FAQ: U.S. Support for the Global Fund to Fight AIDS, Tuberculosis and Malaria

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This FAQ addresses key questions many congressional offices and their constituents have about the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), including: U.S. support for the Global Fund, how the Fund works with and complements U.S. global health programs, as well as the high levels of performance and transparency that the Global Fund achieves.

Why are we sending U.S. tax dollars overseas when we have big needs at home?

Foreign assistance funding represents just about 1 percent of the federal budget, yet it has major positive impacts for both the United States and other countries. These investments help bring stability, economic growth and better health to countries, while advancing America’s security and our reputation in the world. Improved health services in other countries will help contain the next Ebola or Zika, and help stop it from spreading globally.

Global health funding is only a quarter of 1 percent of the U.S. budget, and these programs have demonstrated dramatic impact. Since 1990, the number of annual child deaths has been cut by more than one half. Approximately 18.2 million people are now receiving lifesaving AIDS treatment. The malaria death rate among children under age 5 is down 69 percent since 2000. Efforts to diagnose and treat tuberculosis (TB), a disease that has plagued humanity for centuries, have saved millions of lives in the same period.

More on the investment case for the Global Fund is available here.

How do we know money for the Global Fund is going to good use?

Global Fund-supported programs have saved more than 20 million lives since 2002. Programs supported by the Global Fund are projected to save 14 million more lives by the end of 2019. The Global Fund is consistently rated highly in independent reviews for exceptional performance, transparency and impact, including:

  • A 2017 assessment by the Australian government that gave the Global Fund a top rating for its effective approach to investing donor money, and confirmed the Global Fund as a strong, responsive development partner.
  • A 2017 review by the Multilateral Organisation Performance Assessment Network (MOPAN) that gave the Global Fund top ratings for its organizational architecture, operating model and financial transparency and accountability.
  • A 2016 UK Government Multilateral Aid Review that awarded the Global Fund the highest possible rating for overall organizational strength.

Read more about the Global Fund’s transparency and risk management efforts.

Why do we need the Global Fund when we already have U.S. global health programs working on these three diseases, like the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI)?

The Global Fund is a public-private partnership that works closely with and complements the in-country work of U.S. global health programs. The Global Fund is unique because it leverages funding from other donors (by law the U.S. cannot provide more than one-third of Global Fund resources). The Global Fund also builds incentives into its grant agreements to ensure implementing countries are increasing their own investments in the health of their people.

The Global Fund provides financing that helps country programs, working with U.S. health programs to purchase treatments, bed nets, diagnostic tests and other health commodities. PEPFAR and USAID officials have said, “Our partnership with the Global Fund helps maximize the impact and efficiency of our bilateral investments targeting AIDS, tuberculosis, and malaria by enabling the United States to strategically deploy our resources. … We can’t have one without the other.”

Read more about the Global Fund’s work with U.S. bilateral health programs here.

The budget is tight this year; why should the Global Fund receive the same amount of funding from the U.S. as it has in the past three fiscal years?

At the Global Fund’s Fifth Replenishment Conference in 2016, the U.S. pledged up to $4.3 billion over three years, matching $1 for every $2 from other donors. To stay on target for our three-year pledge, the U.S. should appropriate $1.35 billion to the Global Fund in Fiscal Year (FY) 2018, the same level as for FY 2015, 2016 and 2017.  A $1.35 billion appropriation in FY 2018 is consistent with the one-to-two matching requirement in U.S. law, and is justified by the increased pledges by other nations from the Fund’s successful replenishment and ongoing resource mobilization efforts.

In its FY 2018 budget, the White House has proposed $1.125 billion for the Global Fund – a $225 million or 17 percent cut from the last several years.

Sustained U.S. investment in the Global Fund leverages investment by other donors. Stepping back from our commitment would send a negative message to donors and implementing countries about U.S. commitment to the Global Fund, potentially undermining efforts to generate increased funding from donors other than the U.S.

The Global Fund has an excellent track record of receiving funds pledged – nearly 100 percent of funds pledged for the last replenishment cycle have been received.

Finally, it’s about impact. Every dollar invested in the Global Fund counts, and even a modest cut would reduce the number of lives saved, damage efforts to end AIDS, TB and malaria, and create greater threats to global health security. Every $100 million invested in Global Fund-supported programs:

  • Saves 133,000 lives
  • Provides antiretroviral therapy for 107,000 people
  • Provides treatment for 31,000 women to prevent passing HIV to their babies
  • Provides TB treatment and care for 153,000 people
  • Provides 4,300 people with treatment for multi-drug resistant TB
  • Distributes 6.2 million mosquito nets to protect children and families from malaria
  • Spurs up to $2.2 billion in long-term economic gains

Learn more about the Global Fund’s impact.