Abstract

BackgroundThe creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, also known as the Global Fund, was prompted by the lack of a timely and effective global response, and the need for financing to fight against three devastating diseases: HIV/AIDS, tuberculosis, and malaria. During the formation of the Global Fund, necessary anti-corruption, transparency, and accountability (ACTA) structures were not put in place to prevent fraud and corruption in its grants, which resulted in the misuse of funds by grant recipients and an eventual loss of donor confidence in 2011. The Global Fund has instituted various ACTA mechanisms to address this misuse of funding and the subsequent loss of donor confidence, and this paper seeks to understand these implementations and their impacts over the past decade, in an effort to probe ACTA more deeply.ResultsBy restructuring the governing committees in 2011, and the Audit and Finance; Ethics and Governance; and Strategy Committees in 2016, the Global Fund has delineated committee mandates and strengthened the Board’s oversight of operations. Additionally, the Global Fund has adopted a rigorous risk management framework which it has worked into all aspects of its functioning. An Ethics and Integrity Framework was adopted in 2014 and an Ethics Office was established in 2016, resulting in increased conflict of interest disclosures and greater considerations of ethics within the organization. The Global Fund’s Office of the Inspector General (OIG) has effectively performed internal and external audits and investigations on fraud and corruption, highlighted potential risks for mitigation, and has implemented ACTA initiatives, such as the I Speak Out Now! campaign to encourage whistleblowing and educate on fraud and corruption.ConclusionsFrom 2011 onwards, the Global Fund has developed a number of ACTA mechanisms which, in particular, resulted in reduced grant-related risks and procurement fraud as demonstrated by the decreased classification from high to moderate in 2017, and the reduction of investigations in 2018 respectively. However, it is crucial that the Global Fund continues to evaluate the effectiveness of these mechanisms; monitor for potential perverse impacts; and make necessary changes, when and where they are needed.

Highlights

  • The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, known as the Global Fund, was prompted by the lack of a timely and effective global response, and the need for financing to fight against three devastating diseases: HIV/AIDS, tuberculosis, and malaria

  • The CCMs are responsible for fulfilling the “Code of Ethical Conduct for Country Coordinating Mechanism Members,” which was approved in April 2019 and has stipulations regarding anti-fraud and anti-corruption measures, such as restrictions to mitigate conflicts of interest and a requirement to prevent, detect, and stand up to corruption [22]

  • As we have demonstrated in this paper, the Global Fund has a wide range of mechanisms designed to promote accountability and transparency

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Summary

Introduction

The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria, known as the Global Fund, was prompted by the lack of a timely and effective global response, and the need for financing to fight against three devastating diseases: HIV/AIDS, tuberculosis, and malaria. During the formation of the Global Fund, necessary anti-corruption, transparency, and accountability (ACTA) structures were not put in place to prevent fraud and corruption in its grants, which resulted in the misuse of funds by grant recipients and an eventual loss of donor confidence in 2011. The Global Fund to Fight AIDS, Tuberculosis and Malaria, known as the Global Fund, was established in 2002 as an international financial institution to pool donations and rapidly disburse grants to help in-need countries procure medicines as a part of the global response to the HIV epidemic [1]. The Global Fund was created in response to a clear need in the global health space for emergency financing to fight three major infectious diseases: HIV/AIDS, tuberculosis, and malaria, which continue to kill more than 2.4 million people per year [2, 3]. Garcia (2019) refers to corruption as an “ignored pandemic,” one that claims the lives of 140,000 children annually [10]

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