Annual Report

2004

 The Global Fund to Fight AIDS,

Tuberculosis and Malaria 2005
I S B N 9292240234
The designations employed and the
presentation of the material in this
publication do not imply the expression
of any opinion whatsoever on the part of
the Global Fund concerning the legal
status of any country, territory, city or area
or of its authorities, or concerning the
delimitation of its frontiers or boundaries.
The mention of specific companies or
of certain manufacturers products does
not imply that they are endorsed or
recommended by the Global Fund in
preference to others of a similar nature
that are not mentioned.
This Page
Homecare volunteer Thulile Dlamini,
aged 25, packs her bag with homecare
supplies such as gloves, paracetamol and
soap. She walks long distances to visit
clients in the areas surrounding her village
in Swaziland.

The Global Fund

Annual Report 2004
5

Message from Chair + Vice-Chair

Message from Executive Director

Core Operating + Governance Structures

of the Global Fund

10

World maps illustrating country coverage of Global Fund

grants by disease

11

World map illustrating per capita health investment

by the Global Fund

12

2004: The Year in Review

18

Performance Measurement
What the Global Fund Measures + How

Global Fund Operations + Results

22

Resource Mobilization, Communications + Advocacy

26

Pledges + Contributions to the Global Fund

28

Secretariat Management

36

Grant Performance

Country Profiles
11

Moldova

17

Burundi

39

Morocco

Approved Grants + the Organization

44

Approved Grants

54

List of Board Members (2004)

56

Technical Review Panel (2004)

58

Global Fund Secretariat

63

Financial Statements 2004

In Central Jail, Bilaspur, India, treatment

success has increased significantly with
the introduction of diagnosis and treatment
under DOTS, funded with a Global Fund
grant. Inmates in the tailoring workshop
make clothes, which are sold in the prison
shop and local markets.

Global Fund Annual Report 2004

Message from the

Chair + Vice-Chair
The Global Fund to Fight AIDS, Tuberculosis and Malaria was created out of a global commitment
to stop the spread of three diseases which together kill six million people every year and put a
brake on economic and social development in large parts of the world.
In 2004, we displayed this commitment through a substantial increase in pledges and a fourth
round of grant approvals, which bring the Global Funds total pledges to US$ 5.9 billion and
its grant commitments to US$ 3.1 billion for over 300 grants in 127 countries.
The past year has been a year of expansion, of consolidation, and of development. The volume
of our activities has grown substantially. The Board, the Secretariat, recipients and partners have
continued to find ways of working better together.We have further established and embedded
our procedures for the Global Funds work. Most important, the grants have turned into actual
programs on the ground, which in time have turned into results.
The Global Fund finances effective programs, designed, owned and implemented by publicprivate partnerships in recipient countries.We measure our success by the results achieved by these
programs. In 2004, the first results appeared.While they naturally are modest in scope, these early
results are heartening and reinforce our belief in performance-based funding, a core principle for
the Global Fund.
The past year has provided numerous lessons in what is needed to achieve results and in how
to assist in overcoming challenges. These lessons have deepened and focused the collaborations
between all the partners and stakeholders who together make up the Global Fund network. The
achievements of this year are the achievements of all those who have participated in the projects
we fund; the challenges are ours to solve together.
The Global Fund is unique, but it is a product of the collective experience and vision of all who
have engaged in its creation and development. The year reviewed in this publication reinforces
our belief that the Global Fund is a worthy endeavor. It strengthens our commitment to further
develop and improve our ability to save lives.
It has been an honor to serve the Fund and the communities it aids over the past two years.We offer
our thanks and gratitude to the staff of the Secretariat and our fellow Board members for their
support and commitment.

Tommy G. Thompson
Chair of the Board

Dr Hlne Rossert-Blavier
Vice Chair of the Board

Secretary of Health and Human Services

Department of Health and Human Services
United States of America

Director General
AIDES
France

In Bucharest, Romania, outreach workers

travel by van and on foot at night to
reach injecting drug users with needle
exchange services, condoms and referrals
for HIV testing.

Global Fund Annual Report 2004

Message from the

Executive Director
The year 2004 was a year of substantial growth and progress for the Global Fund and its mission.
Total resources pledged to the Global Fund rose from $4.9 billion to $5.9 billion. Round Four of
investments was launched, bringing our total portfolio of investments to 310 programs in 127
countries.At the end of the year, the two-year value of this portfolio stood at $3.1 billion and the
five-year value at $8.1 billion.
An extremely successful Partnership Forum was held in Bangkok, at which the Global Fund was
able to listen to and learn from the criticisms and suggestions of many stakeholders from all
around the world. The Global Fund held its first African Board Meeting in Arusha, Tanzania, and
Board Members were able to undertake informative site visits to programs in Kenya, Rwanda,
and Tanzania. I particularly appreciate the assistance and hospitality of President Benjamin Mkapa
and the Tanzanian Government in making this historic event so successful.
The year 2004 was also a year in which the Secretariat, the exceptional group of women and men
in Geneva who do the daily work of the Global Fund, strengthened and expanded. Staff numbers
increased during the year from 80 to approximately 120. The Secretariat was reorganized at midyear. Importantly, systems and procedures were steadily improved to ensure that our
services are of the highest quality and that we are fully able to respond to the rapid expansion in
our portfolio of investments.
The results that we share with you in this report and elsewhere show substantial achievement and
provide reassurance that the Global Fund is on the right track and that the programs we are
financing are making a positive difference in the lives of millions of people around the world. The
results reported also give confidence that our overall model of country-led, performance-based
financing is sound and is working. However, there is no room for complacency.At the end of 2004
the average age of the programs in our portfolio was only 11 months. Phase 2 Renewals, the acid
test of performance-based financing, had not yet begun and, most importantly, the large-scale
results, in terms of infections prevented and lives saved, had not yet been achieved. There is much
yet to be done, and 2005 will be a pivotal year, especially for the achievement of results and our
ability to measure these results in a credible and transparent fashion.
I would like to thank the many people and organizations who have contributed to the Global
Funds success and helped us to improve our systems and procedures. Particular thanks should go
to the many partners and stakeholders who have expanded the guidance and technical assistance
that they provide to recipients of Global Fund finance, often in spite of their own limited resources.
The Global Fund is a financing mechanism. The massive scale-up in response to AIDS, TB
and malaria, that we all desire, can only be achieved if we work closely with all partners, including
multilateral and bilateral organizations, civil society and the private sector, to ensure that the
money flows to well designed and effectively managed programs which will bring real and rapid
improvement in the lives of people and communities throughout the developing world.We look
forward to further strengthening these partnerships in 2005.

Professor Richard G A Feachem

Executive Director

Global Fund Annual Report 2004

Core Operating +
Governance Structures
of the Global Fund
Seven core structures form the basis for
the governance and operation of the Global
Fund: the Board, the Secretariat, the Technical Review Panel, Country Coordinating
Mechanisms, Principal Recipients, Local
Fund Agents and the Partnership Forum.
These bodies are complemented by a
broad network of partners that provide critical support for the development of grant proposals, the implementation of funded programs and
the smooth running of related
processes such as drug procurement
or human resource development.
The Global Funds Board approves grants and supports resource
mobilization to meet the Global
Funds financial needs. In March
2004 at its seventh meeting, the
Board appointed Dr. Hlne RossertBlavier, the General Director of the
French NGO AIDES and the member representing Developed Country
Nongovernmental Organizations, as
its Vice-Chair, replacing outgoing
Vice-Chair Dr. Suwit Wibulpolprasert from the Ministry of Public
Health in Thailand. Until June 2004,
the Board had 18 voting members
and five non-voting members, representing donors and recipient countries, NGOs and communities living
with and affected by the diseases, the

private sector and private foundations, as well as key operating partners.At its eighth Board meeting in
June 2004, the Board approved the
status change of the member for
NGOs Representing Communities
Affected by the Diseases from nonvoting to voting member. This increased to 19 the number of voting
members and reduced to 4 the number of non-voting members.An additional (voting) seat representing
donors will be added to the Board at
a future date.
In 2004, the Board had six ad hoc
committees: Governance and Partnership; Monitoring, Evaluation, Finance and Audit; Portfolio Management and Procurement; Resource
Mobilization and Communications;
Partnership Forum and Ethics.At its
tenth meeting in Tanzania in November 2004, the Board approved
changes to its committee structure to
increase effectiveness and streamline
Board processes. These changes will
be further elaborated and imple-

mented in a phased approach in

2005.
In July 2004, the Global Fund held
its First Biennial Partnership Forum
in Bangkok with 450 participants
from varied stakeholder constituencies. The Forum, which is a formal
part of the Global Funds governance
structure, provides an external advisory function by inviting diverse
stakeholders to review the Global
Funds progress and provide input
for improvement. The Forum was the
culmination of six months of regional meetings and on-line communications, which provided the basis
for discussion and debate in
Bangkok.A formal report containing
a series of recommendations by the
Forum was submitted to the Global
Funds Board for consideration at its
tenth meeting in November 2004.
A Secretariat, staffed by approximately 120 professional and administrative personnel in 2004, conducts
day-to-day operations; mobilizes resources from the public and private
sectors; manages grants; provides financial, legal and administrative support; collects strategic information
and monitors performance; supports
the Board, its committees and the
Technical Review Panel; and reports
information regarding the activities
of the Global Fund to the Board and
to the public. The Secretariat is based
in Geneva, Switzerland.At its seventh
meeting in March 2004, the Board
reappointed Dr. Richard Feachem as
Executive Director of the Global
Fund for a second two-year term.

Core Operating + Governance Structures

Global Fund Annual Report 2004

Guiding Principles

Seven principles guide the policies and operations of the Global Fund, from
its governance to its grant-making. These principles reflect a consensus
by the many stakeholders whose consultations in 2001 laid the foundation
for the Global Fund.
The Global Fund:
1. Operates as a financial instrument, not an implementing entity.
2. Makes available and leverages additional financial resources.
3. Supports programs that evolve from national plans and priorities.
4. Operates in a balanced manner with respect to different geographical
regions, diseases and health-care interventions.
5. Pursues an integrated and balanced approach to prevention, treatment,
care and support.
6. Evaluates proposals through an independent review process.
7. Operates transparently and accountably and employs a simplified,
rapid and innovative grant-making process.

The Technical Review Panel

(TRP) is an independent body of international health and development
experts that assesses all grant proposals for technical and scientific
merit based on global best practices.
Members convene for two weeks in
Geneva to review the proposals submitted for each funding round, and
the TRP then makes recommendations to the Board on proposals that
deserve funding. The TRP also provides ongoing support to any proposal clarifications following Board
approval.
Before a country applies to the
Global Fund for a grant, it normally
convenes a multisectoral Country
Coordinating Mechanism (CCM),
which represents public and private
sectors, including government, nongovernmental and faith-based organizations, people living with and
affected by the diseases, bilateral and
multilateral development agencies,
and academic institutions. The CCM
develops and submits grant proposals to the Global Fund based on national strategies, multi-stakeholder
priorities and identified gaps in exist-

ing funding from all sources.After

the Global Fund approves a grant, the
CCM oversees implementation of
funded programs, reviews reports of
Principal Recipients and ensures
cross-sector coordination. CCMs are
central to the Global Funds commitment to local ownership and participatory decision-making.
For each grant, at least one Principal Recipient (PR) is accountable for
the resources committed and disbursed by the Global Fund. The PR,
which is nominated by the CCM and
approved by the Global Fund, supervises program implementation, often
with several sub-recipients. PRs work
with the Secretariat and sub-recipients to develop program goals, performance indicators and targets to be
included in an initial two-year grant
agreement.At intervals specified in
the agreement, the PR requests disbursements from the Global Fund
based on verified progress updates
and the cash requirements of the
program. This is the foundation for
the Global Funds system of performance-based grant making and its
focus on tangible results.

As the Global Fund has no staff

outside its Secretariat in Geneva, it
contracts a Local Fund Agent (LFA)
for each recipient country to assess
the capacity of a nominated PR to
manage and administer grant proceeds, manage the implementation of
funded programs and report on financial and programmatic progress.
The LFA also verifies all disbursement requests, progress updates and
reviews annual audit reports. In
2004, following a competitive international tender, the Global Fund
confirmed the following firms as its
LFAs in recipient countries around
the world: Chemonics International
Inc., Crown Agents for Overseas
Governments and Administrations
Ltd., Deloitte Touche Tohmatsu
Emerging Markets Group, KPMG
International, Pricewaterhouse
Coopers, the Swiss Tropical Institute
of Chad and the United Nations Office for Project Services.
The Global Fund is a financing
institution and not an implementing
agency.As such, it relies upon its
partners to provide technical assistance and capacity-building support
to current and potential grant recipients. Bilateral agencies, businesses
and foundations, nongovernmental
and multilateral organizations
including UNAIDS, the World
Health Organization and the World
Bank work side by side with
Country Coordinating Mechanisms
to develop high-quality proposals, to
strengthen local capacity to manage
grants and to assist in the implementation of grant-funded programs.
The World Health Organization provides international clinical standards
for medical responses to AIDS, tuberculosis and malaria, and plays an important role in the prequalification of
drugs for the three diseases. UNAIDS
is playing an essential role in providing important technical support at
the country level and support and
strategic advice for monitoring and
evaluation at local and national levels.

