The Global Fund: managing great expectations

Brugha, Ruairı́; Donoghue, Martine; Starling, M.; Ndubani, Phillimon; Ssengooba, Freddie; Fernandes, Benedita; Walt, Gill

doi:10.1016/s0140-6736(04)16595-1

Cited by 112 publications

(92 citation statements)

References 4 publications

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“…Moreover, given that most of the activities proposed corresponded to the 2007-2011 Multisectoral Strategic Plan objectives, it could be argued that both the plan and the proposals responded to the same few unchecked strategies developed over a decade before. This has been found in prior studies (Brugha et al, 2004;Kapilashrami & McPake, 2012;Libatique, 2004) where proposals seemingly state facts to support the country's view rather than the other way around.…”

Section: Development Of a Favorable Environmentsupporting

confidence: 53%

A critical analysis of Peru's HIV grant proposals to the Global Fund

Cáceres

Amaya

Sandoval

et al. 2013

Global Public Health

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2 Peru has applied to six of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) rounds for funding, achieving success on four occasions. The process of proposal development has, however, been criticised, especially concerning the use of evidence, relevance/consistency, and performance indicators.We aimed to analyse the Peruvian Global Fund proposals according to those dimensions, providing feedback to improve future local efforts and inform global discussions around Global Fund procedures. We analysed the content of four HIV-focused proposals (rounds 2, 5, 6 and 8) regarding epidemic context, needs identification and prioritisation, and monitoring and evaluation systems.Peruvian proposals submitted after round 1 were described as resulting from collaborative inputs involving formerly unrepresented sectors, principally 'vulnerable populations'. However, difficulties arose regarding the amount and quality of evidence about the epidemiological context; limited consideration of social determinants of the epidemic; lack of theory-driven interventions and little synergy across projects; and the inclusion of weak monitoring and evaluation systems, with poor indicators and measurement procedures.Prioritising the development of analytical and technical skills to generate Global Fund proposals would enhance the country's capacity to produce and utilise evidence, improve the technical-political interface, strengthen information systems, and lead to more informed decisionmaking and accountability. HIV/AIDS proposal elaboration processes have undergone different phases in Peru. The unsuccessful proposal for round 1 (which was not available and does not form part of this analysis) was formulated independently by the Ministry of Health. This proposal was followed by three consecutive, successful proposals (rounds 2, 5, and 6) and another unsuccessful proposal submitted for round 8. A new proposal submitted for round 10 under the special provision for key populations has recently been approved but was also not part of this analysis. The proposal approved for the 10th round (for US$12.5 million) in 2011 brought the total amount for HIV/AIDS activities by the Global Fund to approximately US$90 million (Global Fund, 2010). Table 1 presents a brief description of the four proposals that served as a basis for this study. from one proposal to the other; c) to assess whether the proposals include the appropriate mechanisms for monitoring and evaluating impacts and outcomes. These three dimensions encompass the key technical aspects of a programmatic proposal, all of which should be evidence-based: background, goals and activities, and performance assessment. For each of these objectives, we formulated indicators intended to operationalise the key dimensions identified for analysis (see Table 2). Study limitationsThis study has limitations such as the difficulty in defining a single, detailed evaluation framework across different proposals in an evolving context; restrictions in assessing the context where eac...

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Section: Development Of a Favorable Environmentsupporting

confidence: 53%

A critical analysis of Peru's HIV grant proposals to the Global Fund

Cáceres

Amaya

Sandoval

et al. 2013

Global Public Health

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“…[2][3][4] The Global Fund to Fight AIDS, Tuberculosis and Malaria is one of the largest funders to support low-and middle-income countries in fighting these diseases, which are critical to achieving health-related MDGs. [3][4][5][6][7][8][9][10][11][12] As of mid-2006, the Global Fund has approved proposals worth US$9.6 billion, of which US$ 5.5 billion is approved and committed in 132 countries. Based on these approved proposals, a total of 333 programmes have been funded, US$ 4.1 billion worth of grant agreements signed and over US$ 2.4 billion disbursed to the recipients.…”

Section: Objectivementioning

confidence: 99%

Global Fund-supported programmes' contribution to international targets and the Millennium Development Goals: an initial analysis

Komatsu

Low‐Beer

Schwartländer

2007

Bull World Health Organ

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“…[11][12][13] HIV/ AIDS and other opportunistic infections exert the greatest limitations for health care in the world by causing serious debility, morbidity and mortality in the affected population. 14,15 It is also regarded as the major factor behind population decrease in the last 10 years in the overall life expectancy in Sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

“…16,17 This implies that the majority of 3 the people suffering from HIV/AIDS cannot afford modern health care because of the high cost associated with HIV/AIDS drugs. 12,13 However, the use of medicinal plant species in Uganda especially in Njeru sub-county persist, and is likely to increase substantially because of the increase in human population, ever increasing cases infections with HIV and other diseases. The high demand for medicinal plants fuels the non-sustainable harvesting of medicinal plant species.…”

Section: Introductionmentioning

confidence: 99%