The precarious promise of the Global Fund

African Journal of AIDS Research

The International Journal of African Historical Studies, 2006

2011

Recent years have seen the re-emergence of charges of AIDS exceptionalism in response to significant increases in global funding for health that have coalesced around HIV/AIDS treatment. These increases are argued to illustrate that AIDS demands an exceptional and exaggerated portion of global resources to the detriment of other health needs and the strengthening of health systems. I argue in contrast that AIDS 'exceptionalism' in funding represents a welcome departure from a longstanding norm that tolerates grossly insufficient domestic and global allocations to health. In this light, AIDS 'exceptionalism' while a political anomaly, has acted as a transformative corrective to exclusionary and inequitable HIV/AIDS policies, and may offer important strategic opportunities for increasing attention to other global health inequities and assuring realization of the right to the highest attainable standard of health. To realize this potential, civil society actors, policy-makers and international organizations should utilize the normative, strategic and operational possibilities opened up by amplified AIDS funding as the thin edge of a considerably larger global health wedge.

2011

On March 3-4, 2011, UN staff, donors, and civil society representatives met in New York to discuss how the Global Fund to Fight AIDS, Tuberculosis and Malaria might best operationalize the promotion of human rights and equitable access as one of its five strategic objectives.The meeting covered the following human rights issues related to the Global Fund's 2012-2016 strategy:Scope and content of the Global Fund's human rights commitment and obligation;Promoting human rights in Global Fund-supported programs and advocacy;Oversight and monitoring and evaluation of the Global Fund's portfolio according to human rights criteria;Addressing human rights risks and violations associated with Global Fund grants.Discussion papers on each of these issues, as well as a paper exploring the relationship between human rights and equity, were prepared for the meeting

Bringing Global Governance Home

This chapter compares the efforts of NGOs in Russia and South Africa to mediate global approaches to tackling the HIV/AIDS epidemic in their home contexts. It illustrates both the benefits and drawbacks of engaging with GGIs that offer significant levels of authority to NGOs along with very specific rules and standards. Such strong tools, when placed in NGOs’ hands, can help them to mediate effectively in a welcoming domestic political environment; but if dominant political actors oppose global norms, they can lead to pitched battles between civil society and government actors. NGO activists who persevere in a relatively open democratic regime that protects civil and political rights, such as South Africa, can contribute to domestic normative change over time, leading eventually to government policies that align with global principles. Where the political environment is relatively closed and repressive of civil society, as in Russia, NGOs may struggle to muster sufficient authority ...

2010

for the valuable information and insights they provided through interviews and related email conversations. We would also like to thank Camila Aguilar for her support during the initial phase of this study.

2008

Alastair Fraser researches the relationship between Africa and the West. He is interested in how donor governments and rich country Non-Governmental Organisations (NGOs) use the money they give in aid to promote their preferred economic and social agendas, and particularly in African responses to these interventions. His doctoral research at Oxford University is on the impact of Western donor and NGOs interventions on Zambian political economy, 1997-2007.

Bulletin of the World Health Organization, 2006

In August 2005, the Global Fund to fight AIDS, Tuberculosis and Malaria (the Global Fund) Secretariat suspended its five grants to Uganda following a PricewaterhouseCoopers audit report that exposed gross mismanagement in the Project Management Unit. How could this have been avoided? How can other countries avoid a similar pitfall? We argue that if a legitimate and fair decision-making process were used, the suspension of funding to Uganda could have been avoided, and that this lesson should be applied to other countries. The "accountability for reasonableness" framework of relevance, publicity, revisions and enforcement would help in implementing legitimate and fair decision-making processes, which would improve effectiveness, accountability and transparency in the implementation of Global Fund programmes, preventing future suspension of funding to any Global Fund projects.

This article provides a case study of overseas development assistance for AIDS to South African civil society; it analyses how power is exercised as well as resisted in the context of international aid. While it is argued that governance theory tends to underestimate power inequalities in the context of policy networks, this case is instead related to the theoretical debate regarding whether current global power structures can be analysed in terms of a (US-led) neoimperialism, or whether they should rather be understood in terms of postimperialist power constellations based on ‘regulation of self-regulation’ through market mechanisms, and with an emphasis on ‘civil society participation’. While the case demonstrates how US aid under the Bush administrations to a certain extent involved a ‘civilising mission’, it is argued that ‘regulation of self-regulation’ was the more significant form of governing AIDS aid networks, contributing to a development through which AIDS activism went through a process of ‘NGO-isation’, de-politicising the AIDS issue.

The Review of Austrian Economics, 2009