Joe Cerrell is director of the Bill & Melinda Gates Foundation European office. The opinions expressed are his own.
Ten years ago, I sat around a conference room at the Bill & Melinda Gates Foundation to weigh-in on a decision about whether to contribute to the then newly-established Global Fund to Fight AIDS, Tuberculosis and Malaria.
Born out of a group of donors that joined together following the G8 summit in Japan, the Global Fund aimed to aggressively confront a global health crisis by targeting three deadly diseases. At the time, the Gates Foundation was smaller in size than today, yet there was consensus around the table that the investment was warranted.
Since that time, the Gates Foundation has been deeply engaged in the growth and evolution of the fund, and in hindsight it has proven to be one of the best decisions Bill and Melinda Gates have made in terms of saving lives.
In its short lifespan, the Global Fund has already saved the lives of 7.7 million people. We know this because it closely tracks progress and impact.
A lot of people believe – rightly in some cases – that multilateral institutions don’t always operate with the same level of efficiency of entities in the private sector.
But we have been very impressed by the way the Global Fund is run, with an ethos for constant improvement and a commitment to innovation.
For example, many in the non-profit sector espouse more meaningful collaborations with the private sector.
Yet the Global Fund has truly been a leader, supporting partnerships like (RED), which get companies involved to raise money for HIV/AIDS in Africa, and increase their sales, which has resulted in more than $160 million raised in the last four years.
These days there’s plenty of debate about whether or not aid works. And the Fund itself has come under close scrutiny in recent months about how well it tracks the money it disburses.
Some think they can and should do better, yet I can think of few better stories to illustrate my belief aid does work – when done properly – than the Fund.
Their high level of transparency sets it apart from other bilateral and multilateral institutions. This transparency and accountability means that we also hear about it when things go wrong.
It’s unrealistic to expect no operational challenges when you’re dealing with billions of dollars in aid in difficult environments. It’s how you deal with those challenges that count, and so yet again this is where the Fund is setting the standards.
Making good on its commitment to transparency, the Fund commissioned an independent panel earlier this year to evaluate how it can improve its operations and effectiveness.
The panel’s recommendations, which were in line with the Global Fund’s own reform agenda, were met by the Global Fund Board with great openness.
They committed to deliver on the recommendations this week, and to continue to adjust practices to use its resources as efficiently as possible.
Still, some feel that the Fund isn’t going far enough. They say that even very small amounts of money that cannot be accounted for should be grounds for cutting off that country’s grant monies from the Fund.
It’s a worthwhile but entirely unrealistic aspiration that such irregularities do not occur in some programs. Of course organizations like the Fund should aspire to the highest degrees of effective stewardship of resources and implement stringent measures of accountability.
However, we also need to acknowledge some degree of risk organizations like the Fund undertake as well as the inherent challenges they face in some of the places they work.
We need to be sure that in pursuit of such rigorous policies, donors don’t unwittingly stifle innovation, new approaches and ultimately big impact in tackling killer diseases.
For the Bill & Melinda Gates Foundation, the Global Fund is an invaluable partner, and the progress they have achieved is bringing us closer than ever to the reality of global health equity. Every day, programs supported by the Global Fund save at least 4,400 lives.
With continued efforts to enhance strong oversight and support for effective governance, we can improve on the Global Fund’s impressive record and ensure that millions more lives are saved and the progress against global disease is secured for generations to come.