Region transmissibles the Global Fund’s financial needs. (Pakistan) Ministry of Foreign Affairs Mr.Ejaz Rahim France Federal Secretary Health ———————— Government of Pakistan Italy (until May 2004) Mr.Giuseppe Deodato VOTING MEMBERS ———————— Director-General Development Mr.Tariq Farook Cooperation Canada (Germany, United Federal Secretary Health Ministry of Foreign Affairs Kingdom, Switzerland) Government of Pakistan Italy Dr.Ernest Loevinsohn (from May to November 2004 ) ———————— Director General ———————— Japan CIDA/PAHMD Mr.Syed Anwar Mahmood Mr.Shigeki Sumi Canada Federal Secretary Health Deputy Director General ———————— Pakistan Multilateral Cooperation Department Communities (NGOs (from November 2004) Ministry of Foreign Affairs representative of the ———————— Japan Communities Living with Eastern and Southern Africa ———————— the Diseases) (South Africa) Latin America + Caribbean Ms.Anandi Yuravaj Dr.Manto Tshabalala-Msimang (Barbados) Program officer Minister of Health Dr.Carol Jacobs India HIV/AIDS Alliance South Africa Chairman National HIV/AIDS India ———————— Commission ———————— European Commission (Belgium) Prime Minister’s Office Developed Country NGO Dr.Lieve Fransen Barbados Dr.Hélène Rossert-Blavier Head of Unit ———————— Director General Human and Social Development Point Seven Group AIDES Federation Directorate General for Development (Sweden – Denmark, Ireland, France European Commission Netherlands, Norway) ———————— Belguim Mr.Lennarth Hjelmåker Developing Country NGO Director,Ambassador Ms.Rita Arauz Molina Department for Global President Development (GU) Foundation Nimehuatzin Ministry of Foreign Affairs Nicaragua Sweden
List of Board Members Global Fund Annual Report 2004 55
Private Foundations EX OFFICIO MEMBERS Dr.Helene D.Gayle WITHOUT VOTING RIGHTS Director HIV/AIDS and TB Bill and Melinda Gates Foundation UNAIDS Executive Offices Dr.Peter Piot United States Executive Director ———————— UNAIDS Private Sector ———————— Mr.Rajat Gupta WHO Senior Director Dr.Jong-Wook Lee Worldwide McKinsey & Company Director-General United States WHO ———————— ———————— South-East Asia (India) World Bank Mrs.Sushma Swaraj Mr.Geoffrey Lamb Union Minister Vice President Ministry of Health and Family Welfare Consessional Finance India and Global Partnerships (until June 2004) The World Bank ———————— United States Dr.Anbumani Ramadoss Union Minister Ministry of Health and Family Welfare BOARD-DESIGNATED India NON-VOTING SWISS MEMBER (from June 2004) ———————— Mr.Edmond Tavernier USA Managing Partner Mr.Tommy G.Thompson Tavernier Tschanz Secretary of Health and (Attorneys-at-Law) Human Services Switzerland Department of Health and Human Services United States ———————— West + Central Africa (Cameroon) Mr.Urbain Olangueno Awono Minister of Public Health Cameroon ———————— Western Pacific Region (China) Dr.Huang Jiefu Vice Minister of Health China
56 Global Fund Annual Report 2004 Technical Review Panel 2004
The Technical Review Panel is an David Hoos* TUBERCULOSIS EXPERTS independent, impartial team of experts Assistant Professor of Epidemiology appointed by the Board to review Colombia University Rosmini Day* Mailman School of Public Health Manager applications requesting support from United States National Tuberculosis Programme the Global Fund and to make ———————— Indonesia recommendations to the Board for Michel Kazatchkine ———————— approval. The Technical Review Panel Director Paula Fujiwara National Agency for AIDS Research Deputy Executive General guarantees the integrity and consistency France International Union against of an open and transparent proposals ———————— Tuberculosis and Lung Diseases review process. Kasia Malinowska-Sempruch* United States Director of International ———————— TRP members