Paul Farmer, co-founder of Boston-based Partners in Health – selected in second position in The Global Journal’s Top 100 NGOs ranking – has come out strongly in support of The Global Fund to Fight Tuberculosis, AIDS and Malaria.  As previously reported, The Global Fund is facing a funding shortfall of $2 billion, resulting in a recent board decision to freeze all new grant-making until at least 2014.

Writing in the New York Times, Farmer described The Global Fund as one of the ‘most ambitious global health endeavours in generations’ and emphasised the ‘question is not whether The Global Fund works, but how to ensure it keeps working for years to come’.  Critically, the funding deficit has hit when for the first time ‘the end of AIDS became plausible’.  

Drawing on his own extensive experience overseeing preventive health programs delivered with the support of The Global Fund in Haiti, Lesotho and Russia, Farmer outlined four key reasons why the international community must summon the political will to safeguard the financing institution’s long-term sustainability.

Firstly, according to Farmer the global disease burden makes it imperative that access to health care is expanded, rather than reduced.  Secondly, because The Global Fund not only provides grants for treatment, but also seeks to build capacity in local health systems, its activities have ‘profound spillover effects’ on other health and development priorities.  Thirdly, the organization’s effectiveness as a ‘truly multilateral’ vehicle demonstrates the potential for meaningful cooperation and partnership between donor and recipient nations.  Finally, that contraction in the global economy is ‘a lousy excuse to starve one of the best (and only) instruments’ for helping people who ‘live on a few dollars a day’.

Ultimately, Farmer paints a stark picture – between the chance at ‘an AIDS-free generation’, and the short-term desire of contributing members to get their ‘fiscal house in order’.  Significantly, serious budgetary pressure has coincided with a period of leadership instability at the organization.  The Global Fund’s current Executive Director, Michel Kazatchkine, is to step down in mid-March after five years at the helm.  The appointment of Gabriel Jaramillo – a former banker rather than doctor – to the newly-created position of General Manager is expected to herald a strategic shift, aimed at streamlining the institution’s core grant-management function and prioritizing greater efficiency and accountability.

(Photo © Partners in Health)