Requesting Aid: Political Determinants of Variation in State Applications for Global Fund Grants

Abstract

Why do states decide to apply for funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria? The Fund is an international institution that has approved over US $21 billion in grants since 2002. All countries meeting certain basic eligibility criteria are free to apply for funding once per disease per year. While it seems rational for states to le as many applications as possible, a country only applies in an average of 29% of the cases it is eligible for, and even particularly active states only apply around half the time. What can explain this variation? Using data from nine years of application decisions, I show that requesting aid is primarily based on the domestic political situation an executive fi nds itself in. Governments that have a more secure hold on power within an e ffective political system, and do not run on nationalist platforms, can minimize the political costs of applying; they are significantly more likely to turn to the Fund than others. The results remain robust when a number of possible confounding factors are accounted for. Contrary to expectations, a country's actual public health concerns are of lesser importance when states decide whether or not to request multilateral aid from the Global Fund.