10

Global Fund Annual Report 2004

World maps illustrating country coverage of Global Fund grants by disease

HIV/AIDS

Afghanistan
Algeria
Angola
Argentina
Armenia
Azerbaijan
Bangladesh
Belarus
Belize
Benin

Tuberculosis

Malaria

Bolivia
Botswana
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Central African
Republic
Chad

Chile
China
Colombia
Comores
Congo (Democratic
Republic)
Costa Rica
Cote d'Ivoire
Croatia
Cuba

Djibouti
Dominican Republic
Ecuador
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Gabon
Gambia

Georgia
Ghana
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
India
Indonesia
Iran (Islamic
Republic of)
Jamaica
Jordan
Kazakhstan
Kenya
Kyrgyzstan
Lao PDR
Lesotho
Liberia
Macedonia, FYR
Madagascar
Malawi
Mali
Moldova
Mongolia
Morocco
Mozambique
CARICOM*
CRN+**
Meso***
OECS****

Multi-country
Western
Pacific*****
Myanmar
Namibia
Nepal
Nicaragua
Niger
Nigeria
Pakistan
Papua New Guinea
Peru
Philippines
Romania
Russian Federation
Rwanda
Senegal
Serbia
Sierra Leone
Somalia
South Africa
Sudan
Suriname
Swaziland
Tajikistan
Tanzania
Tanzania/Zanzibar
Thailand
Togo
Turkey
Uganda
Ukraine

Uzbekistan
Vietnam
Yemen
Zambia
Zimbabwe

Afghanistan
Angola
Bangladesh
Benin
Bhutan
Bolivia
Burkina Faso
Burundi
Cambodia
Cameroon
Central African
Republic
Chad
China
Congo (Democratic
Republic)
Cote d'Ivoire
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador

Ethiopia
Georgia
Ghana
Guinea-Bissau
Guyana
Haiti
Honduras
India
Indonesia
Kenya
Kyrgyzstan
Lao PDR
Lesotho
Liberia
Madagascar
Mali
Mauritania
Mongolia
Mozambique
Multi-country
Western Pacific*
Myanmar

Namibia
Nepal
Nicaragua
Pakistan
Panama
Paraguay
Peru
Philippines
Romania
Russian Federation
Rwanda
Serbia
Serbia/Kosovo
Sierra Leone
Somalia
Sri Lanka
Sudan
Swaziland
Tajikistan
Tanzania/Zanzibar
Thailand
Togo

Uganda
Uzbekistan
Vietnam
Yemen
Zambia

Afghanistan
Angola
Benin
Benin
Bhutan
Bolivia
Burkina Faso
Burundi
Cambodia
Cameroon
Central African
Republic
China
Comores
Congo (Democratic
Republic)
East Timor
Eritrea
Ethiopia
Gabon
Gambia
Georgia
Ghana
Guatemala

Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
India
Indonesia
Kenya
Lao PDR
Liberia
Madagascar
Malawi
Mali
Mauritania
Mozambique
RMCC*
Andean**
Multi-country
Western Pacific***
Myanmar
Namibia
Nepal
Nicaragua
Niger

Nigeria
Pakistan
Papua New Guinea
Philippines
Rwanda
Sao Tome
& Principe
Senegal
Sierra Leone
Somalia
Sri Lanka
Sudan
Suriname
Swaziland
Tanzania
Tanzania/Zanzibar
Thailand
Togo
Uganda
Uzbekistan
Vietnam
Yemen
Zambia
Zimbabwe

* RMCC:
Mozambique, South
Africa,
Swaziland

* CARICOM
Antigua & Barbuda,
Bahamas, Barbados, Belize, Dominica, Dominican
Republic, Grenada,
Guyana, Haiti,
Jamaica, St. Kitts
& Nevis, St. Lucia
St. Vincent &
the Grenadines,
Suriname,
Trinidad & Tobago
** CRN+:
Antigua & Barbuda
Dominican Republic, Grenada,
Guyana, Haiti
Jamaica, St. Kitts
& Nevis, St. Lucia,
St. Vincent &
the Grenadines,
Suriname, Trinidad
& Tobago

*** Meso:
Belize, Costa
Rica, El Salvador,
Guatemala, Honduras, Nicaragua,
Panama
**** OECS:
Antigua & Barbuda,
Dominica, Grenada,
St. Kitts & Nevis,
St. Lucia, St. Vincent
& the Grenadines
***** Western
Pacific:
Cook Islands, Fiji,
Federated States of
Micronesia,
Kiribati, Niue,
Palau, Samoa,
Solomon Islands,
Tonga, Tuvalu,
Vanuatu

* Western Pacific:
Cook Islands, Fiji,
Federated States
of Micronesia,
Kiribati, Niue, Palau,
Samoa,
Solomon Islands,
Tonga, Tuvalu,
Vanuatu

** Andean:
Colombia, Ecuador
Peru, Venezuela
*** Western
Pacific:
Cook Islands, Fiji,
Federated States
of Micronesia,
Kiribati, Niue, Palau,
Samoa,
Solomon Islands,
Tonga, Tuvalu,
Vanuatu

C O U N T RY P R O F I L E

Global Fund Annual Report 2004

11

Moldova
Free ARVs and targeted prevention for vulnerable groups
Disease(s) funded: HIV/AIDS, TB

When it became known that Ludmila U,

an obstetrician for 17 years, was HIVpositive, she lost her job, social network
and hope for a normal life. Yet, seven
years on, she has a second chance.
Free antiretroviral (ARV) treatment has
changed everything about living with
HIV, rapidly improving her own health
and that of her friends. Future has
returned to her vocabulary. When asked
what life would be like without ARVs,
Ludmila gives a sad smile and replies:
There would be no life.
The HIV/AIDS epidemic among
Moldovas four million people was
late to start but quick to take hold.
While many infections were not reported until after the mid90s,
prevalence escalated by nearly 10
percent in 20012003 alone, reaching
0.2 percent among adults.As for tuberculosis, 2002 saw some 98.1 notified cases and 15.6 mortality per
100,000 people.
Providing free ARV treatment,
the first nation-wide initiative of its
kind in a nation of the former Soviet
Union, is central to the countrys integrated response to the two diseases,
led by the National Programs for the
Prevention and Control of
HIV/AIDS/Sexually Transmitted Infections and Tuberculosis. The work
is enhanced by a Round One grant
from the Global Fund, signed in
March 2003.With the Ministry of
Healths Project Coordination, Implementation and Monitoring Unit
(PCIMU) as the Principal Recipient,
nearly US$ 5.03 ($5,026,861 as of
March 2005) million of the two-year
budget of US$ 5.3 million has been
disbursed to date.

Approved Funding to date: US$ 11.7 million

By the end of 2004,ARVs had

been provided to 115 people (109
adults and 6 children), with two
health facilities supported to provide
needed services.While the numbers
may seem low in absolute terms, they
represent an important start to scaling up comprehensive care and support to the nearly 2,000 people reported to be living with HIV by the
end of 2003. Direct procurement and
government negotiation of drug
prices have resulted in reductions in
both overall treatment acquisition
costs and per patient ARV costs.
As well as increasing access to
treatment, the National Program and
its partners have also developed prevention strategies targeting groups
that are particularly vulnerable to infection. These include young people,
prisoners, truck drivers, commercial
sex workers, men who have sex with
men and injecting drug users
(IDUs).
Evidence is already beginning to
emerge that this targeted approach is
slowing the epidemic among some
groups.With IDUs, for example, the
sharing of infected syringes had contributed to HIV prevalence of 1.6
percent in 2002. However, data now
show that the number of new cases
among IDUs is stabilizing at a relatively low level, and the proportion of
IDUs among the countrys new infections has dropped from over 80 percent in 2000 to under 55 percent in
2003.
Another first for a state-run initiative in a former country of the Soviet Union was the introduction of
HIV and TB prevention and diagnosis, treatment and care for people in
prisons. HIV prevalence among detainees was over 2 percent in 2002.
Efforts supported by the Global Fund
have brought comprehensive services
to four sites.
Moldovas Country Coordinating

Mechanism (CCM) by actively

involving Ministries as varied as Justice, Labor and Education has
supported the governments efforts
to broaden its responses to
HIV/AIDS, previously confined to
the health sector. It is also, within a
context of increasing external funds
and an urgent need for coordination,
helping to streamline planning
among donors. This includes assuming oversight for other major initiatives in the country, including the
World Banks AIDS program (US$
5.5 million) and a USAID-funded
TB project (US$ 4 million).
According to Dr. Oleg Barba, the
Executive Secretary of the CCM, one
of Moldovas key lessons is that
HIV/AIDS and TB are promoted by
poverty, injustice and discrimination,
and their successful control will require the involvement of a variety of
sectors. In 2004, the CCM improved
its links with all constituencies, appointed a Stakeholder Communication & Coordination Advisor and
started work on revising its terms of
reference and representation. This
helped to strengthen coordination
with NGOs, whose involvement as
Global Fund grant sub-recipients is
facilitated by the Soros Foundation.
Currently, 28 sub-recipients support
some 11,000 people, mostly from
vulnerable populations.
Progress was also made in two
other areas of HIV/AIDS work supported by the Global Fund: voluntary
counseling and testing, with 408,738
people reached; and prevention of
mother-to-child transmission of
HIV, with 35 women and 35 children
reached.While the start of planned
activities targeting young people was
delayed, plans were drawn up to take
action in 2005, introducing a comprehensive, life-skills based curriculum as a mandatory subject in preuniversity education.

Over $3
per capita

Between $13
per capita

Under $1
per capita

GUATEMALA

ECUADOR

CHILE

PARAGUAY

PERU

ARGENTINA

BOLIVIA

VENEZUELA

COLOMBIA

* Caribbean Constiuency includes: CARICOM: Anguilla (territory),

Antigua & Barbuda, Bahamas, Barbados, Belize, British Virgin Islands
(territory), Dominica, Dominican Republic, Grenada, Guyana, Haiti,
Jamaica, Montserrat (territory), St. Lucia, St. Kitts & Nevis, St. Vincent
& the Grenadines, Suriname, Trinidad & Tobago. OECS: Cook Islands,
Federated States of Micronesia, Fiji, Kirbati, Niue, Palau, Samoa,
Solomon Islands, Tonga, Tuvalu, Vanuatu

PACIFIC
OCEAN

PANAMA

COSTA RICA

EL SALVADOR

THE BAHAMAS

HAITI
DOMINICAN
REPUBLIC

BELIZE
HONDURAS
NICARAGUA

JAMAICA

CUBA

SURINAME

GUYANA

CARIBBEAN
CONSTITUENCY*

World map illustrating per capita health investment by the Global Fund

MOROCCO

CTE D'IVOIRE
BURKINA FASO
GHANA
TOGO
BENIN

SIERRA LEONE
LIBERIA

GAMBIA
GUINEA BISSAU
GUINEA

SENEGAL

MAURITANIA

ATLANTIC
OCEAN

NIGERIA

NIGER

NAMIBIA

BOTSWANA

ZAMBIA

GABON

EQUATORIAL GUINEA

MALI

ALGERIA

SOUTH
AFRICA

ANGOLA

DEM. REP.
OF CONGO

CAMEROON

SUDAN

EGYPT

YEMEN

LESOTHO

AFGHANISTAN

PAKISTAN

UZBEKISTAN

MOZAMBIQUE

MADAGASCAR

ZIMBABWE

MALAWI

COMORES

TANZANIA

BURUNDI

RWANDA

KENYA

UGANDA

SOMALIA

CENTRAL AFRICAN REP.

SRI LANKA

THAILAND

BHUTAN

LAOS

CAMBODIA

EAST TIMOR

VIETNAM

BANGLADESH

CHINA

MONGOLIA

MYANMAR

INDIAN
OCEAN

INDIA

NEPAL

TAJIKISTAN

KYRGYZSTAN

RUSSIAN FEDERATION

KAZAKHSTAN

ERITREA
DJIBOUTI

IRAN

AZERBAIJAN

SWAZILAND

ETHIOPIA

ARMENIA

JORDAN

GEORGIA

MOLDOVA

BELARUS

BULGARIA

UKRAINE

MACEDONIA

CHAD

SERBIA

CROATIA

ROMANIA

ESTONIA

INDONESIA

PHILIPPINES

PAPUA
NEW GUINEA

WESTERN PACIFIC
ISLANDS

PACIFIC
OCEAN

12

Global Fund Annual Report 2004

2004
The Year in Review

JANUARY

The United States confirms its pledge

of US$ 547 million for 2004, bringing
the amount potentially available for
Round 4 to US$ 900 million.

Right
Village children
in Thika, Kenya

Executive Director Richard Feachem

travels to Australia to meet with
Prime Minister John Howard.Australia uses this occasion to announce
the countrys first pledge of AUS$ 29
million (US$ 18 million).

renewals, the appointment of new

members to the Technical Review
Panel (TRP) in preparation for
Round 4 and the creation of the
Technical Evaluation Reference
Group (TERG).

Disbursements reach US$ 245 million across 72 countries.

Two countries, Niger and Yemen,

appeal the TRPs decision on their
proposals for Round 3. Both are
successful in restructuring their proposals in order to meet the technical
standards required by the panel.

The Global Fund is extensively discussed during the World Economic

Forum summit in Davos,Switzerland.

The International HIV/AIDS Alliance is selected as a caretaker PR for

a restructured Ukraine grant.

The Asia Pacific Alternative Community Forum 2004, which brings together representatives of community
groups from throughout the region,
takes place in Bangkok. The Global
Fund organizes a one-day consultation immediately after the Forum for
civil society and nongovernmental
organizations to look at ways of
strengthening civil society participation in Country Coordinating Mechanisms (CCMs) and to gather input
on the preparations for the Global
Funds First Biennial Partnership
Forum scheduled to take place in July.

MARCH

Former Japanese Prime Minister

Yoshiro Mori, one of the founding
supporters of the Global Fund at the
Okinawa Summit of the G8 (2000),
announces the launch of Friends of
the Global Fund, Japan. This partner
organization is created to encourage
support for the Global Fund in
Japan, working closely with government and civil society organizations.
Mr. Tadashi Yamamoto, president of
the Japan Center of International Exchange (JCIE), is named director of
Friends of the Global Fund, Japan.

In response to concerns about slow

implementation and reports of serious management problems with
some of the Global Funds three
HIV/AIDS grants to Ukraine, a Secretariat mission is sent to Kiev.After
discussions with partners, stakeholders and the PRs, all three grants are
suspended and disbursed money not
yet spent is asked to be returned.

The Global Fund organizes a daylong induction program for new

Board members.About 25 members
of various delegations go through a
thorough orientation at the Secretariat offices in Geneva, including
meetings with senior officers from
every department, covering such
topics as grant agreements, operational policies and CCM operations.

FEBRUARY

The Seventh Board Meeting is held

in Geneva. Key items on the agenda
include: approval of the 2004 budget,
replenishment of the Global Fund,
discussion on the process for Phase 2

The Irish presidency of the European

Union organizes a conference in
Dublin. The theme of the meeting is
AIDS In Europe.

