Michel Kazatchkine


Gates Foundation boosts funding and confidence in troubled Global Fund | 

World Economic Forum

Bill & Melinda Gates at Davos 2010

The Bill & Melinda Gates Foundation has pledged another $750 million to the ‘troubled’ Global Fund to Fight AIDS, Tuberculosis and Malaria.

Associated Press Gates Injects $750 Million in Troubled Global Fund

Washington Post Gates Injects $750 Million in Troubled Global Fund After Director Resigns

Troubled seems to be part of the Global Fund’s official title these days.

Yesterday, Reuters reported that the head of the Global Fund, Michel Kazatchine, quit due to funding cuts. That’s not quite right. It is true that this initiative created to fight AIDS, TB and malaria has seen funding decline as donors have reneged on their promised pledges.

Kazatchine appears to have resigned largely due to the allegations of mismanagement and tolerance of corruption in an internal shake-up. Some accused donors of using these allegations — which seemed to me a bit hyped as I wrote here and here — as an excuse not to come through with the promised funds.

The subsequent failure of donors and governments to follow through on funding to the Global Fund following this flap made Canadian politician and former UN AIDS ambassador Stephen Lewis absolutely apoplectic.

All this makes the announcement today by Bill Gates at the World Economic Forum in Davos, Switzerland very welcome news to many in the global health community. Davos is the same place he and Melinda announced more than a decade ago that they were giving the same amount of money to launch the Global Alliance for Vaccines and Immunization (GAVI).

Here’s a series of reports from 2001, in the wake of that announcement, I wrote for the Seattle PI.

There just seems to be something the Gateses like about announcing global funds at Davos and giving that $750 million figure. Some saw GAVI as a model for the later creation of the Global Fund.

Both are collaborative international projects that award grants to poor countries based on their performance in combating diseases of poverty — one aimed at fighting the top three killers and the other aimed at boosting childhood vaccinations in poor countries.

Both have trouble with “fraud and mismanagement” which, to some extent, comes from them handing over more control of in-country operations to, uh, countries not known for doing too well at combating fraud and mismanagement. But if the subcontractor shirks on the plumbing, the contractor pays for the leaks.

After the Gates announcement, Sarah Boseley at The Guardian raised an interesting question in her article today The Global Fund – saved and wrapped in a US flag?

With the Gates Foundation stepping in where the international community has stepped back, Boseley asks if the Global Fund risks becoming a bit too unilateral, less European. That may sound petty from an American perspective, but it’s not. These initiatives really can only succeed if they are truly multilateral.

Politics aside: Between these two funds over the past decade, more than 10 million deaths have been prevented and some disease rates in poor countries have been significantly reduced. Not a bad return.

Here’s a pretty good video from the Global Fund making its case with a little help from Bono, Bill Gates, Bill Clinton and others (many of whom who are probably now in Davos):

A bad turn in the global fight against AIDS | 

Flickr, Benny Sølz

As the Los Angeles Times and others reported this week, the global effort to fight AIDS has paid off with a 21 percent decline in deaths since the pandemic’s peak in 2005:

The number of people getting lifesaving (drugs) rose 20% from 2009 to 2010. Three African countries, Botswana, Nambia and Rwanda, achieved universal access, defined by UNAIDS as access for 80% or more of those eligible. Four African countries, Kenya, Ethiopia, Swaziland and Zambia, had coverage for between 60% and 80% of infected people.

In short, this international response to fight disease in poor countries has truly paid off.

Which is why it’s so painful to learn that the organization leading this response, the Global Fund for Fighting AIDS, TB and Malaria, announced this week it will have to suspend its next round of funding for these efforts due to a shortfall in donations.

Global Fund Executive Director Michel Kazatchkine said the “conversion rate” for pledges to donations (meaning, how many governments or other donors keep their promises) has dropped sharply as compared to earlier commitments made.

Some of this may be due to the economic downturn. But some may also be due to earlier allegations of financial mismanagement that caused some donors, most notably Germany, to withhold promised contributions to the Global Fund.

Many, including me, saw some of the media reports of “fraud” as a bit over-the-top given the actual amount of money alleged to have been misspent, but the public image of the initiative has suffered — and perhaps given donors the excuse they needed to renege on their promised commitments.

A crisis looms, writes Sarah Boseley at The Guardian, in which this means people will die:

There is no doubt that people who could have been spared will instead fall ill and die as a result of the drying up of funds. There is also a Damoclean sword hanging over the heads of people who are alive and well thanks to drug treatment for their HIV infection. The Global Fund – together with Pepfar (the President’s emergency plan for Aids relief) has been the main source of money to pay for drugs. Those who start the combination treatments to prevent HIV causing Aids must stay on the drugs for life. If they stop, there is a danger the virus will become resistant to the drugs they are on.

Similarly, the group variously known as Doctors Without Borders or Médecins Sans Frontières says:

The dramatic resource shortfall comes at a time when the latest HIV science shows that HIV treatment itself not only saves lives, but is also a critical form of preventing the spread of the virus, and governments are making overtures that there could be an end to the AIDS epidemic.


Global Fund identifies fraud, media has learned | 

Flickr, by AMagill

Circle of money

Today’s big global health news: An international fund that was created (with significant support from the Gates Foundation) to fight AIDS, tuberculosis and malaria in poor countries has identified episodes of fraud or at least misappropriation of funds amounting to tens millions of dollars.

That sounds pretty bad all right.

But first, let’s keep in mind that the media normally doesn’t usually pay that much attention to the Global Fund for AIDS, Tuberculosis and Malaria — which I’ve written about a bit, and is estimated to have saved millions of lives so far. This story about fraud, however, really had legs!

As a journalist-blogger covering global health and development, I’m supposed to add value by not just reporting the news but also providing perspective, or context, on the nature of the news story.

So, let me just start by saying I had to chuckle when I read this story from the Associated Press over the weekend:

GENEVA — A $21.7 billion development fund backed by celebrities and hailed as an alternative to the bureaucracy of the United Nations sees as much as two-thirds of some grants eaten up by corruption, The Associated Press has learned.

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Video: The Global Fund | 

The United Nations is holding a meeting (yes, another one … that’s what they do) this week to ask governments and donors to advance the fight against three of the world’s biggest killers.

Here is a fairly compelling video that describes the progress achieved so far and advocates for more support of the Global Fund to Fight AIDS, Tuberculosis and Malaria:

Kofi Annan: If we are all in the same boat, then a hole at one end of the boat puts us all at risk.

Michel Kazatchkine: When it comes to fighting an epidemic, everyone has to come together.

Bill Gates: Saving lives has a catalytic effect that allows the community to take care of itself.

Bono: Over 3,500 lives are saved every day … that’s 1.3 million people every year.

Carla Bruni-Sarkosy: There is still a lot of work that has to be done, but it is in reach.

Ban Ki-moon: If we ease up, these diseases will re-emerge. We either win this fight or we lose it. The success of the Global Fund is a test of global solidarity.