The BMJ examines the history of fraud allegations against the Global Fund to Fight AIDS, Tuberculosis and Malaria and the organization’s ongoing reform efforts. “Most observers agree that after a honeymoon first decade, the Global Fund had grown so big, and the economic climate and attitudes to diseases such as AIDS have changed so dramatically, that more rigor and efficiency was needed, fraud or no fraud,” BMJ writes. The Fund is expected to appoint a new director “and a new funding model, to be announced on November 15, [which] are supposed to get things back on track” (Arie, 11/12).
“Look in the global strategies for HIV, [tuberculosis (TB)], malaria, maternal and child health, polio eradication, [neglected tropical diseases (NTDs)], and [non-communicable disease (NCDs)] — among many others — and you’ll see Nigeria at or near the top of the ‘Must Win’ countries,” Todd Summers, a senior adviser at the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the CSIS “Smart Global Health” blog. “Home to 170 million people, many of them desperately poor, Nigeria carries a huge and disproportionate share of burden for many of the world’s most deadly diseases,” he writes, noting the country, “one of the most important countries for all three diseases, is losing more in revenues than all of the Global Fund’s annual contributions combined.” He continues, “So, somehow, the Nigerian government needs to do a better job of capturing the revenues it’s due, and channeling a greater percentage of that revenue to the urgent health needs of its citizens, but that doesn’t seem to be happening.” However, Summers concludes “there’s some good news to report” on overall governance in the country, and he provides some examples (11/8).
The Global Fund to Fight AIDS, Tuberculosis and Malaria has published Issue 11 of its newsletter, the “Global Fund News Flash.” The issue focuses on program impact, reporting that “the Global Fund [last week] approved a country impact evaluation plan to support its strategy of investing for impact,” and noting “[a] management focus on impact helps programs prioritize activities, identify risks, and steer investments toward gaps in coverage.” The newsletter goes on to examine the Global Fund’s “efforts to build impact assessment into its business model,” as well as efforts to reach the health-related Millennium Development Goals in Ethiopia (11/7).
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, on Monday published Issue 201 of its “Global Fund Observer.” Among other articles, the issue features an article on a recently released Aidspan paper examining how the Global Fund calculates lives saved; a commentary on how the Global Fund’s new funding model will affect its Latin America and the Caribbean portfolio; and an article examining five new reports from the Office of the Inspector General (OIG) — “three on audits in Bangladesh, Djibouti and Ghana, and two on investigations in Djibouti and South Africa” (11/5).
IRIN examines the controversy surrounding the Affordable Medicines Facility-malaria (AMFm), writing, “The argument over the way it operates has reignited ahead of a board meeting of the [Global Fund to Fight AIDS, Tuberculosis and Malaria] on 14-15 November, which is due to assess the success of the project and its reliance on private sector providers.” The news service reports on an evaluation of AMFm published recently in the Lancet and another paper by Oxfam criticizing the facility. The Global Fund Board, which administers AMFm, “is meeting in nine days to decide whether AMF has worked as was intended, and whether it should be continued, scaled up, or abandoned altogether,” IRIN writes (11/5).
The Associated Press examines the debate over the future of the Affordable Medicines Facility-malaria (AMFm), after the recent release of two papers evaluating the program’s effectiveness. AMFm was established in 2010 as “a pilot project to subsidize artemesinin combination drugs, the most effective malaria treatment,” the AP writes, noting the $460 million program is managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. “Last week, a report by Oxfam, an international charity, labeled the program a failure and said there was no proof it had saved lives because officials didn’t track who received the drugs,” the news service writes, adding, “But in another paper published Wednesday in the journal Lancet, experts insisted the program was ‘an effective mechanism’ to lower the price of preferred malaria drugs and make them widely available.” The Global Fund is scheduled to discuss the future of the program at a meeting next month, according to the AP (Cheng, 10/31).
Researchers from Imperial College London, the Harvard Global Equity Initiative, and Harvard School of Public Health “have identified three global organizations that new funding initiatives should emulate in order to meet health priorities in poorer countries, in research published [Thursday] in the journal the Lancet,” Imperial College London reports in an article on its webpage. The study, “a comprehensive review of new funding methods that raised money for health in developing countries between 1990 and 2010 … found that the GAVI Alliance, … the Global Fund [to Fight AIDS, Tuberculosis and Malaria], and UNITAID, … were the sole organizations whose innovative financing methods had raised and distributed funds on a global scale,” the article notes, adding, “The authors concluded that innovative financing is essential to reduce dependence on contributions from donor governments. These innovative instruments provide a different way of raising money from new sources and making it available to address global health problems” (10/25).
Negative Effects Of Global Health Initiatives On Developing Countries' Health Systems Exaggerated, Review Shows
“An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated,” according to a press release from the Royal Society of Medicine. The systematic review, published on Wednesday in JRSM Short Reports, “found that much of the research literature did not fulfill the requirements of rigorous scientific evidence,” according to the press release. “The systematic review identified 24 studies published in peer-reviewed scientific journals between 2002 and 2009 that have commented on adverse effects on health systems arising from investments by the Global Fund,” the press release states, adding, “All the studies evaluated contained only seemingly anecdotal evidence or authors’ perceptions or interpretations of circumstances” (10/24).
Differing Opinions About AMFm 'Unlikely To Be Resolved' After Global Fund Decision On Program's Future
In her “Global Health Blog,” Guardian health editor Sarah Boseley examines the Affordable Medicines Facility-malaria (AMFm), “which aims to enable countries to increase the provision of affordable artemisinin combination therapies (ACTs) through not only the public sector but also the private sector and [non-governmental organizations (NGOs)].” Following pilot projects in seven African countries and an independent evaluation by the London School of Hygiene and Tropical Medicine, the Global Fund to Fight AIDS, Tuberculosis and Malaria, which hosts AMFm, is set to decide the future of the scheme at a board meeting in November. She notes Oxfam recently released a report criticizing the mechanism, saying the evaluation was flawed because it looked at the number of ACTs sold and not lives saved.
The Associated Press examines access to antiretroviral treatment in Myanmar, which “ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.” The country, also known as Burma, has been hindered by decades of rule by a military junta and economic sanctions imposed by developed countries, including the U.S., the AP notes, and writes, “Of the estimated 240,000 people living with HIV [in the country], half are going without treatment.” However, “as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions,” the news agency writes, adding, “The Global Fund [to Fight AIDS, Tuberculosis and Malaria] recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015,” as well as medications to fight tuberculosis (TB). The AP details one man’s efforts to obtain antiretrovirals, which are reserved for patients with CD4 cell counts below 150 cells, versus the WHO recommended 350 (Mason, 10/22).