The Global Fund holds its first regional meeting for the Middle East in
Amman, Jordan. The regional meeting is held to give CCM members an
opportunity to ask questions, receive
assistance and share best practices
with each other.
World TB Day is held with the
theme,Every breath counts stop
TB now!The Global Fund expresses
its support for the Stop TB Partnership and the fight against TB.
APRIL

After discussion with the Board, the

decision is made to allow reprogramming of existing malaria grants to include the purchase of new-generation drugs, artemisinin-based combination therapies (ACT) in those
countries where drug resistance has
reached levels of 15 percent or more.
Because ACT drugs are roughly fifteen times more expensive than conventional first-line treatments, this
will require additional funds. The
Board approves setting aside US$ 90
million for this purpose.

Four of six siblings in an orphan-headed

household in Swaziland fetch water at the
end of the day. Global Fund financing
covers school fees for these children and
ensures that they receive food rations from
the communitys grain stores.

A coordinated effort with UNAIDS

and the World Bank leads to the announcement of the organizations
jointly working to make the principle
of the Three Onesa reality. (The
Three Onesare one agreed
HIV/AIDS action framework that
provides the basis for coordinating
the work of all partners; one national
AIDS coordinating authority, with a
broad based multisectoral mandate;
and one agreed country-level monitoring and evaluation system.)
The next in the series of regional
meetings is held in Siam Reap, Cambodia including recipients from the
entire Asian region.
Work begins on developing an Early
Warning System,which will be used to
alert the Secretariat to potential problems with grant management or implementation in recipient countries.
Africa Malaria Day is held with the
theme A Malaria-Free Future. The
central point of the celebration is the
Matam region of Senegal, where
African musician Youssou NDour
holds a large open-air concert.

MAY

Canada, one of the earliest supporters

of the Global Fund, announces that it
will double its pledge for 2004 to
CAD$ 70 million (US$ 50 million).
Canada had initially pledged CAD$
150 million (US$ 100 million) for the
period 2002 to 2005, equally divided
over the four years. In the same
pledge, Canada also commits CAD$
35 million (US$ 25 million) for 2006.
The annual World Health Assembly
(WHO) is held in Geneva. This is the
decision-making body for the World
Health Organization, which gathers
annually to review WHO policies
and processes. The Global Fund provides a presentation to the delegates
of the Assembly.
Responding to the rapid growth of
the Global Fund portfolio and workload, the Secretariat undergoes a reorganization in order to more effectively align staffing resources with
urgent requirements.
The East African regional meeting
for CCM members is held in
Nairobi, Kenya.

The TRP meets to review the

173 eligible proposals submitted
for Round 4.
JUNE

The Eighth Board Meeting is held in

Geneva. The first priority is the approval of the 69 grants for 50 countries recommended by the TRP.Approved grants have a total value of
US$ 2.9 billion over 5 years and US$
968 million over two years.
Actor Rupert Everett travels to
Cambodia to see work being done
by Global Fund-financed programs
in support of the Global Funds participation in the XV International
Conference on HIV/AIDS to be held
in Bangkok in July
The Global Fund publishes its first
procurement guide for use by CCMs
and procurement staff working on
Global Fund-financed programs.
The Bill and Melinda Gates Foundation and the Institute for Global
Health, University of California, San
Francisco, team up with the Global
Fund to present on the theme of

Scaling Up Health Investments in

Developing Countries: Lessons
About What Worksat a UKsponsored conference at Wilton Park.
Working in partnership with the
WHO, the World Bank, UNICEF,
UNAIDS, USAID, the US Department of State and Department of
Health and Human Services and the
Centers for Disease Control, the
Global Fund publishes The Monitoring and Evaluation Toolkit, which
technical partners and CCMs can
use as a guide for determining program indicators.
Regional meetings are held for recipients in Sofia, Bulgaria and Ouagadougou, Burkina Faso.
Friends of the Global Fight is
launched in the United States with
former head of the Motion Pictures
Association of America, Jack Valenti,
as President. This NGO plans to raise
awareness of and funds for the
Global Fund in the USA.

JULY

The Global Fund hosts the first Partnership Forum in Bangkok immediately preceding the World AIDS Conference. This biennial event forms
part of the governance structure of
the Global Fund and serves as an opportunity for the Global Fund to inform a broad group of stakeholders
of progress and challenges. More importantly, it also provides an opportunity for those who may not have a
direct voice on the Board to provide
feedback and guidance.
A new report, A Force for Change:
The Global Fund at 30 Months, is
launched by the Global Fund at the
Partnership Forum in Bangkok. This
report, which includes in-depth profiles of Global Fund efforts in five
countries, sets out progress to date in
terms of grant agreements, disbursements and milestones achieved.
Thailand hosts the XV International
AIDS Conference from 1116 July.
Over 10,000 scientists, health-care
workers and activists from around
the world gather to present and de-

bate medical, social and political issues related to the fight against AIDS.
During the conference, the Bill and
Melinda Gates Foundation announces a new pledge of US$ 50
million to the Global Fund.
The United Kingdom announces
a new pledge of an additional
154 million, effectively doubling
the existing pledge for the period
20052007.
The Global Fund has disbursed US$
430 million in 85 countries. This sum
represents 35% of the two-year grant
commitments for which disbursement has commenced.
VH1, a cable entertainment channel
which is part of the Viacom group of
companies, launches a national advertising campaign on behalf of the
Global Fund. This campaign, which
focuses on the theme Join the
Fight, features a series of 30-second
ads under the tag line,Stopping
AIDS before it stops the world. The
spots, which run on average a hundred times a month, are designed to

16

Global Fund Annual Report 2004

raise public awareness of the Global

Fund and the threat of AIDS.
AUGUST

USAID and the Centers for Disease

Control co-sponsor a conference in
Atlanta, Georgia on monitoring and
evaluation. This conference is a direct
outgrowth of the joint efforts by
these two agencies and several others
in conjunction with the Global Fund
to produce the Monitoring and Evaluation Toolkit, which provides guidance for national M&E systems for
HIV/AIDS, tuberculosis and malaria
programs, and also coordinates the
reporting requirements of all donor
agencies in order to relieve the administrative burden on recipient
countries and their governments.
SEPTEMBER

The Global Fund launches its first

public awareness campaign in France
with pro bono support from the international advertising group Publicis. The campaign, which includes
print and television advertising, aims
to raise awareness of the Global Fund
among the general public and to
build support for government donations to the Global Fund. The Global
Fund receives more than US$ 1.8
million worth of free placement for
both print and video advertisements
over a four-month period.
The Technical Evaluation Reference
Group (TERG) is established.
In response to a plea by Nelson Mandela, Bono and Jack Valenti, the
United Kingdom announces an additional pledge of 3 million (US$ 5.3
million) to the Global Fund.
Together with the Global Alliance for
Vaccines and Immunization, the
Global Fund hosts the annual meeting of the European Foundations
Association in Geneva.
Nairobi, Kenya is the site of a Global
Fund conference, attended by 17
countries, on the re-programming of
Global Fund grants to allow for the
purchase of third-generation ACT
drugs for malaria.

Year in Review

The U.S. businessman Ted Turner

launches an appeal to private donors
in the United States in the hopes that
additional funds will allow the U.S.
to maximize its donation to the
Global Fund.
OCTOBER

Disbursements reach US$ 628 million in 98 countries.

A regional meeting for CCM members is held in Fiji.
The Netherlands, in response to the
urgent appeal by Nelson Mandela,
agrees to bring forward 5 million
(US$ 6 million) from their pledge for
2005. This additional contribution in
2004 allows the United States to add
another US$ 18 million to their total
contribution for 2004.
NOVEMBER

As a lead-up to its ninth Board meeting, the Global Fund organizes a series of site visits for Board members
to clinics, hospitals and other projects
benefiting from Global Fund grants
in Rwanda, Tanzania and Kenya.
The ninth Board meeting is held in
Arusha, Tanzania the first Board
meeting to be held in Africa. The
meeting opens with a high-level session addressed by the Presidents of
Tanzania, Kenya and Uganda and a
representative of the President of
Rwanda, as well as the UK Minister
for International Development.
The Board takes a unanimous decision to launch Round 5 for approval
in September 2005.
Sweden announces an additional
contribution of SEK 16 million (US$
2.2 million) to the Global Fund in response to Mr. Mandelas plea.
DECEMBER

Germany announces that it will more

than double its 2005 pledge from
38 million to 82 million (US$
157 million), making Germany the
fourth-largest donor to the Global
Fund.
Executive Director Richard Feachem
visits China and Japan.

The Global Fund signs a headquarters agreement with the government

of Switzerland, giving the Global
Fund privileges and immunities similar to other international organizations. The headquarters agreement
enables the Global Fund to undertake a number of administrative
changes which will make the organization more effective and efficient.
World AIDS Day takes place on 1
December.
The Global Fund is represented at the
annual meeting of the International
Confederation of Free Trade Unions
(ICFTU) in Tokyo.
Preparations are launched for Phase
2, the approval of continued funding
for grants which have reached the
two-year mark since their first disbursement.
At a meeting in Abuja, Nigeria, participants discuss progress made on
reaching the health-related Millennium Development Goals

C O U N T RY P R O F I L E

Global Fund Annual Report 2004

17

Burundi
Providing holistic HIV/AIDS care against the odds
Disease(s) funded: HIV/AIDS, TB, malaria

Stricken by ongoing political and social

instability following an 11-year civil
war that claimed over 300,000 lives,
and severely restricted by inadequate
medical services, Burundi is making
remarkable progress in its efforts to
provide comprehensive HIV/AIDS
prevention and care.
In Burundi, the HIV prevalence is 3.6
percent among the adult population
(15 years and above). Life expectancy
has dropped to 40 years and some
200,000 children have been orphaned.
A Global Fund grant worth up to US$
4.9 million over the first two years was
signed with Burundi on 10 April 2003
for the scale-up of prevention and care.
The three pillars of the grant are the
holistic care of people living with
HIV/AIDS, prevention of mother-tochild transmission of HIV and capacity-building for the delivery of health
services. To date, US$ 4.9 million has
been disbursed to the Principal Recipient, the Executive Secretariat of the
National HIV/AIDS Council.
The Global Funds support has particularly enhanced the governments
efforts to provide comprehensive care,
support and treatment for people living
with HIV/AIDS. These efforts have
taken a complementary approach
supplying not only antiretroviral therapy and drugs for opportunistic infections, but also providing psychosocial
support to improve everyday wellbeing for patients and their families.
Services are coordinated and delivered
by a broad range of stakeholders,
including hospitals, social workers,
community health centers, local and
international nongovernmental organizations, national reproductive health
programs and government institutions,
as well as private institutions.

Approved Funding to date: US$ 24.3 million

Despite some initial delays, which

postponed the start of most activities
until the second year of the grants
implementation, the program has
begun to show concrete results. Over
1,900 people had been provided with
antiretroviral therapy and psychosocial
support by the end of 2004.Although
this is only 58 percent of the programs
target for its first two years, it represents
important progress when measured
against the 2003 baseline of 600 people
reached and provides a solid foundation for the next phase. This foundation, combined with decreasing drug
prices and increasing funding from
new donors, has resulted in the country
adjusting its overall treatment targets
upwards for the coming years.
By late 2004, results also began to
emerge from the two other central
components of this Global Fund grant.
In programs for the prevention of
mother-to-child transmission of HIV,
antiretroviral prophylaxis was provided to 335 pregnant women living
with HIV/AIDS and 220 newborns,
representing 88 and 57 percent of the
programs targets respectively. Based on
the National Action Plan for 20026,
the work had initially involved upgrading a pilot site and extending services
to two further sites, but has been
extended to 11 sites (Bujumbura and
in-country). It also promoted Voluntary Counseling and Testing (VCT) in
prenatal consultations, extending services to entire family units, not just to
pregnant women.
Grant-funded,capacity-building
efforts focused on integrating civil society into programs for health services
delivery by building on the experiences,
skills and contacts of nongovernmental
and community-based organizations
and networks of people living with
HIV/AIDS.This has ensured that prevention and care interventions are
appropriate and accessible to community members,including those who are

most vulnerable and often marginalized.It has also formalized the unique
role of civil society organizations as the
interface between national strategies,
medical professionals and people at the
community level,improving both the
quality and accessibility of prevention
and care for communities.
Burundis successes with these
grant-funded programs is indicative of
the multisectoral collaboration considered by some to be unprecedented in
the countrys recent history that has
characterized its program management
and enabled it to achieve results despite
a background of national turmoil.As
Principal Recipient, the Executive Secretariat of the National HIV/AIDS
Council expanded its pool of sub-recipients from the originally budgeted six to
eighteen, including several from civil
society. Since the grant signing, several
new donors have started to contribute
to the countrys national HIV/AIDS
strategy. The broadly representative
Country Coordinating Mechanism is
working with these donor partners and
coordinating the efforts of development
stakeholders under one cohesive
national disease strategy.

18

Global Fund Annual Report 2004

Performance
Measurement
What the Global Fund Measures + How

the seven principles spelled out in

its founding documents (see box on
page 9). The measurement framework with its four levels operational performance, grant performance, systems effects and impact
was developed under the oversight of
the Technical Evaluation Reference
Group (TERG) and the Monitoring
and Evaluation, Finance and Audit
(MEFA) Committee, and approved
by the Board.
The four levels of the measurement
framework (see Fig. 1, right)
are as follows:
1. Operational performance

BUILDING A PERFORMANCEBASED FUNDING SYSTEM

Above
Improving
laboratory facilities
in underserved
regions and
training health
care professionals
in diagnosis and
treatment are part
of Chinas strategy
to fight HIV/AIDS,
TB and malaria.

