Global Fund hires new chief, fires watchdog and obfuscates on malaria

Today was a big day for news out of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The initiative, which has clearly helped turn back the spread of AIDS and these other killer diseases in poor countries, announced it has selected a new leader, Mark Dybul, decided to either kill off or modify a controversial malaria program and also fired its inspector general.

Oh, and it also announced it will give grants to countries that can show the quickest results.

Many, if not most, of these changes can be traced back to 2011 allegations of fraud and mismanagement at the Global Fund made by its inspector general, John Parsons, that were, arguably, highly exaggerated by the Associated Press and other media, and reported as if it was their own investigative reporting expose.

I noted at the time that, in fact, the problems were orders of magnitude smaller than the AP and other breathless media reports were claiming — and that the problems had been identified by the Global Fund itself as part of its internal management reviews.

For example, the AP reported that ‘two-thirds of the grants’ in the $22 billion Global Fund had been lost to corruption and mismanagment. It actually turned out to be maybe one percent.

Many follow-up news reports adhered to the hysterical narrative using phrases to describe the Global Fund as ‘plagued with fraud’ and with ‘astonishing levels of corruption’ which caused some governments to suspend funding — which means some people in poor countries didn’t get life-saving treatment. Which means people died.

This wasn’t to say there weren’t problems at the Global Fund. But many others felt these stories were over the top; it looked like someone had an ax to grind with the way this story was presented. I don’t know what drove the hyperbole. Neither the Global Fund or its former inspector general — who raised the allegations of fraud — are offering much of an explanation for his termination.

Well, so that’s mostly water under the bridge now.

Mark Dybul

Dybul, former head of Pepfar for President George W. Bush, is widely respected for his leadership and commitment on matters of global health. Some are privately concerned that Dybul’s appointment may portend a shift for the Global Fund away from a truly multilateral approach to one that tends to favor the U.S. government policies in global health. That, of course, assumes we have a global health policy. Anyway, we’ll have to wait and see.

It’s not clear to me what’s happening to the Affordable Medicines Facility for malaria (AMFm). If, as the Global Fund press release indicates, it is merely being incorporated into ‘core programs,’ that will be good news to advocates of this scheme using the private marketplace for distributing anti-malaria meds.

If it’s more an obliteration than an absorption into the Global Fund, this may satisfy the critics like Oxfam International, who felt the emphasis on the private market was wasteful and inefficient.

Finally, in firing Parsons, the Global Fund nevertheless emphasized it remains committed to rigorous internal audits and evaluations of grantees. During the fraud scandal, Parsons was quoted defending his findings and journalists wrote of him working against a culture of cover-up at the fund. On the other hand, some of the media reports attributed to the inspector general’s office were bordering on the hysterical. At some point, maybe we’ll get the entire story.

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About Author

Editor Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom-at-humanosphere.org, follow him on Twitter @tompaulson and/or send a comment below.