assigned to Round 3 are noted Harm Reduction Programme Fabio Luelmo with an asterisk (*) Open Society Institute Medical Officer,Global Tuberculosis Poland Programme (retired) HIV/AIDS EXPERTS ———————— World Health Organization Godfrey Sikipa Argentina Dave Burrows Senior HIV/AIDS and Infections ———————— Director Diseases Specialist Pierre-Yves Norval AIDS Projects Management Group RTI International Medical Officer,Stop TB department Sydney Zimbabwe World Health Organization Australia ———————— France ———————— Suniti Solomon* ———————— Alex Godwin Coutinho* Director Antonio Pio Director YRG Care Consultant in Public Health The AIDS Support Organization India and Respiratory Diseases Uganda ———————— Argentina ———————— Papa Salif Sow Peter Godfrey-Faussett Department of Infectious Diseases Reader in Infectious and Fann Hospital Tropical Diseases, Senegal London School of Hygiene and ———————— Tropical Medicine Stefano Vella United Kingdom Director ———————— Istituto Superiore di Sanita (ISS) Hakima Himmich Italy President Moroccan Association of Fight against AIDS Morocco
Technical Review Panel Global Fund Annual Report 2004 57
MALARIA EXPERTS CROSS-CUTTING EXPERTS Richard Skolnik Executive Director Andrei Beljaev Jonathan Broomberg Harvard School of Public Health Associate Professor General Manager: Strategy President’s Emergency Plan The Chair of Tropical and and Health Policy for AIDS Relief Parasitic Diseases Discovery Holdings Limited United States Russian Medical Academy of South Africa ———————— Postgraduate Training ———————— David Peters Russian Federation Malcolm Clark Deputy Director of Health ———————— Principle Program Associate Systems Program John Mulenga Chimumbwa Center for Pharmaceutical Management Johns Hopkins University East Africa RBM Focal Point Management Sciences for Health Bloomberg School of Public Health UNICEF United Kingdom Canada Zambia ———————— ———————— ———————— Daniel Denolf* Wiput Phoolcharoen* Mary Ettling Managing Director and Director of Health Systems Malaria Team Leader Te chnic a l Adv is or Research Institute Bureau of Global Health World Bank/BMZ Ministry of Public Health United States Agency for Belgium Thailand International Development ———————— ———————— United States Kaarle Olavi Elo Glenn Post ———————— Acting Assoc.Director for Asia-Pacific Senior Medical Officer Giancarlo Majori Middle East and North Africa Office of HIV/AIDS Director UNAIDS US Agency for International Istituto Superiore di Sanita Finland Development Italy ———————— United States ———————— Sarah Julia Gordon* ———————— Jane Elizabeth Miller* Director Jayasankar Shivakumar Manager of Malaria Programs Ministry of Health International Consultant Population Services International Guyana former World Bank Country United Kingdom ———————— Director for Thailand Wilfred Griekspoor India Director Emeritus, ———————— McKinsey & Company Stephanie Simmonds Board Member,Médecins Sarajevo Hospice Sans Frontières Holland United Kingdom The Netherlands ———————— ———————— Michael James Toole Leenah Hsu Center for International Health Manager of South East Asia Health Burnet Institute and Development Programme Australia United Nations Development Programme United States ———————— Danguole Jankauskiene* Assoc.Prof.,Vice-Dean of Public Management Department Mykolas Romeris University Vilnius Lithuania ———————— Rima Shretta* Consultant Management Sciences for Health Kenya
58 Global Fund Annual Report 2004 The Global Fund Secretariat
