Multilateral Aid Review summary - The Global Fund to fight AIDS, TB and Malaria (GFATM)

GFATM is a global public/private partnership that raises and disburses funds to prevent and treat HIV/AIDS, tuberculosis and malaria.  Since its creation in just 2002, the Fund has become the biggest multilateral funder of health related MDGs.

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Contribution to UK development objectives	Strong
	+	Critical in the delivery of MDG 6 as the leading organisation disbursing finance to AIDS, TB and malaria.
	+	Finances a range of high impact interventions throughout pre-pregnancy, pregnancy, birth and childhood, with an important impact on MDGs 4 and 5.
	+	Impressive results: By June 2010, an estimated 5.7 million lives had been saved through Global Fund supported interventions.
	_	The Fund is reasonably well aligned to disease burden, though the challenge fund business model means it could be stronger.
	_	There are clear weaknesses and bottlenecks in the business model which impede faster progress and even more impressive results.
	_	The Fund’s policies and practices are not sufficiently flexible or responsive to fragile contexts given the high share of fragile states financing in the portfolio.
	+	GFATM carries out a thorough assessment of gender relevance of all proposals, though the quality of proposals in terms of addressing gender issues has been poor.
Organisational strengths	Strong
	+	The Fund is a results-focussed organisation; the quality and depth of reporting is very high, and allows donors to hold the Fund to account.   Standards for financial management and audit are very high.
	+	There have been attempts to control cost inflation, both at the overall programmatic level and within the Secretariat, though more needs to be done.
	+	Beneficiary voice is reasonably well embedded into all layers of governance.
	_	The Fund places heavy burdens on countries and partners and despite its focus on a country-led approach, its own systems and requirements often take precedence.
	_	The time between grant approval and disbursement is not quick enough, and a persistent issue for the UK is the large ‘cash balance’ on the Global Fund’s books.
	+	The Fund’s decision to publish and require recipients to publish procurement data has been a major driver for a range of innovations in transparency.
Capacity for positive change	Likely
	+	There is scope and appetite to simplify processes and improve efficiency and effectiveness.
	_	The Fund must make sure it can put its resources to work on the ground more quickly.