This Lancet editorial responds to the 25th Board meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria held in Accra, Ghana in November, stating, “Tensions were high as the Fund had to make difficult decisions in a year that has been plagued by financial shortfalls, corruption, and calls for organizational reforms. … However, the Fund remains committed to ensuring the continuation of essential services and to supporting existing grants over new ones to the end of 2013.”

It continues, “Tougher rules will be introduced such as limiting of funding to some middle-income countries,” and “The board also approved a consolidated transformation plan that, alongside the new strategy, will provide a roadmap for the organization’s transition from its present emergency response approach to one providing sustainable long-term funding for successful interventions.” The editorial concludes, “The plan will improve risk management, fiduciary controls, and governance of the organization” (12/3).