The Secretariat of the Global Fund Fatiha Terki Brigitte Caron continued to benefit in 2004 from the Fund Portfolio Manager Assistant services of many individuals, including Algeria Canada ———————— ———————— those on short-term contracts and Karmen Bennett Erica Weikle* secondments. Based in Geneva, the Fund Portfolio Manager Receptionist Secretariat is led by Richard Feachem, Australia Canada Executive Director July 2002. Listed ———————— ———————— Nicole Gloor Susan O’leary below are those who have either been Assistant to the Executive Resource Mobilization Officer recruited through international Director’s Office Canada / United Kingdom competition to fixed-term (two-year) Australia ———————— contracts or who worked at the Global ———————— Julie Archer Patricia Kehoe Communications Officer Fund for at least six months in 2004. Contract Specialist Canada / Ireland For each individual, his or her country Australia ———————— of origin is also indicated. ———————— Susan Scott * Peita Sexton Assistant An askerisk (*) indicates those individuals who left Assistant to the Chief Operations Officer Canada / United Kingdom before 31st December 2004. A double asterisk (**) Australia ———————— specifies secondees. ———————— Marguerite Samba-Maliavo Angela Smith Fund Portfolio Manager Fund Portfolio Manager Central African Republic Australia ———————— ———————— Nagwa El-Abd Taufiqur Rahman Assistant Cluster Leader Egypt Bangladesh ———————— ———————— Seble Abebe Maria Kirova Assistant Fund Portfolio Manager Ethiopia Bulgaria ———————— ———————— Olivier Faure-Vincent Césarie Sebititaweho-Camara Finance Officer Assistant France Burundi ———————— ———————— Sabine Gabriel Robert Bourgoing Manager,Contracts Communications Officer France Canada
Secretariat Global Fund Annual Report 2004 59
Roberto Garcia* Hans Zweschper Barry Greene Fund Portfolio Manager Proposals Manager Chief Financial Officer France Germany Ireland ———————— ———————— ———————— Michel Lavollay** Esther Odartey-Wellington Julia Van Riel-Jameson Senior Director Executive Assistant Administration Officer France Ghana Ireland ———————— ———————— ———————— Sîan Hamilton-Rousset William Wilson* Mariangela Bavicchi** Assistant IT Officer Donor Relations France / United Kingdom Ghana Italy ———————— ———————— ———————— Michèle Young Linden Morrison Bartolomeo Migone Assistant Fund Portfolio Manager Senior Legal Officer France / United Kingdom Guyana Italy ———————— ———————— ———————— Beatrice Bernescut Marie-Stephane Gruenert Carl Manlan Assistant Assistant Program Officer France / USA Haiti Ivory Coast ———————— ———————— ———————— Christoph Benn Marton Sziraczki Marie-Claire Ouattara Director,External Relations Program Officer Assistant Germany Hungary Ivory Coast ———————— ———————— ———————— Doris D’cruz-Grote** Nazir Ahmed Wilfred Thalmas CCM Coordinator Receptionist Assistant Germany India Ivory Coast ———————— ———————— ———————— Nicole Delaney Prerna Banati Naboundou (Bintou) Toure Special Assistant to Strategic Information Officer Assistant the Chief of Operations India Ivory Coast Germany ———————— ———————— ———————— Sudha Venkatram Emiko Naka* Tina Draser Program Officer Manager Fund Portfolio Manager India Japan Germany ———————— ———————— ———————— Paul Lalvani Mikiko Sawanishi Marion Hachmann-Gleixner Manager,Procurement Services Fund Portfolio Manager Program Officer India / USA Japan Germany ———————— ———————— ———————— Houtan Afkhami Eiichi (Ben) Seki** Martina Niemeyer Assistant Director,Portfolio Support & Policy Assistant Operational Partnerships Iran / USA Japan Germany ———————— ———————— ———————— John Burke Hind Khatib Othman Florian Prem Chief Administrative Officer Cluster Leader Manager Information Management Ireland Jordan Germany ———————— ———————— ———————— Anne-Marie Byrne Jacqueline Adhiambo Christina Schrade Assistant Human Resources Assistant Advisor to the Executive Director Ireland Kenya Germany ———————— ———————— ———————— Aisling Campbell Annett Odhiambo Bernhard Schwartlander Human Resources Assistant Assistant Director,Strategic Ireland Kenya Information & Evaluation ———————— ———————— Germany Danielle Ferris Roselyne Souvannakane ———————— Assistant,Board Relations Fund Portfolio Assistant Urban Weber Ireland Laos Cluster Leader Germany