In 2004, the Global Fund made significant progress in designing and

implementing transparent, rigorous
and consistent performance measurement systems for its own operations and for grant-funded programs
in recipient countries.While performance measurement has been
among the core principles of the
Global Fund from its creation, building a functional system to measure
performance and to provide the basis
for funding decisions has been a
gradual process. Due to the urgency
of its mission, the Global Fund ap-

proved its first round of grants only

three months after its creation and
before any detailed architecture for
managing these grants and measuring performance had been designed.
The development of all aspects of its
functional architecture has taken
place in parallel with the ongoing
management of existing grants.
GLOBAL FUND PERFORMANCE
MEASUREMENT: A FOUR-TIERED
SYSTEM

In 2004, The Global Fund established

a comprehensive measurement
framework that evaluates its performance at all levels and addresses

This level measures the performance

of the core functions of the Global
Fund and its Secretariat, including
resource mobilization, grant management, proposal and grant signing,
disbursements and Secretariat costs.
In 2004, key performance indicators
for these areas were shown in a new
management tool called the Executive Dashboard. The monitoring of
key performance indicators is supplemented by ad hoc studies undertaken to assess particular areas in
greater detail, such as the different
elements of the Global Funds basic
architecture.
2. Grant performance

This level measures the performance

of grants and is the cornerstone of
performance-based funding by the
Global Fund. The system was defined
and implemented in 2004 and covers

Performance Measurement

all aspects of the Global Fund grant

process, including proposal development, grant agreements, regular disbursements and Phase 2 evaluations.
Together with its primary technical
partners, the Global Fund developed
the joint Monitoring and Evaluation
Toolkit, which defines simplified
evaluation frameworks and indicators at all levels for the three diseases.
The Toolkit is designed to be of assistance to those applying for Global
Fund grants in establishing universally accepted targets and indicators
for measuring proposed program
performance. In using the Toolkit,
applicants can simplify their grant
designs by focusing on outputs
rather than on processes.
3. Systems effects

This level measures the impact (positive and negative) that the Global
Fund has on the existing systems
through which it works, in particular
at the country level. In 2004, under
the oversight of the TERG and the
MEFA Committee of the Board and
in conjunction with a wide range of
partners and stakeholders, a set of indicators and measurement tools was
developed to measure these effects
with a particular focus on additionality of resources, long-term sustainability of efforts and harmonization
between technical and donor agencies, as well as national partnerships
under the guidance of CCMs. Measurement of these indicators will
begin in 2005.

Global Fund Annual Report 2004

build impact indicators (in addition

to coverage indicators) into all grant
extensions as grants reach the Phase
2 funding stage.
The full implementation and roll-out
of this system follows a phased approach, as the Fund moves from
grant signing and management towards broader systems effects and, ultimately, impact on the three diseases.
At its ninth meeting in November
2004, the Board approved performance indicators for the Executive Director and Secretariat and reviewed
potential performance indicators for
Board functions. Processes for evaluating and approving the continued
funding of years three to five of grants
that reach the two-year mark were
also approved, providing an important final piece of the grant performance measurement system. Operational and grant performance measurement systems were largely in place
by the end of 2004, with a few aspects

19

remaining to be implemented in early

2005. The measurement systems were
put into practice in December 2004
for review of the first 27 grants making application for extension into
their second, three-year phase of the
grant. (The Global Fund approves
grant proposals covering a period of
up to five years. Funds are initially
committed for the first two years of
the proposal period. Continued
funding to cover the remainder of the
proposal period depends on satisfactory program performance and the
availability of resources. The extension of a grant to cover remaining
years of an original proposal is referred to as Phase 2 funding.)
While the indicators for the measurement of systems effects and impact
were developed in 2004,their full implementation and roll-out are priorities for 2005,together with the preparation of a thorough five-year evaluation of the Global Fund in 2006.

Fig. 1: The Global Funds four-level measurement framework

4. Impact

This level provides the means for

measuring the impact of the Global
Fund in the fight to turn the tide of
the three diseases. Indicators for impact measurement have been developed to become part of the Global
Funds grant management systems,
as it will ultimately be the impact that
grant-financed programs have on the
three diseases that will determine the
Global Funds success.While the
basic indicators have been included
in the joint Monitoring and Evaluation Toolkit, in 2005 it will be a priority to fully embed these in grant
agreements as they are negotiated
and signed. The first step will be to

Impact

System effects
Global Fund
contribution

Grant performance

Operational performance

In Bishkek, Kyrgyzstan, approximately

2,200 injecting drug users are reached
with Global Fund-financed needle
exchange services.

Global Fund Annual Report 2004

Operations
+ Results

22

Resource Mobilization, Communications + Advocacy

26

Pledges + Contributions to the Global Fund

28

Secretariat Management

30

Grant Management

36

Grant Performance

21

22

Global Fund Annual Report 2004

Operations + Results

Resource Mobilization,
Communications
+ Advocacy
The Global Fund relies on donations from
governments, foundations, corporations and
individuals to finance the fight against the
three diseases, with the majority of funding
coming from the public sector.
Pledges are received on a continual
basis and can span any number of
years. Resource mobilization activity
is carried out by the Board, by a small
team within the Global Fund Secretariat and by nongovernmental supporters of the Global Fund, including
communities living with the diseases.
As trustee of the Global Fund, the
World Bank manages contributions
to the Global Fund. To receive private
contributions, the Global Fund relies
upon the United Nations Foundation
and its donors. The United Nations
Foundation, a grant-making public
charity established by philanthropist
Ted Turner, receives private donations in support of AIDS, TB and
malaria programs around the world
on a pro bono basis and has chosen
the Global Fund to be one of the primary beneficiaries of such private
contributions. The Foundations status as a non-profit organization in
the United States affords contributors
using this mechanism certain tax
benefits in the United States.
Fund-raising builds on broader
efforts to mobilize support, particu-

larly communications to potential

donors to educate them on the role,
results and needs of the Global Fund.
Communications are also important
to ensure transparency for recipients
and other stakeholders, and work is
increasingly underway by the Secretariat to meet a broader range of
needs for robust and responsive information about the institutional activity and grant progress of the
Global Fund.
Efforts supported by partners to
explore innovative, additional financing mechanisms for the Global
Fund accelerated during the year.
These potential mechanisms included debt conversion to finance
Global Fund programs (for renewals
in a number of high-performing
countries), the International Finance
Facility proposed by the Government of the United Kingdom and an
introduction of global transaction
taxes to finance global public goods,
proposed by France.
In 2004, the Global Funds Board
approved the adoption of a periodic
replenishment funding model. This

decision will enable the Global Fund

to establish a more systematic and
predictable process securing the required resources for the programs it
supports. The UN Secretary General,
Mr. Kofi Annan, and Mr. Sven Sandstrm, Director of the International
Task Force on Global Public Goods,
were nominated and confirmed as
Chair and Vice-Chair of the Global
Funds first replenishment meetings
for 2005.
RESULTS:
RESOURCE MOBILIZATION

In January 2004, the overall financing

need for the Global Fund was projected at around US$ 1.5 billion. This
included resources required to fully
cover the Round 3 grants carried forward from 2003, renewals of existing
Round 1 programs and the financing
of Round 4, the new round slated for
approval in 2004.As of January 2004,
US$ 0.6 billion was forecast to be
available for Round 4. By the end of
the year, pledges for the year had
reached US$ 1.6 billion, and a total of
US$ 1.4 billion had been contributed. This represented an increase of more than 50 percent compared to the total contributions received for 2003. Outstanding pledges
for 2004 were expected to be contributed in early 2005.
A number of new donors pledged
for the first time to the Global Fund
in 2004, including Australia, Hungary, Iceland, the Republic of Korea,
Singapore, Slovenia and Uganda,
bringing the number of donor

In school in Tacoa, Honduras,

children learn about malaria control.

24

Global Fund Annual Report 2004

countries from 44 to 51. In addition,

Canada, the European Commission,
Ireland, Luxembourg, New Zealand,
Sweden, Switzerland, The Netherlands, UK, the Bill and Melinda Gates
Foundation and the Health Authorities of Taiwan pledged additional resources in 2004. Hundreds of individuals from around the world also
made donations to the Global Fund,
and while those donations were relatively small in magnitude (US$ 0.6
million), they point to a broadening
base of support that is building
among the general public.
Taken together, all pledges resulted in a total amount of US$ 5.9
billion through 2004. The average
rate of return on investment managed by the World Bank was 1.6 percent in 2004, resulting in US$ 34.3
million of investment income. This
investment income covered nearly 78
percent of the Global Funds operating expenses in 2004 (US$ 43.5 million), including the fees of Local
Fund Agents (US$ 12.2 million) and
excluding services contributed in
terms of goods and services.
In addition to financial contribu-

Operations + Results

tions, the Global Fund also received

a wide range of non-financial support from private organizations and
individuals. In 2004, over US$ 7 million worth of pro bono support
ranging from staff secondments, to
consulting projects to celebrity engagements was provided to the
Global Fund.
RESULTS:
COMMUNICATIONS
+ ADVOCACY

In July, the Global Funds first substantive progress report, A Force

for Change: The Global Fund at 30
Months, was launched in Bangkok.
The report analyzed the results of the
first 25 grants to reach the one-year
mark and profiled grants in four
countries to give stakeholders an
early impression of the quality and
results stemming from the Global
Fund grant process.
The XV International AIDS Conference, held in Bangkok in July, was
characterized by broad recognition
of how far the Global Fund had come
in its first two years in terms of concrete results, and by strong support

Fig. 2: Funds Contributed Relative to Amount

Pledged for 2004

1,800,000
1,572,607

Contributions as
a percentage of
pledges = 91.6%

1,600,000
1,439,786

1,400,000

1,200,000

1,000,000
US $ '000s

Pledges Made
Through
31 December 2004

Contributions Received
Through
31 December 2004

for its resource needs. The Global

Fund was represented in numerous
sessions coordinated by partners as
well as by the Global Fund, and received positive press coverage
throughout. During the conference,
the Secretariat organized field visits
to Cambodia and Thailand with
British actor Rupert Everett. The trip
produced extensive media coverage,
including a BBC documentary and
feature coverage in US-based magazine Vanity Fair.
In 2004, two nongovernmental
organizations dedicated to raising
awareness of and advocating for increased support for the Global Fund
were launched in the United States
and Japan.
Friends of the Global Fund Japan
was launched in Tokyo in March at a
conference entitled Human Security
Challenges of HIV/AIDS and Communicable Diseases in Asiajointly
sponsored by the Asia Society of New
York and the Japan Center for International Exchange (JCIE).Friends
Japanwas launched with the financial support of the Open Society Institute,the United Nations Foundation
and Vodafone.Both the Chair and
Vice- Chair of the Global Fund Board
were present.The Director is Mr.
Tadashi Yamamoto,one of the leading
foreign policy experts of Japan and a
long-time promoter of Japans increased international engagement.
Friends of the Global Fightwas
launched in June in Washington, DC
Other 6%
with a series of high-profile events at- Administration 7%
tended by senior members of the
Physical
Infastructure 6%
U.S. Congress, the administration
and other U.S. supporters and stakeholders.Friends U.S. was launched
with the financial support and personal engagement of Edward Scott, a
Physical
Infastructure
strong supporter of the Global Fund
13%
in the United States. The NGO
Human
named as its president Jack Valenti,
Resour
& Train
the former head of the Motion Pic20%
ture Association of America.
By the end of 2004,the activities of
both Friends of the Fund in Japan and
Friends of the Global Fight in the U.S.
had already substantially strengthEastern E
& Centra
ened political support and general
awareness in these countries.A similar organization was initiated in EuLatin
rope with plans for a launch in 2005.
America
9%

East Asia,
South East Asia,
Oceania 18%

Operations + Results

A major media outreach effort

was launched in September 2004 to
raise awareness of the Global Fund
among the general public in key
donor countries. The campaign
started in Paris through a series of
print and television advertisements
placed with support from the Publicis
Group. Media placements were provided on a pro bono basis with a
value of over 1.7 million. Following
the successful launch in France, the
Publicis Group has begun to expand
its already substantial commitment to
the Global Fund by making preparations for similar campaigns in other
key markets.
In the U.S., the Global Fund initiated a collaboration with the media
group Viacom, which runs AIDS
awareness campaigns as a central
part of its corporate social responsibility program. This collaboration
has focused on the development of
advertising and programming promoting the Global Fund on VH1, a
satellite and cable channel reaching
90 million U.S. households, as well as
a substantial international audience.
Three ads were produced during the
first half of 2004 and launched during the XV International AIDS Conference in Bangkok in July. These ads
were linked to the creation of a consumer website,investinginourfuture.org, which provides information about the Global Fund, about
the fight against the three diseases
and facilitates opportunities for donations and local action in support of
the fight. This website was created
through assistance from Friends
U.S. and the UN Foundation. The
collaboration with VH1 and other
Viacom properties, as well as increasing collaboration with the UN Foundation, Kaiser Family Foundation,
the Global Business Coalition against
HIV/AIDS and others have placed
the Global Fund in a position to
greatly expand its advocacy and individual fund-raising activities in the
United States in 2005.
Other important promotional activities in 2004 included the production of two short films as an introduction of the Global Fund to interested audiences. One of the films was
produced for the U.S. market and

Global Fund Annual Report 2004

25

List of Pro Bono Services Contributed by the Private Sector in 2004

Booz Allen Hamilton
Review of Board & Committee structures
Celebrity: India Arie
Time and creative services in producing Global Fund documentary in Africa
in partnership with VH1
Celebrity: Rupert Everett
Time and creative services in producing Global Fund documentary in Asia
Celebrity: Tom Hanks
Creative services in providing voice-over for Global Fund video (US version)
Celebrity: Emma Thompson
Creative services in providing voice-over for Global Fund video (European version)
McKinsey
Development of Executive Directors performance criteria
Piper Rudnick
Legal advice and staff expertise on various issues to develop the Global Funds risk
management system in 2005 and beyond
Publicis Group and media partners
Advertising services and airtime/print space for Global Fund advertising
campaign in France
Sidley, Austin, Brown & Wood
Legal advice and preparatory work on registering the Global Fund name and
logo internationally
Sterling Group
Marketing strategy consulting services to refine the external positioning for the
Global Fund and help the Fund better communicate with the key target audiences
The Bill and Melinda Gates Foundation
Cost of secondment of events coordinator from FHI to organize Partnership Forum
UN Foundation
Sponsorship of Global Fund consumer website development, management
of private donor contributions to the Global Fund and dedicated staff to mobilize
partnerships and resources for the Global Fund
VH1 (Viacom)
Advertising services and airtime for Global Fund advertising campaign

was used extensively by Friends

U.S. throughout the country.A second, similar film was created for a
broader, international audience. In
addition, a set of four Public Service
Announcements (PSAs), each starring a well-known African musician,
were produced and shown extensively on TV5, a European-based
French-language satellite channel
with a global reach. Some of these
PSAs were also shown during the annual African Music Awards, known
as the Kora Awards.

