The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria on Thursday named as its new Executive Director Ambassador Mark Dybul, who helped create and then lead PEPFAR under former President George W. Bush, Intellectual Property Watch reports (Hermann, 11/15). According to the New York Times, “[h]e is respected by many AIDS activists in the United States, though there is some lingering controversy about his time in the Bush administration related to abstinence policies and anti-prostitution pledges imposed by conservative lawmakers as well as concerning strict licensing requirements for generic drugs” (McNeil, 11/15). The Financial Times reports Dybul said, “The most important thing is to look forward, not to the past. The U.S. funded more condoms than all other sources and 90 percent of all antiretrovirals are generics.” The newspaper notes, “Dybul’s appointment from a shortlist of four was adopted by the fund’s 26-strong board — composed of donor and recipient countries, non-governmental organizations, and business representatives — with just two abstentions, including France” (Jack, 11/15).
The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria on Thursday announced it will “integrate” the Affordable Medicines Facility-malaria (AMFm), implemented in 2010 as a pilot program to provide low-cost artemisinin-based combination therapies (ACTs) in poor and rural areas, “into its existing core system of providing grants to countries to purchase drugs, bed nets and other malaria-control measures,” Nature News Blog reports (Butler, 11/15). “During a transition period in 2013, the lessons learned from the operations and resourcing of Phase 1 of the AMFm, such as manufacturer negotiations and the co-payment mechanism, will be integrated into core Global Fund processes,” a Global Fund press release states.
“In a bid to ensure the global fight against three of the world’s most devastating diseases remains efficient, the Board of the … Global Fund to Fight AIDS, Tuberculosis and Malaria voted [Thursday] to begin an immediate transition” to a new grant-funding approach, the U.N. News Centre reports (11/15). The new funding model “is designed to be simpler, more flexible, and have greater impact in conquering the diseases,” according to Reuters. “The new system relies upon closer discussions with the recipient countries, along with other donor groups and experts, over the design of their disease-fighting programs”; “will focus on addressing the needs of the poorest countries with the highest number of infections”; and will allow flexible grant cycles “instead of falling in set time periods, so that they can be coordinated better with a country’s budgetary cycle, [the Board] said,” the news agency writes (Dawson, 11/15).
“The Global Fund to Fight AIDS, Tuberculosis and Malaria said in a statement Thursday that its board had terminated the employment of Inspector General John Parsons ‘after a careful review of his performance, which was found to be unsatisfactory,'” the Associated Press reports (11/15). “The decision … , which was effective immediately, was based on a review by the board, an independent external peer review of the audit function, and a report by the group’s audit and ethics committee,” Reuters notes (Nebehay, 11/15). In a statement, the Global Fund said, “The Board confirms its full support for an independent and strong Office of the Inspector General.” The statement continues, “The Board said that it recognized the need to maintain continuity in the work of the audits and investigations currently underway, while the Global Fund conducts a search for a new Inspector General.” That process is expected to take about six months, and an interim Inspector General will be appointed soon, according to the statement (11/15).
The Global Fund to Fight AIDS, Tuberculosis and Malaria on Wednesday said an investigation by the group’s Inspector General into grants in Cambodia “uncovered credible and substantive evidence of serious financial wrongdoing, on procurement and other issues,” Agence France-Presse reports (11/15). In a statement, the organization said, “Immediate action has been taken to protect the health of people supported by Global Fund grants in Cambodia, by adopting safeguards in procurement, financing and management” and added it “is committed to maintaining its grants in Cambodia and to expanding safeguards to protect its investments.” The statement adds, “An investigation report by the Office of the Inspector General is being finalized, and is expected to be publicly released once it is completed in the coming weeks” (11/14). According to AFP, “The mismanaged money amounts to under $1 million and was allocated to Cambodian officials to spend on anti-malaria programs, said a source with knowledge of the investigation, speaking on condition of anonymity” (11/15).
Writing in Huffington Post’s “The Big Push” blog, Lucy Chesire, executive director and secretary to the board of the TB ACTION Group, notes “countries from north and south, U.N. organizations, private sector companies and [non-governmental organizations (NGOs)] are meeting in Geneva [this week] at the Board meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria to discuss how best to invest available resources against the three killer diseases.” She highlights “a new approach to fight AIDS, which basically could lead to the end of the global pandemic,” noting, “UNAIDS calls it ‘the people-centered investment approach.'” Chesire interviews Bernhard Schwartlander, director of evidence, innovation and policy at UNAIDS, about this new approach.
The Affordable Medicines Facility-malaria began as a pilot program in 2010 to “provide a ‘co-payment’ to the manufacturers of [artemisinin-based combination therapies (ACTs)], thereby allowing commercial wholesalers and private or government health services to purchase the drugs at a fraction of the already low negotiated price,” Kenneth Arrow, a Nobel laureate in economic sciences in 1972 and an emeritus professor of economics at Stanford University, writes in a New York Times opinion piece. The program subsidized ACTs — a newer, more effective malaria treatment — to “sell [them] as cheaply as [less-effective] chloroquine in Africa’s private pharmacies and shops, where half of all patients first seek treatment for malaria-like fevers,” he states. “Strikingly, it has worked,” Arrow writes, noting a recent independent review of the program published in the Lancet.
Recent successes in increasing the treatment and decreasing the incidence of HIV/AIDS, tuberculosis (TB), and malaria, along with other global health advances, “is thanks to the hard work and cooperation of people from many different walks of life: politicians of all stripes, business leaders, grassroots activists, clergy, health workers, government agencies and many more,” Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, writes in the Huffington Post “Impact” blog. She says the Global Fund to Fight AIDS, Tuberculosis and Malaria has been “[c]entral” to these developments, and the “U.S. government has been a crucial leader in supporting international health and the Global Fund.” She adds, “Sustained commitment will ensure more lifesaving success.” Derrick also recognizes the work of doctors and businesses.
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).