60 Global Fund Annual Report 2004 Secretariat
Sandra Irbe ElHadj (As) Sy Vinand Nantulya Fund Portfolio Assistant Director,Operations Senior Technical Advisor Latvia Policy & Country Support Uganda ———————— Senegal ———————— Doumit Abi-Saleh ———————— John Ochero Manager,Information Technology Sanja Gohre Program Officer Lebanon Communications Officer Uganda ———————— South Africa ———————— Joseph Shaheen ———————— Tim Clark PDF Forms Developer Ntombekhaya Matsha Manager,Publications & Multi-Media Lebanon Officer,Private Sector & Civil Society United Kingdom ———————— South Africa ———————— Patricia Chatsika ———————— Philippa Dobrée-Carey Human Resources Assistant Dianne Stewart Assistant Malawi Manager,Board Relations United Kingdom ———————— South Africa ———————— Aleph Henestrosa ———————— Anne Duke Fund Portfolio Manager Adele Sulcas Director,Human Resources Mexico Private Sector Partnerships Officer United Kingdom ———————— South Africa ———————— Sandii Lwin ———————— Richard Feachem Fund Portfolio Manager Ricardo Lacort Monte* Executive Director Myanmar Technical Officer United Kingdom ———————— Spain ———————— Karin Nasheya ———————— Hillary Hughes* Assistant Rajesh Anandan Fund Portfolio Manager Namibia Manager,Private Sector Partnerships United Kingdom ———————— Sri Lanka ———————— Lee Obomeghie* ———————— Daniel Low-Beer Fund Portfolio Manager Chrishan Thuraisingham Senior Manager,Strategic Niger Fund Portfolio Manager Information & Evaluation ———————— Sri Lanka United Kingdom Kingsley Moghalu ———————— ———————— Manager,Global Partnerships Ruwan De Mel Mike Marchment** Nigeria Manager Financial Support Advisor,Operations Management ———————— Sri Lanka / Australia United Kingdom Elizabeth Hoff ———————— ———————— Cluster Leader Marie-Louise Rosencrantz* David Powell Norway Fund Portfolio Manager Fund Portfolio Manager ———————— Sweden United Kingdom Jon Liden ———————— ———————— Head,Communications Anouk Affolter* Kate Thomson* Norway Assistant Civil Society Officer ———————— Switzerland United Kingdom Nilofar Mohideen Bawa ———————— ———————— Finance Assistant Anne Eberle David Ball Pakistan Assistant Senior Finance Officer ———————— Switzerland United Kingdom / Switzerland Arletty Pinel ———————— ———————— Senior Advisor, Gladys Lopatka Duncan Earle Grant Performance & Development Assistant Cluster Leader Panama Switzerland USA ———————— ———————— ———————— Valery Chernyavskiy Martin Straub* Eric Godfrey Fund Portfolio Manager Manager,Performance Matrix Senior Finance Officer Russia Switzerland / Australia USA ———————— ———————— ———————— Mabingue Ngom Geofrey Bash* Nicole Gorman Cluster Leader Assistant Program Officer Senegal Uganda USA
Secretariat
Brad Herbert** Chief of Operations USA ———————— Thomas Hurley Cluster Leader USA ———————— Toby Kasper Assistant USA ———————— Catherine Lijinsky Assistant USA ———————— Alfred Nimocks* ** Event Coordinator USA ———————— Dexter Roberts Assistant USA ———————— Paul Schumacher Program Officer Analyst USA ———————— Jessie Schutte-Aine Fund Portfolio Manager USA ———————— David Sullivan Legal Officer USA ———————— Liz Tung Operational Policy Officer USA ———————— Mark Willis Fund Portfolio Manager USA ———————— Dustin Cosentino* Assistant USA / Canada ———————— Nankhonde Kasonde Fund Portfolio Manager Zambia ———————— Eleanor Tembo Assistant Zambia ———————— Dorcas Mapondera Assistant Vector control through spraying with Zimbabwe insecticides forms part of a malaria prevention program in Sri Lanka.
Supplies for outreach activities are divided and packaged in a warehouse distribution center in Bishkek, Kyrgyzstan.
