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The Global Fund to Fight AIDS, Tuberculosis and Malaria was rushed into existence in 2002, a bold new initiative to fight three diseases crippling the developing world.
United Nations Secretary General Kofi Annan called for the world's rich nations to donate $7 to $10 billion a year in new money to conquer the killer trio. And 6 months later, developed countries had met to pledge an initial $2.1 billion over 5 years, while 58 poor nations had received approval for their multi-sector programs to fight HIV/AIDS, tuberculosis and malaria, the world's three leading infectious killers.
But almost as soon as the Fund was launched, it started to go sour. There was no problem with the proposals -- which covered everything from DOT clinics for tuberculosis in Sierra Leone and condom distribution for Haitian prostitutes, to bed net vouchers for Tanzanian mothers and antiretrovirals in Peru. Excellent grant applications kept coming in, but the money didn't. One year after its inception, the Fund's supporters were already talking about it being bankrupt. It was already clear that, without a massive injection of cash, there would not be sufficient money to fund proposals past the first year.
At the same time, Fund skeptics -- led by the US delegation to the board of directors -- were insisting on sophisticated monitoring measures that threatened to delay disbursement for months or even years. As quickly as it had captured imaginations, the Fund teetered on the brink of disaster.
The first 6 months of 2003, though, brought the Global Fund new life. "The Fund is delivering," said Jeffrey Sachs, the maverick Columbia University economist who helped Kofi Annan come up with the idea of a war chest for the three diseases, and who emerged in the Fund's first year as one of its strongest critics. "There has been an incredible outpouring of proposals, of programs, of thinking and energy in very poor countries, from people that for the first time see a chance to actually do something. The Fund is energizing high-quality partner-ships in these countries. And money is getting disbursed."
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