In 2004, the Global Funds website

was visited about 500,000 times,
doubling the site traffic of the previous year.
The Global Fund also received
extensive world press coverage, being
mentioned 3,500 times in the main
English language media, 300 times in
French, more than 200 times in
Spanish and about 200 times in the
German and Italian media. However,
these figures do not take into account
recipient countries national press.

26

Global Fund Annual Report 2004

Operations + Results

Pledges + Contributions
to The Global Fund
DONORS

Contributions Received Through 31 Dec 2004

For 20012003
For 2004
TOTAL

Pledges Made Through 31 Dec 2004

Due in 2005
Due in 2006

TOTAL

Governments
Andorra
Australia
Austria
Barbados
Belgium
Brazil
Burkina Faso
Cameroon
Canada
China
Denmark
European Comm
France
Germany

100

1076
100
19437
50
75

50000
2000
28607
187425
123138

13828

10271

50006
2000
16188
264413
198939

100
13828
1076
100
29708
50
75

100006
4000
44796
451838
322077

3928

6698
50

100
59322
2000

57029
198939

13395

4000

57029
198939

100
17755
1076
100
49801
100
75
100
159328
10000
44796
565896
719955

49423

45945

95367

108753

192971

397092

Greece

332

332

Hungary

10

10

10

Iceland

206

206

206

Ireland
Italy

20996
215160

12299

33295
215160

265252

33295
480412

Japan

160394

104726

265120

265120

1000

100
3315

88
51678
734

9081
35672
20
400
5000

500

77
2244

44
54345
625

17865
10
600
5000

8
500
1000

177
5558

132
106022
1359

9081
53536
30
1000
10000

100

61008

1000

5000

25

50

5000

8
500
1000
25
177
5558
100
132
167030
1359
50
10081
53536
30
1000
20000

2500

2500
200

5000
200

2500
200

1000
2500
600

1000
10000
1000

Kenya
Korea (Repub of)
Kuwait
Liberia
Liechtenstein
Luxembourg
Mexico
Monaco
Netherlands
New Zeland
Niger
Nigeria
Norway
Poland
Portugal
Russia
Rwanda
Saudi Arabia
Singapore
Slovenia

All figures are in US$ 000s

Operations + Results

Global Fund Annual Report 2004

27

Pledges Made Through 31 Dec 2004

Due in 2005
Due in 2006

TOTAL

Pledges + Contributions to The Global Fund

DONORS

Contributions Received Through 31 Dec 2004

For 20012003
For 2004
TOTAL

South Africa
Spain
Sweden
Switzerland
Thailand
Uganda
United Kingdom
United States
Zambia
Zimbabwe
Sub-Total

2000
35000
33858
10000
1000

118248
622725
25
158

15000
48033
2343
1000
500
60033
458881

2000
50000
81892
12343
2000
500
178581
1081606
25
158

1500

1000
500
91195
435000

35000

2000
1000
193711
600000

2000
100000
81892
12343
5000
2000
463487
2116606
25
158

1790591

1388937

3179528

1314905

1307220

5801653

Support for Operating Expenses

DFID
GTZ

219
442

219
442

219
442

Japan

415

415

415

Other

42

42

42

1790591

1390055

3180646

1314905

1307220

5802772

100000

50000

150000

150000

200
100
100

200
100
100

200
100
100

634

100
100
500
1000
100
112
1044
1059

1000

100
100
500
2000
100
112
1044
1059

Total Govts
Private Sector
Bill & Melinda Gates Fdn
Hewlett Foundation
Novartis
Statoil

The United Nations Foundation and its donors

Mr. Kofi Annan
Amb. D. Fernandez
Eni S.p.A.
Heath Authorities of Taiwan
Intl Olympic Committee
Real Madrid Soccer Match
Winterthur
Other UNF Donors
Other Private Sector Donors

100
100
500
1000
100
112
1044
425
20

140

160

160

Sub-Total: Cash
In-kind

103402

51389
7265

154791
7265

1000

155791
7265

Total: Private Sector

103402

58654

162056

1000

163056

1893993

1448709

3342703

1315905

1307220

5965828

Grand Total

28

Global Fund Annual Report 2004

Operations + Results

Secretariat
Management

In December 2004, the Global Fund

signed a headquarters agreement with
the government of Switzerland, giving the
Global Fund privileges and immunities
similar to other international organizations.
The headquarters agreement will
enable the Global Fund to undertake
a number of administrative changes
to make the organization more effective and efficient.
As a young organization, the
Global Fund is continually making
adjustments to its systems and architecture in response to lessons learned
and the demands of its core business.

In 2002, the Global Fund designed

and set in place the basic systems for
negotiation and oversight of grant-financed programs. In 2003, it tested
its new structure and systems and
began to look at specific organizational development processes to
complement its growth.
In May 2004, the Global Funds
Secretariat underwent a structural

Fig. 3: Secretariat expenses as a percentage of total expenditure in 2004

Grants
Operating expenses
excluding donated services
Secretariat expenses
LFA fees
Board & TRP expenses
Total expenditure
excluding donated services
Donated services
Total expenditure
per the audited financial statements

US$ millions
854.4

Percentage of total expenditure

95.2%

28.1
12.2

3.1%
1.4%

3.2
43.5

0.4%
4.8%
897.9
7.2
905.1

100.0%

reorganization in order to streamline

operational processes and increase
organizational efficiency. The move
to four pillars Business Services,
External Relations, Operations and
Strategic Information & Evaluation
was made in response to the needs
of the organization in its rapid
growth to become a significant
grant-making institution in less than
three years. The organizational development process is ongoing and
reaches beyond the Secretariats
structure to include its focus on continual learning and improvement,
formal and informal opportunities
for staff training, and the growth of
its organizational culture.
The Global Funds operating expenses in 2004 amounted to US$
43.5 million (excluding US$ 7.3 million worth of donated services). Of
this, US$ 28.1 million went to running the Secretariat, US$ 12.2 million
was paid in fees to Local Fund Agents
and US$ 3.2 million met the expenses of the Board and Technical
Review Panel. These operating expenses represented 4.8 percent of
total expenditures in 2004, with all
the remainder going to grants.As the
size of the Global Funds grant portfolio increases substantially over the
coming years, operating expenses are
expected to become a diminishing
part of total expenses, reaching less
than two percent by the end of 2006.
In 2004, 78 percent of operating expenses were met by investment income on the Global Funds investment portfolio.

In the slums of Nairobi, the Kenya

Network of Women with AIDS
provides treatment and care to children
orphaned by HIV/AIDS.

30

Global Fund Annual Report 2004

Operations + Results

Grant
Management

PROPOSALS + APPROVALS

Above
Education on
HIV prevention,
counseling and
testing services,
and condoms
are provided to
Roma squatters
in Romania.

The Global Fund finances grants

through rounds of grant applications. To date, four rounds have been
approved and a fifth has been
launched and will come up for approval at the Eleventh Board Meeting
in September 2005.
Through its first four rounds,the
Global Fund has approved a total of
US$ 3.1 billion over two years to 310
programs in 127 countries.The four
proposal rounds were approved in
April 2002,January and October 2003,
and June 2004.With a few exceptions,
the countries benefiting from these
grants comprise all those that are currently experiencing the most severe
burdens of disease or are at risk for fu-

ture disaster due to rapidly growing

infection rates.Nearly two-thirds are
countries classified by the World Bank
as low-income countries,while onethird are lowermiddle-income countries with severe disease burdens or
very high infection growth rates.
Three percent of the portfolio goes to
ten upper-middle-income countries
with very high disease burdens or infection growth rates.
Despite the fact that there are no
criteria for grant approval other than
the technical quality of proposals,a
persistent distribution pattern has
emerged for grants over the four
rounds.Sixty percent of the approved
funding is going to sub-Saharan
Africa,while 23 percent is spent in
Asia,the Middle East and North
Africa,and the remaining 17 percent is
shared between Latin America,the
Caribbean and Eastern Europe.Just
over 56 percent of funding goes to
fight HIV/AIDS,31 percent goes to
malaria and 13 percent is allocated to
TB programs.
Reflecting the breadth of Global
Fund recipient partners at the country
level,half of the principal recipients
are governments,while one-quarter
are nongovernmental organizations,
and the remaining quarter are faithbased organizations,private sector
companies,academic institutions or
communities living with the diseases.
One of the major changes in development assistance for health over
the past few years has been the acceptance by donors of the necessity
to finance drugs and health-related

commodities with an open-ended

timeframe.As the need for a drastic
expansion in the use of these products such as antiretrovirals and
other drugs, condoms, diagnostic
equipment and insecticide-treated
bednets became apparent, it also
became clear that developing countries would not be able to finance the
full cost of large-scale purchasing in
the short- or medium-term. The
Global Fund was set up in part to finance these purchases, and approximately 50 percent of committed
funds are for the purchase of drugs
and other commodities. The rest is
being used to strengthen infrastructure and expand the training of
health-care and other supporting
personnel.
Although the Global Fund is dedicated to the fight against the three
diseases, it was designed and operates with a view to strengthening
overall healthcare delivery systems in
funded countries.Wherever possible,
it emphasizes the need for integration and synergy with general health
services and the importance of
avoiding duplication or unnecessary
verticalprogramming within the
health sector. In a number of countries in particular in sub-Saharan
Africa HIV/AIDS, TB as an opportunistic co-infection with
HIV/AIDS, and malaria constitute
an overwhelming burden on existing
health services.A strengthening of
health system capacity to deal with
these diseases will strongly improve
overall health system performance.

Operations + Results

Global Fund Annual Report 2004

31

The Global Funds grant-making process in brief

Step 1
Global Fund Secretariat announces
a call for proposals.
Step 1
Country Coordinating Mechanism
(CCM) prepares proposal based on
local needs and financing gaps.
As part of the proposal, the CCM
nominates one or more Principal
Recipients (PR). In many cases,
development partners assist in the
preparation of the proposal.

PACE OF GRANT
MANAGEMENT

From its inception, the Global Fund

had a rapid start-up, signing its first
grant agreements while still developing operational procedures and
guidelines. One of the consequences
of this parallel process was that early
grant agreements were signed before
necessary assessments of principal
recipients financial and procurement
capacities had been completed. This
often slowed down grant implementation, since weaknesses were discovered and had to be rectified before
any substantial grant activities could
begin.Another consequence was that
early grants were signed without targets that measured core activities of
funded programs, instead often including targets that measured related
but not core activities.
From Round Three onwards, the
Global Funds Secretariat has given
particular attention to improving the
quality of the grant agreements
signed. It is working with its partners
to ensure that all grants have clear
performance targets that show the
coverage of their grant activities
in other words, targets that reflect
people reached with interventions,
service points supported and people
trained within defined service delivery areas. The Secretariat also now
requires that all assessments when
appropriate are completed before the
grants are signed in order to reduce
the number of conditions precedent
to grant signing. This will lead to
faster disbursement in the future.

Step 3
The Secretariat reviews proposals to
ensure they meet eligibility criteria
and forwards all eligible proposals
to the Technical Review Panel (TRP)
for consideration.
Step 4
The TRP reviews all eligible proposals for technical merit and makes
one of four recommendations to the
Global Fund Board: (1) fund; (2)
fund if certain conditions are met;
(3) encourage resubmission; and
(4) do not fund.
Step 5
The Board approves grants based
on technical merit and availability
of funds.
Step 6
The Secretariat contracts with one
Local Fund Agent (LFA) per country.
The LFA certifies the financial management and administrative capacity of the nominated PR(s). Based on
the LFA assessment, the PR may
require technical assistance to
strengthen capacities. Development
partners may provide or participate
in such capacity-building activities.
The strengthening of identified
capacity gaps may be included as
conditions precedent to disbursement of funds in the grant agreement between the Global Fund and
the PR.

Step 7
The Secretariat and PR negotiate a
grant agreement, which identifies
specific, measurable results, to be
tracked using a set of key indicators.
Step 8
The grant agreement is signed.
Based on a request from the Secretariat, the World Bank makes the
initial disbursement to the PR. The
PR makes disbursements to subrecipients for implementation, as
called for in the proposal.
Step 9
Program and services begin. As the
coordinating body at the country
level, the CCM oversees and monitors progress during implementation.
Step 10
The PR submits periodic disbursement requests with updates on programmatic and financial progress.
The LFA verifies information submitted and recommends disbursements based on demonstrated
progress. Lack of progress triggers a
request by the Secretariat for corrective action.
Step 11
The PR submits a fiscal year
progress report and an annual audit
of program financial statements to
the Secretariat through the LFA.
Step 12
Regular disbursement requests and
program updates continue, with
future disbursements tied to ongoing progress.
Step 13
The CCM requests funding beyond
the initially approved two-year
period. The Global Fund approves
continued funding based on
progress and availability of funds.