Global Fund Annual Report 2004 63 Financial Statements 2004
64 Report of the Independent Auditors 65 Statement of Financial Position 66 Statement of Activities 67 Statement of Cash Flows 68 Statement of Changes in Funds 69 Notes to the Financial Statements
64 Global Fund Annual Report 2004
Report of the Independent auditors
Financial Statements Global Fund Annual Report 2004 65
Statement of Financial Position
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
Statement of Financial Position at 31 December 2004 Restated In thousands of US dollars Notes 2004 2003
ASSETS
Cash and bank balances 2.4, 3.1 1’881 225
Funds held in trust 2.4, 2.5, 3.1, 3.2 2’205’078 1'741'968
Promissory notes 2.6, 3.3 237’449 62’460
Contributions receivable within one year 2.6, 3.4 93’239 104’182
Prepayments and miscellaneous receivables 5’706 2'699
2’543’353 1’911’534
Contributions receivable after one year 2.6, 3.4 129’204 146’837
Total ASSETS 2’672’557 2’058’371
LIABILITIES and FUNDS
Liabilities
Undisbursed grants payable within one year 2.7, 3.6 919’047 610'885
Accrued expenses 4’235 303
923’282 611’188
Undisbursed grants payable after one year 2.7, 3.6 191’040 272'340
Total LIABILITIES 1’114’322 883'528
FUNDS 1’558’235 1’174’843
Total LIABILITIES and FUNDS 2’672’557 2’058’371
The notes represent an integral part of the Statement of Financial Position
3
66 Global Fund Annual Report 2004
Statement of Activities
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
Statement of Activities for the year ended 31 December 2004 Restated In thousands of US dollars Notes 2004 2003
INCOME
Contributions 2.6, 3.5 1’254’688 1’416’650
Bank and trust fund income 2.9 33’819 28'235
Total INCOME 1’288’507 1’444’885
EXPENDITURE
Grants 2.7, 3.7 854’368 1'063'304
Operating expenses 3.8 50’747 32'555
Total EXPENDITURE 905’115 1'095'859
INCREASE IN FUNDS for the year 383’392 349’026
The notes represent an integral part of the Statement of Activities
4
Financial Statements Global Fund Annual Report 2004 67
Statement of Cash Flows
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
Statement of Cash Flows for the year ended 31 December 2004
In thousands of US dollars Notes 2004 2003
CASH FLOWS FROM OPERATING ACTIVITIES
Contributions received 3.5 1’101’008 1’330’862
Bank and trust fund income 34’329 28’930
1’135’337 1’359’792
Grants disbursed 3.7 ( 627’506 ) ( 231,200 ) Payments to suppliers and personnel ( 43’065 ) ( 36,889 )
( 670’571 ) ( 268,089 )
CASH FLOWS FROM OPERATING ACTIVITIES being the net increase in cash and cash equivalents 464’766 1'091'703
CASH AND CASH EQUIVALENTS at beginning of the year 2.4, 3.1 1'742'193 650'490
CASH AND CASH EQUIVALENTS at end of the year 2.4, 3.1 2’206’959 1'742'193
The notes represent an integral part of the Statement of Cash Flows
5
68 Global Fund Annual Report 2004
Statement of Changes in Funds
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
Statement of Changes in Funds at 31 December 2004 Restated In thousands of US dollars Notes 2004 2003
FUNDS at the beginning of the year as previously reported 727'108
Prior periods’ effect of change in accounting policy 2.2, 2.6, 3.5 98’709
FUNDS at the beginning of the year, restated 1’174’843 825’817
INCREASE IN FUNDS for the year as previously reported 383’392 300’898
Change in accounting policy 2.2, 2.6, 3.5 - 48’128
INCREASE IN FUNDS for the year 383’392 349’026
FUNDS at the end of the year 1’558’235 1’174’843
Attributed as follows:
Foundation capital 50 50 General Funds 1’558’185 1’174’793
1’558’235 1’174’843
The notes represent an integral part of the Statement of Changes in Funds
6
Financial Statements Global Fund Annual Report 2004 69
Notes to the Financial Statements
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
1. Activities and Organization
The Global Fund to Fight AIDS, Tuberculosis and Malaria (the “Global Fund”) is an independent, non-profit foundation that was incorporated in Geneva, Switzerland on 22 January 2002. The purpose of the Global Fund is to attract and disburse additional resources to prevent and treat AIDS, tuberculosis and malaria. The Fund provides grants to locally- developed programs, working in close collaboration with governments, non-governmental organizations, the private sector, development agencies and the communities affected by these diseases.
The Global Fund has been founded on the following principles: • Rely on local experts to implement programs directly; • Make available and leverage additional financial resources to combat the three diseases; • Support programs that reflect national ownership and respect country-led formulation and implementation processes; • Operate in a balanced manner in terms of different regions, diseases and interventions; • Pursue an integrated and balanced approach covering prevention, treatment and care, and support in dealing with the three diseases; • Evaluate proposals through independent review processes based on the most appropriate scientific and technical standards that take into account local realities and priorities; • Seek to establish a simplified, rapid, innovative grant-making process and operate in a transparent and accountable manner based on clearly defined responsibilities. One accountability mechanism is the use of Local Fund Agents to assess local capacity to administer and manage the implementation of funded programs.
