In this Financial Times opinion piece, journalist Andrew Jack examines how, “[a]fter a period of fast expansion, and strong progress in tackling AIDS, [tuberculosis (TB)] and malaria alike,” the Global Fund to Fight AIDS, Tuberculosis and Malaria “has become a target in the era of austerity. With a shift in power between the world’s traditional and emerging economies, and donors seeking ways to cut support, billions of dollars and millions of lives are at stake.” Jack recaps a brief history of the Fund in the 10 years since its inception; highlights a number of ways in which the Fund has been distinctive from other organizations; and notes several issues that have led to calls for reform within the Fund.

“While Global Fund programs may have limitations, they can have positive results beyond their immediate remit. … For all the Fund’s faults, moreover, the danger is that the alternatives are worse,” he writes, concluding, “This week, it approved the appointment of a new top manager and a more professionalized board. Simon Bland, the U.K. government’s director who has recently taken over as chairman, says: ‘We do need to do a course correction. That’s clearly been taken on board by the executive. The need to change is no longer in dispute'” (11/24).