32

Global Fund Annual Report 2004

Operations + Results

Affected communities 4%

Other 5%

Fig. 4: Distribution
of the Global Fund grant portfolio by type
Other 6%
Academic
& educational by region and by disease
of Administration
expenditure,
by
type
of Principal
Recipient,
7%
organizations 5%
Physical
Infastructure 6%

Faith-based
organizations 5%
Affected
communities
4%
Private
sector
5%

Other 5%

Other 6%
Academic & educational
organizations 5%

Administration 7%
Physical
Infastructure
Physical6%
Infastructure
13%

Drugs &
Commodities
49%

Faith-based
organizations 5%

Government
51%

Private sector 5%
NGOs
25%

Human
Resources
& Training
20%
Physical
Infastructure
13%

Drugs &
Commodities
49%

Government
51%
NGOs
25%

Human
Resources
& Training
20%
Eastern Europe
& Central Asia 7%

Tuberculosis
13%

Latin
America
9%
Eastern Europe
& Central Asia 7%
East Asia,
South East Asia,
Oceania 18%
Latin
America
9%

Sub-Saharan
Africa 61%

East Asia,
South East Asia,
Oceania 18%

Malaria
31% Tuberculosis
13%

Sub-Saharan
Africa 61%

Malaria
31%

HIV/AIDS
56%

HIV/AIDS
56%

South Asia, Middle East

& North Africa 5%

South Asia, Middle East

& North Africa 5%

Finally, proposal formats for future

rounds have been improved to ensure that they are more user-friendly
and that all critical information required for the Technical Review
Panel is included in the proposal.
Most grants are at an early stage,
building the capacity to reach more
people in the near future. The average age of a Global Fund grant at the
end of 2004 was eleven months.
As of 31 December 2004, the
Global Fund had signed 67 grant
agreements for Round One out of a
total of 69. One grant to the Democratic Peoples Republic of Korea had
been cancelled and one grant to
Zimbabwe was being negotiated. For
Round Two, 96 grant agreements had
been signed out of a total of 100.
Sixty-three grant agreements had
been signed out of a total of 72 for
Round 3. Of the remaining Round 3
grants, a grant for the Democratic
Peoples Republic of Korea was cancelled, as was a grant for Iran, and negotiations were in progress for a
Multi-Country Americas grant and a
grant for Yemen. Round 4 was approved at the end of June 2004 and
13 grant agreements out of a total of
73 had been signed by the end of the
year. Grant signing for remaining
Round 4 grants will increase rapidly
in the first half of 2005.
DISBURSEMENT

Fig. 5: Disbursements compared to life of grants elapsed

80%
70%
60%
80%
50%
70%
40%
60%
30%
50%
20%
40%
10%
30%
0%

Overall

Round 1

Round 2

Round 3

20%
10%
0%

Overall

Round 1

Round 2

Round 3

The rate at which the Global Fund

disbursed money to grant recipients
accelerated in 2004 and reached a cumulative total amount disbursed of
US$ 860 million by 31 December
2004, out of a total commitment in
signed grant agreements of US$ 2.1
billion. Of funds disbursed to that
time, 52.3 percent was disbursed to
sub-Saharan Africa, 17.3 percent to
East Asia and the Pacific, 13.3 percent
to Latin America and the Caribbean,
9.6 percent to Eastern Europe and
Central Asia, 3.5 percent to North
Africa and the Middle East, and 4
percent to South Asia.
To evaluate whether disbursements are on track, the Global Fund
compares disbursed funds as a percentage of all committed funds with
the proportion of time elapsed since
the grant agreements were signed.

Operations + Results

Global Fund Annual Report 2004

33

Fig. 6: Grant agreements signed as a proportion of total grants approved by the Board
2002 2003
Q1

Q2

2004
Q3 Oct

57
69

126

1
9
4

14

9
12

21

4
30
1
35

2
17
1
20

3
6

8
8

52 1040

93

206

314

165

44

55

1970 $ million

58

139

165

47

50

174

860 $ million

No. of Grants Signed

Round 1
9
Round 2

Round 3

Round 4

All rounds
9
Funds
Committed ($ m)
Funds
Disbursed ($ m)

225

Nov

Total
No.
%
Dec to Date Approved Signed

67
96
63
13
239

68
100
72
73
313

99%
96%
88%
18%
76%

86% of $1 billion goal by end of 2004

* Includes total number of prospective grants approved (i.e. including components where more than one grant will be assigned) and grants for which funding
was formerly provided (i.e. suspended grants)

Applying this technique, the disbursement record is described in Figure 7 below for each funding round
and for the portfolio as a whole.
Of the total amount of disbursements to 31 January 2005, 82 percent
was disbursed to Rounds 1 and 2
grants, 16 percent to Round 3 grants
and 2 percent to Round 4 grants.
Round 3 and 4 grants, which are
younger, have disbursed in excess of
grant time elapsed because the first
disbursement to recipients is usually
larger than average. Over time, expenditure lines up more closely with
time elapsed. From 2005, Rounds 3
and 4 grants will receive increasing
disbursements and therefore contribute much more significantly to
results. Overall, disbursements are
roughly on track relative to the time
elapsed for signed grants.
While comparing the rate of disbursement with time elapsed since
grant agreement signing is an important way to evaluate whether or not
disbursements are on track overall,
the disbursement rate for any single
grant is never constant. Disbursement rates may vary for a number of
reasons:
some grants absorb money
more slowly than others due to
limited capacity;

with many, absorption capacity

will grow over time as grant
funding, partner involvement or
a broadened sub-recipient
base result in an increase in
absorptive capacity;
the level of verifiable programmatic performance a lack of
progress on the part of the PR
or evidence that the PR is
not disbursing to sub-recipients
causes recipients to receive
money at a slower rate;
the amounts of disbursement

requests vary according to the

types of activities planned for
the disbursement period
for example, drug procurement
requires more money than the
training of staff.
Nongovernmental principal recipients have performed well in absorbing funds, with an average disbursement rate of 91 percent of expected
disbursement, as compared to an average of 79 percent for governmental
principal recipients.

Fig. 7: Approvals, commitments and disbursements by funding round

Round

Approved

2-year
approved1

2-year
signed2

2-year
disbursed3

Mean %
of 2-yr amt
disbursed4

Mean time
elapsed4

Round 1
Round 2
Round 3
Round 4
Total

Apr-02
Jan-03

$
$

555
859

$
$

545
810

$
$

370
336

70%
46%

77%
50%

Oct-03
Jun-04

$
$
$

635
1,038
3,087

$
$
$

543
72
1,970

$
$
$

136
18
860

33%
32%
49%

16%
6%
48%

Disbursements by funding round $ figures in millions, as of 31 December 2004

1. Proposals approved for funding by the Board (initially for two years, with an extension to five years
where approved)
2. Grant agreement signed by the Secretariat, committing funds for 2-year term of grant
3. Amount transferred to recipients disbursed incrementally based on performance
4. Calculations based on grants which have received one or more disbursements

34

Global Fund Annual Report 2004

Local Fund Agents by country during 2004

PWC
KPMG
UNOPS
STI
DTI
CROWN

Afghanistan (PWC)
Algeria (PWC)
Angola (PWC)
Argentina (PWC)
Armenia (KPMG)
Azerbaijan (UNOPS)
Bangladesh (DTT)
Belarus (KPMG)
Belize (KPMG)
Benin (PWC)
Bhutan (KPMG)
Bolivia (PWC)
Botswana (PWC)
Bulgaria (KPMG)
Burkina Faso (STI)
Burundi (PWC)
Cambodia (KPMG)
Cameroon (PWC)
Central African
Republic (PWC)
Chad (STI)
Chile (PWC)
China (UNOPS)
Colombia (PWC)
Comoros (PWC)

Cote DIvoire (PWC)

Congo DR (PWC)
Costa Rica (PWC)
Croatia (KPMG)
Cuba (PWC)
Djibouti (STI)
Dominican Republic
(DTT)
Dominican Republic
(PWC)
East Timor (PWC)
East Timor (UNOPS)
Ecuador (PWC)
Egypt (PWC)
El Salvador (KPMG)
Equatorial Guinea (STI)
Eritrea (KPMG)
Estonia (PWC)
Ethiopia (KPMG)
Gabon (PWC)
Gambia (PWC)
Georgia (KPMG)
Ghana (PWC)
Guatemala (DTT)
Guinea (PWC)

Guinea-Bissau (PWC)
Guyana (DTT)
Haiti (KPMG)
Honduras (PWC)
Indonesia (PWC)
India (UNOPS)
Iran (KPMG)
Jamaica (PWC)
Jordan (PWC)
Kazakhstan (KPMG)
Kenya (KPMG)
Korea DPR (KPMG)
Kosovo (UNOPS)
Kyrgyzstan (PWC)
Laos (KPMG )
Lesotho (PWC)
Liberia (PWC)
Lutheran World
Federation (DTT)
Macedonia (UNOPS)
Madagascar (PWC)
Malawi (PWC)
Mali (KPMG)
Mauritania (PWC)
Moldova (PWC)

Mongolia (UNOPS)
Morocco (PWC)
Mozambique (DTT)
Multi Country CARICOM (DTT)
Multi Country OECS
(DTT)
Multi Country CRN+
(DTT)
Multi Country Africa
(PWC)
Multi Country Andean
Region (PWC)
Multi Country Meso
Americas (PWC)
Multi Country Western
Pacific Islands
(KPMG)
Myanmar (KPMG)
Namibia (PWC)
Nepal (PWC)
Nicaragua (PWC)
Niger (STI)
Nigeria (KPMG)
Pakistan (KPMG)

Panama (PWC)
Paraguay (PWC)
Peru (PWC)
Philippines (PWC)
Romania (KPMG)
Russian Federation
(PWC)
Rwanda (Crown
Agents)
Sao Tome and
Principe (STI)
Senegal (KPMG)
Serbia (UNOPS)
Sierra Leone (PWC)
Somalia (PWC)
South Africa (KPMG)
Sri Lanka (PWC)
Swaziland (PWC)
Sudan North (KPMG)
Sudan South (KPMG)
Suriname (PWC)
Tajikistan (PWC)
Tanzania (PWC)
PWC (PWC)
Thailand
KPMG(KPMG)
Thailand

Togo (PWC)
Turkey (PWC)
Uganda (PWC)
Ukraine (PWC)
Uzbekistan (PWC)
Vietnam (KPMG)
Yemen (KPMG)
Zambia (PWC)
Zanzibar (PWC)
Zimbabwe (PWC)

UNOPS
STI
DTT
CROWN

MANAGING UNDERPERFORMING GRANTS

Over the first 18 months of the

Global Funds existence, a portfolio
manager handled all of the issues associated with each of their grants.As
the implementation of some grants
faced more obstacles than others,
portfolio managers quickly found
that a few grants took up most of
their time, leaving little time to support their remaining grants. In May
2004, the Global Fund created a support unit, Operational Partnerships
and Country Support, whose responsibility it is to assist slow-moving grants, leaving the portfolio managers free to continue routine support of higher-functioning grants.
This process has enabled the Secretariat to simultaneously serve recipi-

ents better by devoting more resources to particular issues before

they turn into serious problems and
to better manage the Global Funds
risk exposure.
The support unit was tasked with
generating several tools to aid problem-solving strategies. Tools whose
development was begun in 2004 include an early warning system to flag
problems with grants at early stages
of development. This system would
respond to a wide variety of triggers,
of varying urgency and type, such as
time-sensitive factors or disbursement information, and would also
respond to the computerized Grant
Management Tool.A related diagnostic tool would simultaneously
help define the nature of the problem, while a system is being created

to define and monitor appropriate

steps to be taken by the Secretariat in
coordinated action with partners.
LOCAL FUND AGENTS

The decision not to have a Global

Fund presence outside Geneva, and
instead secure the services of incountry Local Fund Agents (LFAs), is
among the most innovative elements
of the Global Funds grant management structure.
LFAs are contracted to assess the
capacity of nominated Principal Recipients (PRs) to administer grant
funds and, beyond grant signature, to
report on financial and programmatic progress and challenges to program success. During grant implementation, LFAs also ascertain
whether PRs are undertaking

Operations + Results

product and other procurement consistent with the Global Funds guidelines. In addition, LFAs verify a PRs
periodic disbursement requests,
progress updates and review annual
audit reports. From late 2004, the
scope of LFA services has expanded
to provide critical objective input into
the Phase 2 grant renewal process.
Although the idea behind the
Local Fund Agent (LFA) model is not
unique, no other major development
finance mechanism has so far made
use of outside assessment and verification of the type and scale of the
Global Funds LFA system. The lack
of previous experience and best practices in this field means there is a constant need to assess and seek ways of
improving performance of the LFA
system.A thorough review of the effectiveness, benefits and weaknesses
of individual LFAs and the system of
outsourced oversight in general was
carried out in 2004. The review included 13 in-depth case studies of
LFA performance and an independent overall report on the effectiveness
and value-for-money of existing LFA
contracts and working arrangements.
From this review came a number of
recommendations which are now
being implemented through changed
work procedures and revised terms
for future contracts.
Among the revisions that were
made to the LFA system during 2004
was a more fully defined day-to-day
role of the LFA, with quality control
and assurance services continuing to
be provided by central teams with
whom the Global Fund directly contracts. Contracts were re-negotiated,
moving from a fee for service
framework, to one focused on delivery of performance-based verification of implementation services. In
the negotiation of contracts, the
Global Fund has been moving away
from a one size fits allmodel by reducing LFA oversight in well-performing countries, and enhancing all
forms of grant oversight in countries
where greater challenges exist. It has
also introduced a systemic approach
to program verification tied to perceived programmatic risks.As increasing numbers of country grants
made at new rounds involve the re-

Global Fund Annual Report 2004

peated use of the same PRs, the role

of LFAs in such cases will inevitably
change, especially where the need for
comprehensive assessment is rendered unnecessary.
An LFA officer position was created to oversee the Global Funds relationship with LFAs and ensure the
delivery of optimal LFA services. By
the end of 2004, this position had not
yet been filled.
COUNTRY COORDINATING
MECHANISMS

Over the past 18 months, the Global

Fund Secretariat has undertaken a
comprehensive analysis of the early
experiences of CCMs based on case
studies from 17 countries, a particularly in-depth study of CCMs in four
countries, two multi-country studies
of NGO involvement in CCMs, a
multi-country study on the involvement of People Living with
HIV/AIDS, an International Labour
Organization review of private sector
participation, and two studies of
faith-based organizations integration into Global Fund processes, as
well as feedback from regional meetings and Secretariat staff.
These assessments all stress the
value and benefits of the CCMs,
pointing out that CCMs have taken
inclusiveness and multisectoral collaboration a step forward in the
health sectors of many developing
countries.
However, they point to a variety
of problems which are hampering
the CCMs performance and therefore are negatively affecting the overall Global Fund process. Some of the
problems facing CCMs are due to
practical limitations; travel costs, language barriers, lack of organization
among constituencies and scarce resources for administration have hindered the smooth functioning of
some CCMs. In others, the government has not been willing to fully include nongovernmental groups in
decision-making processes and oversight functions, and this has reduced
genuine multisectoral participation.
In addition, in many countries,
the role of the CCM vis--vis other
forums for health planning and coordination needs to be clarified in

order to align CCMs with the UNAIDS principle of The Three Ones:
one agreed HIV/AIDS Action
Framework that provides the basis
for coordinating the work of all partners; one National AIDS Coordinating Authority with a broad-based
multisectoral mandate; one agreed
country-level Monitoring and Evaluation System. The CCM is a mechanism which should be flexible
enough to be fully aligned with other
decision bodies where appropriate.
Improving CCMs is among the
Global Funds most central priorities.
The conclusions of this analysis
led to a set of revised requirements
and recommendations for CCMs,
covering areas such as membership,
representation and process, and
which were adopted by the Board in
November 2004. The analysis also resulted in a set of performance criteria
for CCMs to be implemented in
2005. Other results of the analysis include a series of workshops to be carried out in 2005 to build capacity in
common areas of weakness, including project management and basic
business skills, and an expansion of
the Global Funds mailing list for
CCM communications to include
not only Chairs and Vice-Chairs but
also all other CCM members.
As part of the systems effects
framework development, the Global
Fund has developed a simple CCM
checklist which was approved by the
Board in November 2004. This
checklist will serve as a tool for yearly
self-assessments of CCM composition and functioning and as a basis
for regular sample audits. The Global
Fund has initiated a study that will
develop a baseline for all CCMs by
June 2005.