Financial contributions to the Global Fund are held in the Trust Fund for the Global Fund to Fight AIDS, Tuberculosis and Malaria (the “Trust Fund”) until disbursed as grants or for operating expenses. The Trust Fund is administered by the International Bank for Reconstruction and Development (the “World Bank”), as Trustee. The responsibilities of the Trustee include management of contributions and investment of resources according to its own investment strategy. The Trustee makes disbursements from the Trust Fund only upon written instruction of the Global Fund.
Most contributions are received directly in the Trust Fund. Some contributions for the benefit of Global Fund are also received by the United Nations Foundation and are held in trust for the Global Fund until subsequently transferred to the Trust Fund.
Personnel and administrative services to support the operations of the Global Fund are provided by the World Health Organization (“WHO”) under an agreement between WHO and the Global Fund. The Global Fund bears in full the cost of these personnel and services. Funds remitted to WHO for this purpose are treated as funds held in trust by WHO for the benefit of the Global Fund until an expenditure obligation is incurred.
These financial statements were authorized for issuance by the Board on 22 April 2005.
7
70 Global Fund Annual Report 2004
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
2. Significant Accounting Policies
2.1 Statement of Compliance
The financial statements have been prepared in accordance with and comply with the International Financial Reporting Standards issued by the International Accounting Standards Board (“IASB”) and interpretations issued by the International Financial Reporting Interpretations Committee (“IFRIC”).
These standards currently do not contain specific guidelines for non-profit organizations concerning the accounting treatment and presentation of the financial statements. Consequently Statement of Financial Accounting Standard (“SFAS”) 116: “Accounting for Contributions Received and Contributions Made” has been applied in respect of the recognition of contributions and grants.
2.2 Basis of Presentation
The financial statements are presented in US dollars, the Global Fund’s operating currency, rounded to the nearest thousand. Management elected not to operate and report in Swiss Francs, the domestic currency, as its cash flows are primarily in US dollars.
The financial statements are prepared under the historical cost convention. The fair value of non-current contributions receivable, promissory notes and undisbursed grants has been determined as indicated in Notes 2.6 and 2.7.
The preparation of the financial statements requires that management make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent liabilities at the date of the financial statements, and reported amounts of income and expenses during the reporting period. If in the future such estimates and assumptions, which are based on management’s best judgment at the date of the financial statements, deviate from actual circumstances, the original estimates and assumptions will be modified through the statement of activities as appropriate in the year in which the circumstances change.
In 2004, the Global Fund has changed its accounting policy for the recognition of contributions receivable, as further described in Note 2.6. This change in accounting policy has been accounted for retrospectively. Comparative information in these financial statements has been updated to reflect this change. The cumulative impact of this change is an increase on prior years’ Funds of USD 147 million (2002 : 99 million) as detailed in the Statement of Changes in Funds.
2.3 Foreign Currency
All transactions in other currencies are translated into US dollars at the exchange rate prevailing at the time of the transaction. Monetary assets and liabilities in other currencies are translated into US dollars at the year-end rate.
8
Financial Statements Global Fund Annual Report 2004 71
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
2. Significant Accounting Policies (continued)
2.4 Cash and cash equivalents
The Global Fund considers that cash and cash equivalents include cash and bank balances and funds held in trust that are readily convertible to cash within three months.
2.5 Funds held in Trust
The financial statements include funds that are held in trust solely for the benefit of the Global Fund by the World Bank, the World Health Organization and the United Nations Foundation.
Assets held in trust by the World Bank are maintained in a commingled investment portfolio for all of the trust funds administered by the World Bank. These investments are actively managed and invested in high-grade instruments according to the risk management strategy adopted by the World Bank. The objectives of the investment portfolio strategy are to maintain adequate liquidity to meet foreseeable cash flow needs, preserve capital (low probability of negative total returns over the course of a fiscal year) and maximize investment returns.
The returns on funds held in trust are accounted for on an accruals basis.
2.6 Contributions
In accordance with SFAS 116 contributions governed by a written contribution agreement are recorded as income when the agreement is executed. Other contributions are recorded as income upon receipt of cash or cash equivalents, at the amount received.
Contributions are considered received when remitted in cash or cash equivalent, or deposited by a sovereign state as a promissory note, letter of credit or similar financial instrument.