35

36

Global Fund Annual Report 2004

Operations + Results

Grant
Performance

Overall Targets + Results

Each Global Fund grant sets a target for the number

of people it aims to reach with key interventions over
the five-year lifetime of the grant. When the targets
for all grants in the first four funding rounds are tallied,
a cumulative set of global targets is reached:
Fig. 8: Expected outcomes for Rounds 1-4 after five years
HIV/AIDS

TUBERCULOSIS

MALARIA

1.6 million people on

antiretroviral treatment

3.5 million additional TB cases

treated successfully under the
DOTS treatment strategy

108 million bednets to protect

families from transmission of
malaria

More than 12,000 new treatments

for multidrug-resistant tuberculosis,
quadrupling current numbers on
treatment

145 million artemisinin-based

combination treatments for
drug-resistant malaria

52 million people reached with

voluntary counseling and testing
for HIV
More than one million
orphans supported through
medical services, education
and community care

These are rolling targets, as they

will increase as new rounds are included and because the five-year target refers to the lifetime of each grant
and not to a fixed calendar period.

Since they include Round Four

grants which have yet to start implementation, the first batch of grants
contributing to these targets will
reach their targets by 2007 and the

last batch by early 2010. Long before

then, however, there will be more
grants approved in successive funding rounds, so these targets will increase with each new round.

Operations + Results

By the end of 2004, the average

age of Global Fund grants was 11
months. Cumulative results for the
grant portfolio as of 31 December

Global Fund Annual Report 2004

2004 were as follows (no significant

results for HIV orphans and multidrug-resistant tuberculosis cases
have been recorded yet, as these

37

targets predominantly stem

from grants that are too young to
show results).

Fig. 9: Cumulative results for grant portfolio at end of 2004

HIV/AIDS

TUBERCULOSIS

MALARIA

130,000 people on antiretroviral

treatment

385,000 TB cases treated under

the DOTS strategy*

More than 1 million people

reached with voluntary counseling
and testing services for HIV

* Some of these treatments are

not yet completed and can
therefore not yet be proven
successful

More than 1.35 million families

with insecticide-treated bednets
to prevent malaria.

In addition,an estimated tens of

millions have been reached through a
wide range of prevention programs,
including behavior-change campaigns,community outreach programs,condom distribution,targeted
support for injecting drug users,sex
workers and mobile populations,
school programs,and awareness-raising for communities and the media.
Another indication of the pace of
progress is to look at the growth and
acceleration of grant achievements
between their one-year mark and
their 18-month mark. In comparing
the June and December 2004 results
of the earliest 15 grants, a steady
growth and in some cases an acceleration of results is apparent during the
first half of the second year. The
number of people reached with TB
treatment under DOTS increased by
70 percent between June and December 2004, and the distribution of insecticide-treated bednets increased
by 103 percent during the same time
period. The acceleration of TB and
malaria programs is not surprising,
given that the first year of a grant is
predominantly spent on logistical issues, physical infrastructure, procurement and training, and that
these lay the ground for an acceleration of services in the grants second
year.Antiretroviral treatment num-

bers show steady growth rates, with

results increasing by 52 percent between the 12-month and 18-month
marks. These results reflect the challenges faced in scaling up ARV treatment access in settings where training, testing, and diagnostic facilities
are inadequate and where capacitybuilding issues are more complex.
CAPACITY-BUILDING

As important as the Global Funds

headlineresults is the way grants
are building human resource capacity and physical infrastructure in
order to accelerate the scale-up of
prevention and treatment services in
the near future and to ensure that the
quality of services provided is high.
The grants have made important investments in country capacity as the
basis for future scale-up. Over
350,000 people from ministries of
health to community organizations
and peer educators were trained
to fight HIV, TB and malaria in 2004.
Of Global Fund grants approved to
date, 20 percent is being spent on
human resources and 13 percent on
physical infrastructure.
In many countries, Global Fund
grants are being used to scale up existing efforts and to pilot new or expanding programs; in other countries with little capacity or infrastruc-

More than 300,000 people receiving highly effective artemisinin

combination treatment for malaria

ture, national governments, NGOs

and other program implementers are
working hard with the assistance of
bilateral and multilateral partners to
improve procurement systems, train
staff and build clinics.
The results of Global Fund financing are the results of the work of
a broad range of implementing partners. The Global Fund disburses
grant funding to a wide selection of
principal recipients, including government ministries, nongovernmental organizations, private sector businesses, faith-based organizations, academic institutions and organizations representing people living with
or affected by the diseases.
However, it is important to remember that these principal recipients further distribute funds to subrecipients. In Zambia, for example,
sub-recipients include health districts, faith-based organizations and
nongovernmental organizations; in
China, there are several thousand
sub-recipients at every level of government right down to district level.
Results to date are the culmination of
their efforts in the fight against
HIV/AIDS, TB and malaria. It is the
people at all of these levels principal recipients, sub-recipients and
sub-sub-recipients and from the
entire spectrum of public and private

38

Global Fund Annual Report 2004

sectors that carry out the implementation of funded programs to fight

the three diseases.
WORKING WITH PARTNERS

The Global Fund has no presence in

the countries it funds, and as a funding mechanism it plays no part in
program implementation or providing technical assistance. However, as
part of a dynamic network of development partners working to achieve
greater combined results towards
common goals, the Global Fund relies on its partners to provide technical expertise to grant recipients. The
Global Funds network includes a
large and varied group of technical
partners that carry out invaluable
work to provide input to and build
recipient-country capacity for proposal writing, program implementation, problem-solving, harmonization with existing systems and performance evaluation.
Over the past two years, much effort has been made to both
strengthen and systematize the
Global Funds collaboration with
technical partners, and to broaden its
partner network for country-level
technical support throughout the life
cycle of each grant. UNAIDS is central within this network, and over the
past year, the Global Funds collaboration with UNAIDS has intensified
in various areas. UNAIDS is providing critical support to CCMs in
preparing grant performance reports,
leveraging about 30 new monitoring
and evaluation officers who are being
posted in various countries. In addition, UNAIDS is scaling up its involvement and staffing levels to intensify its capacity-building support.
Another central partner is the
World Health Organization (WHO),
and the Global Fund is working
closely to expand and intensify its
collaboration with WHO at all levels.
In 2004, the Stop TB Department, in
collaboration with the Global Stop
TB Partnership, increased its provision of the technical support required by countries during the development of applications to the Global
Fund and is providing significant
support to countries that were approved for Round 4 TB grants pend-

ing clarifications on their proposals.

WHOs Intensified Support and Action Countries initiative is supporting 17 Global Fund recipients in
order to achieve more rapid and
more effective program implementation. Stop TB is also supporting
about 50 countries, including previously unsuccessful applicants in
Round Four, in developing their applications for Round Five, which the
Global Fund will approve in time for
the June 2005 deadline. Finally, the
Global TB Drug Facility is working
with recipients in eight priority
countries to identify bottlenecks in
their procurement and supply management systems and to implement
solutions.
Similarly, close collaboration is
taking place with the WHOs
HIV/AIDS Department and the 3 by
5initiative to put three million people on antiretroviral treatment by the
end of 2005.A joint effort is underway to develop comprehensive technical support plans for accelerating
the scale-up of antiretroviral therapy
and prevention services in 15 to 20
priority countries. The support of the
3 by 5team in speeding up proposal clarifications on approved
Round Four grants, like that of the
Stop TB Department, has also been
invaluable. In addition,WHO is
strengthening its capacity to provide
assistance to countries in procurement and supply-chain management.
In 2004, the collaboration with
WHOs Roll Back Malaria (RBM)
Department was close and complementary, specifically with regards to
the ongoing effort to reprogram existing Global Fund grants to use new,
more effective malaria treatments
that use an artemisinin-based combination therapy (ACT). So far 26
countries have been directly assisted
in this process, and a number of
other countries will be assisted in
producing grant proposals for the
next funding round that cover the
cost of changing national drug protocols to include ACT. RBM has provided valuable support to assist
funded countries in accelerating implementation where progress on
malaria programs has proven too
slow. The Global Fund and RBM are

also working to accelerate the rollout of a new generation of long-lasting mosquito nets, which have
proven highly effective.
The Global Fund has intensified
dialogue on coordination, information exchange and assistance in program countries with bilateral partners. It draws on substantial support
from American, British, Canadian,
French, German and Swedish bilaterals and others that are providing
training and technical support for
the Global Fund application and implementation processes in recipient
countries, and improving participation in CCMs.
The Global Fund is broadening
and deepening its collaboration with
NGO partners and the private sector
based on lessons learned over the

past two years. In a number of countries, the French-led ESTHER initiative supports Global Fund processes
through technical assistance on highquality treatment and care for people
living with HIV/AIDS. The International Council of AIDS Service Organizations (ICASO) is providing support in translating CCM guidelines
and working to increase civil society
and community involvement in
CCMs.A constructive dialogue is
maintained with Mdecins Sans
Frontires on important in-country
issues, in particular concerning
malaria and TB drugs. The Global
Fund has also developed a plan for
collaboration on drug prices and
other areas of support with the Clinton Foundation for a number of subSaharan African countries. In work-

ing with the private sector, the Global

Fund is making a substantial effort to
accelerate engagement through discussions on co-investment opportunities with corporations that have
operations and expertise in developing countries.
CO-INVESTMENT

The co-investment approach seeks to

ensure that,in addition to efforts the
corporations are making to provide
services to their employees and their
dependents,broader communities
will also benefit from quality services
through the reinforcement of public
health services or collaboration with
NGOs receiving Global Fund grants.
Since the last Board meeting,several
proposals for co-investment have
been initiated.In Kenya,Gabon and

Niger,the Global Fund has been

working with European members of
the Global Business Coalition Against
HIV/AIDS to allow local branches of
these companies to associate themselves with recipients of Global Fund
grants.Discussions have also been initiated in China and in India to seek
greater involvement of the private sector in the Global Fund process at the
country level.It is expected that a
number of such proposals will be
made in Round 5 in India.In June
2005,the Global Fund,in association
with the Global Business Coalition
and GTZ,will be organizing the next
meeting on co-investment,bringing
together bilateral organizations,including the UKs Department for International Development (DFID),
Frances Agence Franaise de

Above
TB patients sit
outside a district
health center in
Yangon, Myanmar.

40

Global Fund Annual Report 2004

Developpement (AFD),the Presidents Emergency Plan for AIDS Relief

(PEPFAR),the United Nations,the
World Economic Forum Global
Health Initiative (WEF-GHI),the International Finance Corporation
(IFC),expert groups such as Abt
Associates,Merck and Co,as well as
ESTHER (Ensemble pour une Solidarit Thrapeutique Hospitalire En
Rseau),in order to come to a greater
understanding of roles and responsibilities for building public-private
partnerships at the country level.

Operations + Results

monitoring and evaluation,

and progress achieved at each
disbursement period.
Key performance and country
contextual information
This summarizes the performance data by showing the
percentage of targets met
for key service delivery areas.
Contextual information of
relevance to the interpretation
of grant progress and performance is also included, such as
levels of conflict in a country,
natural disasters, etc.