Contributions receivable under written contribution agreements executed on or before the date of the statement of financial position but which have not been received at that date are recorded as an asset and as income. Contributions and promissory notes receivable later than one year after the date of the statement of financial position are discounted to estimate their present value at this same date. In previous years, contributions receivable later than one year after the date of the statement of financial position were not recorded as an asset or income; in the light of favourable collection experience and to better reflect the Global Fund’s financial position, such contributions are recorded as an asset and as income in 2004, as mentioned in Note 2.2.
Foreign currency exchange gains and losses realized between the date of the written contribution agreement and the date of the actual receipt of cash and those unrealized at the date of the statement of financial position are recorded as part of Contribution income.
9
72 Global Fund Annual Report 2004
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
2. Significant Accounting Policies (continued)
2.6 Contributions (continued)
Non-cash contributions donated in the form of goods or services (in-kind contributions) are recognized at the time of receipt and reported as equal contributions and expenses in the Statement of Activities, at their estimated economic value to the Global Fund.
2.7 Grants
All grants are governed by a written grant agreement and, in accordance with SFAS 116, are expensed in full when the agreement is executed.
Grants or portions of grants that have not been disbursed at the date of the statement of financial position are recorded as liabilities. The long-term portion of such liabilities represents amounts that are due to be disbursed later than one year after the date of the statement of financial position, discounted to estimate its present value at this same date.
2.8 Local Fund Agent Fees
Fees to Local Fund Agents to assess local capacity prior to and during grant negotiation, and to manage and monitor implementation of funded programs as grants are disbursed, are expensed as the work is completed.
2.9 Bank and Trust Fund Income
Bank and trust fund income includes deposit interest on bank balances and realized gains and losses on investments and currencies on funds held in trust.
2.10 Employee Benefits
All personnel and related costs, including current and post employment benefits, are managed by the WHO and charged in full to the Global Fund, apart from insignificant incidental costs borne directly by the Global Fund. There are no unfulfilled obligations for employee benefits outside of the Global Fund’s obligations to the WHO.
10
Financial Statements Global Fund Annual Report 2004 73
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
3. Details relating to the financial statements In thousands of US dollars
3.1 Cash and Cash Equivalents
2004 2003 Cash and bank balances 1’881 225 Funds held in Trust 2’205’078 1’741’968 2’206’959 1’742’193
3.2 Funds held in Trust
2004 2003 World Bank 2’192’288 1’729’149 World Health Organization 12’154 12’567 United Nations Foundation 636 252 2’205’078 1’741’968
3.3 Promissory Notes
2004 2003 Promissory notes to be encashed 216’201 52’773 Unrealized gains on foreign currency promissory notes to be encashed 21’248 9’687 237’449 62’460
Maturing in 2004 - 62’460 Maturing in 2005 237’449 - 237’449 62’460
3.4 Contributions receivable
Restated 2004 2003 Contributions receivable* 201’516 236’420 Unrealized gains on foreign currency contributions receivable 20’927 14’599 Total contributions receivable 222’443 251’019
Receivable within one year 93’239 104’182 Receivable after one year 129’204 146’837 222’443 251’019
* Comprises amounts receivable under written contribution agreements executed on or before 31 December 2004 and 2003 respectively that had not been received at that date.
11
74 Global Fund Annual Report 2004
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
3. Details relating to the financial statements (continued) In thousands of US dollars
3.5 Contributions Restated 2004 2003 Governments 1’195’170 1’314’795 Private sector 59’518 101’855 Total contributions 1’254’688 1’416’650
Cash received including encashed promissory notes 1’101’008 1’330’862 Increase in promissory notes to be encashed 174’989 10’620
Increase / (decrease) in contributions receivable ( 28’575 ) 75’168
Contributions in kind 7’266 - Total contributions 1’254’688 1’416’650
The effect of the change in accounting policy for contributions, as referred to in notes 2.2 and 2.6, is an increase in contributions of USD 48 million for the year ended 31 December 2003 (2002: USD 99 million).
3.6 Undisbursed grants payable
2004 2003 Payable within one year 919’047 610'885 Payable after one year 191’040 272'340 1’110’087 883’225
3.7 Grants 2004 2003 Disbursed in the year 627’506 231’200 Movement in undisbursed grants 226’862 832’104 Grant expense 854’368 1’063’304
12
Financial Statements Global Fund Annual Report 2004 75
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
3. Details relating to the financial statements (continued) In thousands of US dollars
3.8 Operating expenses
2004 2003 Secretariat expenses Personnel 16’854 9’793 Trustee fee 2’150 1’870 Administrative services fee 982 900 Other professional services 3’521 2’078 Travel and meetings 4’673 3’750 Communication materials 7’728 966 Office rental 754 509 Office infrastructure costs 1’376 998 Other 533 1’572 38’571 22’436 Local Fund Agent fees 12’176 10’119 50’747 32’555
Included in Operating expenses above are contributions in kind amounting to USD 7.3 million which have been attributed to Other professional services for USD 0.7 million and to Communication materials for USD 6.6 million. In 2003, contributions in kind were not included in the financial statements as they were not material.
3.9 Personnel
As described in Note 1, personnel to support the operations of the Global Fund are provided by the WHO under an agreement between the WHO and the Global Fund. At 31 December 2004 there were 127 personnel assigned to the Global Fund (2003: 96). Of these, 74 (2003: 55) are assigned under fixed-term contracts, typically of two years duration. All other personnel are assigned under contracts of shorter duration.
3.10Taxation
The Global Fund is exempt from tax on its activities in Switzerland.
3.11Commitments
At 31 December 2004, the Global Fund has the following outstanding operating lease commitments:
Year Office space Office equipment Vehicle 2005 988 19 1 2006 677 19 - 2007 677 19 - 2008 677 15 - 2009 677 7 - Beyond 2009 1’635 - - 5’331 79 1
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76 Global Fund Annual Report 2004
Notes to the Financial Statements (continued)
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Financial Statements
4. Financial Instruments
As described in Note 2.5, those funds held in trust by the World Bank, acting as Trustee for the Global Fund, are actively managed and invested in a commingled investment portfolio in accordance with the investment strategy established for all trust funds administered by the World Bank.
Other than those funds held in trust by the World Bank, as mentioned above, the Global Fund employs the following risk management policies to financial instruments:
Currency risk: The risk that the value of a financial instrument will fluctuate due to changes in foreign exchange rates. The Global Fund does not hedge its exposure risk on foreign exchange as it operates primarily in US dollars.
Interest rate risk: The risk that the value of a financial instrument will fluctuate due to changes in market interest rates. The Global Fund does not use derivative financial instruments to reduce its exposure risk on interest from variable rate bank balances and funds held in trust.
Market risk: The risk that the value of a financial instrument will fluctuate as a result of changes in market prices whether those changes are caused by factors specific to the individual security or its issuer or factors affecting all securities traded in the market. The Global Fund has assigned the management of market risk primarily to the Trustee, and does not use derivative financial instruments to reduce its market risk exposure on other financial instruments.
Credit risk exposures: Credit risk results from the possibility that a loss may occur from the failure of another party to perform according to the terms of a contract. The Global Fund does not use derivative financial instruments to reduce its credit risk exposure.
The Global Fund’s maximum exposure to credit risk in relation to cash and bank balances, funds held in trust, promissory notes and contributions receivable is the carrying amount of those assets as indicated in the statement of financial position. The Global Fund places its available funds with high quality financial institutions to mitigate the risk of material loss in this regard. With respect to the Global Fund’s contributions receivable, management believes these will be collected as they result from mutually signed contribution agreements primarily with governments.
5. Comparative financial information
Certain comparative balances have been itemized for compliance with the current year presentation. Except for the effect of change in accounting policy as identified under Notes 2.2 and 2.6, there is no other impact on the Statement of Changes in Funds.
14
Credits Cover: © Didier Ruef, www.pixsil.com. P2 Gideon Mendel. P4 Gary Hampton. P6 John Rae. P13 Yoshi Shimizu. PP14/15 Gideon Mendel. P17 Jan Van der Hombergh, WHO. P18 Pierre Virot, WHO. P20 John Rae. P23 John Rae. P29 Credit Yoshi Shimizu. P30 John Rae. P39 Virginia Arnold, WHO. P42 Yoshi Shimizu. P53 Gideon Mendel. P61 John Rae. P62 John Rae. P77 John Rae.
This Page A Global Fund grant finances testing and treatment of sexually transmitted diseases and HIV at Hospital Dermatovenerlogic outside Chisinau, Moldova.
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