PHASE 2 FUNDING RENEWALS

Periodic performance evaluation in

the first two years of a grants life
builds to a formal assessment at the
two-year mark for Phase 2 funding to
cover the remaining years of the approved grant period. The first Global
Fund grants were approaching the
end of their first two years at the end
of 2004.As a result, one key area of
work in 2004 was the development of
policies and procedures in preparation for the first tranche of Phase 2
funding applicants.
When grants reach 16 months, the
Global Fund Secretariat invites the
grantee to apply for Phase 2 funding.
Performance and contextual factors
contribute to a broad range of information that is used to make the Phase
2 funding decision. They include:
General grant information
and program objectives
This captures the major elements of the proposal, goals, impact indicators and key dates.
Program results compared
to country-set targets
These measure the services that
were delivered and the progress
made over time against the
targets that were set out in the
grant agreement. Indicators
measure the numbers of people
reached, the growth in capacity
and the supporting environment of the grant.
In-country assessments of
Global Fund grants by Local
Fund Agents
This includes assessments
made through the grants first
two years of procurement,

All of this information is put into a

Grant Performance Report which is
posted on the Global Funds website
as a public document.
Based on the performance and
contextual factors provided,the Secretariat makes a recommendation on
each Phase 2 funding applicant to the
Board.The Board makes the final decision on whether or not to provide
continued funding to grantees.More
than 100 grants will be eligible for
Phase 2 funding in 2005.Lessons
learned by the Secretariat and grant
recipients will be reviewed in 2005
and incorporated in the performancebased funding system going forward.
SYSTEMS EFFECTS + IMPACT

No systematic data exist yet on the

extent to which the Global Fund interacts with and affects its immediate
environment. The Global Fund, with
relevant partners, has developed a set
of core indicators for systems effects
and impact and putting them into
operation over the course of 2005 is a
priority. However, despite the lack of
numerical data, events over the past
three years suggest that the Global
Fund has influenced and adapted to
the existing environment in which it
operates. One clear example is with
CCMs, which have now been established in more than 120 countries
and which have, in many cases, increased civil society involvement in
the planning and decision-making
processes for national programs to
fight AIDS, TB and malaria.
Another example is the increasingly close collaboration and informal work-sharing taking place be-

tween the Global Fund and other

donors, in particular the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR), in program countries.An example of this kind of collaboration was the joint calculation
and announcement of antiretroviral
treatment figures in January 2005 by
the Global Fund and PEPFAR, reflecting the fact that the two mechanisms often finance different elements within the same national
treatment programs.
Finally, it will be the impact
Global Fund financing has in reducing the burden of the three diseases
that will determine its ultimate success or failure. Until now, one can
only infer a very modest global impact against the three diseases from
the results achieved to date. From
Round Five onwards, all grants will
have a set of impact indicators as
part of their overall set of results
measurement built into their Phase
One grant agreements, and all Phase
Two grant extensions will have impact indicators as they begin to be
negotiated and signed in early 2005.
The data gathered through these
processes will make an important
contribution to the measurement of
Global Fund impact.

C O U N T RY P R O F I L E

Global Fund Annual Report 2004

41

Morocco
Initiating a first national HIV/AIDS communication campaign
Disease(s) funded: HIV/AIDS

Among large sections of Moroccan

society, it remains taboo to mention sex
in public. Yet with strong leadership,
spearheaded by the King and the Prime
Minister, things are beginning to change.
In 2004, one of the clearest signs of
this was the launch of the countrys
first national communication campaign on HIV/AIDS. Unprecedented
in North Africa, it is bringing powerful messages about prevention and
care to peoples homes, workplaces
and social environments.
HIV prevalence remains very low
among Moroccos 31 million people,
at an estimated 0.1 per cent in 2003.
Yet with high levels of sexually transmitted infections (600,000 new cases
were registered in one recent year
alone) and HIV prevalence increasing more than two-fold in the 1990s,
there is little room for complacency.
The Ministry of Health has developed a comprehensive national strategy, whose implementation is partly
funded by the Global Fund. The program was submitted to the Global
Fund in Round One and the grant
agreement was signed in March 2003
for a two-year budget of US$ 4.7 million with the National AIDS Program
as the Principal Recipient .
2004 saw the launch of a key element of the work supported by the
Global Fund: a national communication campaign on HIV/AIDS. The
campaign is walking a social and political tightrope, showing respect for
the diversity and sensitivity of Moroccos culture and traditions while
addressing the reality of a disease
that, in at least 76 percent of cases, is
transmitted through heterosexual
sex, both in and outside of marriage.
Some of its messages emphasize

Approved funding to date: US$ 9.2 million

strategies such as abstinence and fidelity and also, for the first time in
the countrys history, publicly promote the use of condoms.Aspects of
the campaign are targeted to young
people and women, two groups particularly vulnerable to HIV infection
in Morocco.
The campaign has benefited
enormously from the countrys increasingly strong national leadership
and political commitment in relation
to HIV/AIDS, including from the
King, who has visited people living
with HIV/AIDS in hospital, as well as
the involvement of the Prime Minister and the Ministry of Habous and
Islamic Affairs. It has also been
greatly aided by a Media for AIDS
Charter, signed by the Ministries of
Health and Communications and the
Directors General of two national television channels and two radio channels, as well as the President of the
Federation of Print Media. By the
end of 2004, the campaign had already disseminated 308 national television spots, 450 radio spots in four
dialects, 100 press releases and 125
city billboards, as well as a mobile
unit which travelled 4,000 km across
the country to provide information
on HIV/AIDs.
Other key areas of work supported by the Global Fund include
HIV prevention with vulnerable
communities such as commercial sex
workers, among whom prevalence
was over 2 per cent in 2003. Here, the
work is largely implemented by NGO
partners and includes information
on prevention, the provision of condoms and information and STI diagnosis and treatment. In 2004, this
component of the program either
met or exceeded all of its key targets.
Over 1.9 million condoms were distributed in the target area, while
172,000 young people and women
benefited from HIV/AIDS aware-

ness-raising events, 27,800 from education initiatives and 2,200 commercial sex workers and female workers
from outreach activities. During the
year, a total of 1,120 peer educators
were trained to support vulnerable
groups, including sex workers, young
people (both in and out of educational settings) and women.
The support of the Global Fund
also strengthened voluntary counseling and testing (VCT) and the provision of care and treatment for people
living with HIV/AIDS.Antiretrovirals (ARVs) and monitoring were
made universally freely available to
all those who are eligible for treatment, 706 people were provided with
ARV treatment, and services were
decentralized, and made available
through five regional referral centers.
Thanks to reduced drug prices, considerable savings were made from the
efficient procurement of ARVs.
The initiatives supported by the
Global Fund are coordinated by a
Country Coordinating Mechanism
(CCM) that reflects the dynamic,
multi-sectoral nature of Moroccos
national response. In 2004, the group
was joined by the Ministry of
Habous and Islamic Affairs on a collaborative NGO project to involve
imams in HIV/AIDS initiatives. New
CCM members in 2004 included
representatives of other ministries
(Communications, Penitentiaries,
Justice), the private sector (Federation of Moroccan Businesses and
Moroccan Association of Pharmaceutical Industries) and NGOs (Moroccan Red Crescent and Moroccan
Family Planning Association). The
CCM continued to promote transparency and created a website
(www.programmesida.org.ma) to
publicly share information on its
composition and function, goals,
monitoring and evaluation plan, and
Principal and Sub-Recipients.

Global Fund Annual Report 2004

Approved
Grants + the
Organization
44

Approved Grants

54

List of Board Members 2004

56

Technical Review Panel 2004

58

The Global Fund Secretariat

43

44

Global Fund Annual Report 2004

Approved Grants

The principal work of the Global Fund is accomplished by rewarding

and managing grants to finance the battle against the worlds three
great health pandemics: HIV/AIDS, tuberculosis and malaria.
Following approval of programs by the Board, grant agreements
commit funds for an initial two-year period, and periodic
disbursements are made on the basis of requests and performance.
The list that follows details funding approved by the Board after
three proposal rounds, by region, country, disease target, and round.
The total sum authorized by Board approval is specified and is
followed by the sum committed as a result of signed grant
agreements as of 31 December 2004 and then by the amount
disbursed as of that same date.
Principal Recipients are listed for all grant agreements signed
by 31 December 2004. In all other cases, these are shown as To Be
Confirmed. This is also the case for Local Funding Agents.
For current and detailed information regarding the grant portfolio
of the Global Fund, please refer to the Global Fund website at
www.theglobalfund.org.

EAST ASIA + THE PACIFIC

Cambodia
HIV/AIDS, Malaria and Tuberculosis
Rounds 1, 2 and 4
38147845
24131619
12003743
Local Fund Agent

KPMG
Principal Recipent(s)

The Ministry of Health and TBC

China

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 3 and 4
112843130
61016212
40320012
Local Fund Agent

United Nations Office for Project

Services
Principal Recipent(s)

The Chinese Centre for Disease Control

and Prevention and TBC

East Timor

Key
REGION

Country
Program(s) Approved for Funding
Round(s) of Approval
Total Funds Approved (in US$)
Funds Committed by Grant Agreement(s) (in US$)
Funds Disbursed at 31 December 2004 (in US$)
Local Fund Agent
Principal Recipient(s)

Malaria and Tuberculosis

Rounds 2 and 3
3268394
3268394
1364450
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The Ministry of Health

Approved Grants

Global Fund Annual Report 2004

Indonesia

Papua New Guinea

Azerbaijan

HIV/AIDS, Malaria and Tuberculosis

Rounds 1 and 4
67921801
36792183
24207542

HIV/AIDS and Malaria

Rounds 3 and 4
14598802
6106557
2185723

HIV/AIDS
Round 4
6553600

Local Fund Agent

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

KPMG

TBC

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Health and TBC

The Department of Health and TBC

TBC

Lao PDR

Philippines

Belarus

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 4
13470615
5987154
4665882

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 3
14176114
14176114
10038851

HIV/AIDS
Round 3
6818796
6818796
1254445

Local Fund Agent

Local Fund Agent

Local Fund Agent

KPMG

Chemonics

KPMG

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Health and TBC

Tropical Disease Foundation, Inc.

Mongolia

Thailand

The United Nations Development

Programme

HIV/AIDS and Tuberculosis

Rounds 1, 2 and 4
3873882
1915623
1835792

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 3
61197279
61197279
36948766

Local Fund Agent

Local Fund Agent

HIV/AIDS
Round 2
6894270
6894270
2691090

United Nations Office

for Project Services

KPMG

Local Fund Agent

Principal Recipent(s)

KPMG

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Health and TBC

The Ministry of Public Health and

RAKS Thai Foundation

Multi-country Western Pacific

Viet Nam

Croatia

HIV/AIDS, Malaria and Tuberculosis

Round 2
7151950
7151950
5392219

HIV/AIDS, Malaria and Tuberculosis

Rounds 1 and 3
23388402
23388402
7626978

HIV/AIDS
Round 2
3363974
3363974
1468709

Local Fund Agent

Local Fund Agent

Local Fund Agent

KPMG

KPMG

KPMG

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Secretariat of the Pacific

Community

The Ministry of Health

The Ministry of Health

and Social Welfare

Myanmar

EASTERN EUROPE +
CENTRAL ASIA

Estonia

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 3
35680724
6997137
2404656
Local Fund Agent

KPMG
Principal Recipent(s)

The United Nations Development

Programme and TBC

Armenia

HIV/AIDS
Round 2
3166641
3166641
1843839
Local Fund Agent

KPMG
Principal Recipent(s)

World Vision International

Armenia Branch

Bulgaria

The Ministry of Health

HIV/AIDS
Round 2
3908952
3908952
2796271
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The National Institute for Health

Development of the Ministry
of Social Affaires

45

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Global Fund Annual Report 2004

Approved Grants

Georgia

Moldova

Tajikistan

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
7099810
4664032
1171271

HIV/AIDS and Tuberculosis

Round 1
5257941
5257941
2976861

HIV/AIDS and Tuberculosis

Rounds 1, 3 and 4
5284725
5284725
3534233

Local Fund Agent

Local Fund Agent

Local Fund Agent

KPMG

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Georgia Health and Social Projects

Implementation Center and TBC

The Project Coordination,

Implementation and Monitoring
Unit of the Ministry of Health

Project HOPE and The United Nations

Development Programme

Romania

HIV/AIDS
Round 4
3891762

Global (LWF)

HIV/AIDS
Round 1
485000
485000
348000

Turkey

Local Fund Agent

HIV/AIDS and Tuberculosis

Round 2
38671000
38671000
21474170

DTT Emerging Markets

Local Fund Agent

TBC

Principal Recipent(s)

KPMG

Principal Recipent(s)

The Lutheran World Federation

Principal Recipent(s)

TBC

Kazakhstan

HIV/AIDS
Round 2
6502000
6502000
3419670

The Ministry of Health and Family

Russian Federation

Local Fund Agent

Ukraine

HIV/AIDS
Round 1
17296598
17296598
17296598

Local Fund Agent

HIV/AIDS and Tuberculosis

Rounds 3 and 4
125614264
37903176
12661235

KPMG

Local Fund Agent

Pricewaterhouse Coopers

Principal Recipent(s)

Pricewaterhouse Coopers

Principal Recipent(s)

The Republican Center for

Prophylactics and Control of AIDS

Principal Recipent(s)

The International HIV/AIDS Alliance,

The Ministry of Health, The Ukrainian
Fund to Fight HIV Infection and AIDS
and the United Nations Development
Programme

Kyrgyzstan

HIV/AIDS and Tuberculosis

Round 2
6170873
6170873
2195940

The Open Health Institute,

Partners In Health and TBC

Serbia + Montenegro

Local Fund Agent

HIV/AIDS and Tuberculosis

Rounds 1 and 3
5147700
5147700
2342301

Pricewaterhouse Coopers

Local Fund Agent

Principal Recipent(s)

United Nations Office for Project

Services

The National AIDS Center

and National Center of Phtisiology

Macedonia, FYR

HIV/AIDS
Round 3
4348599
4348599
1240413
Local Fund Agent

United Nations Office for Project

Services

Local Fund Agent

Uzbekistan

HIV/AIDS, Malaria and Tuberculosis

Rounds 3 and 4
12160743
4760755
407181
Local Fund Agent

Principal Recipent(s)

Pricewaterhouse Coopers

The Economics Institute in Belgrade

and The Ministry of Health

Principal Recipent(s)

Serbia + Montenegro (Kosovo)

Tuberculosis
Round 4
2122441

Local Fund Agent

Principal Recipent(s)

TBC

The Ministry of Health

Principal Recipent(s)

TBC

The National AIDS Center of the

Ministry of Health and TBC

Approved Grants

LATIN AMERICA +
THE CARIBBEAN
Argentina

HIV/AIDS
Round 1
12177200
12177200
8123197
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The United Nations Development

Programme

Belize

HIV/AIDS
Round 3
1298884
1298884
342578
Local Fund Agent

KPMG
Principal Recipent(s)

Belize Enterprise for Sustainable

Technology

Bolivia

HIV/AIDS, Malaria and Tuberculosis

Round 3
14500232
14500232
3404860
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

Centro de Investigacin, Educacin

y Servicios (CIES)

Chile

HIV/AIDS
Round 1
13574098
13574098
11283052

Global Fund Annual Report 2004

Costa Rica

Guatemala

HIV/AIDS
Round 2
2279501
2279501
1486604

HIV/AIDS and Malaria

Rounds 3 and 4
18137660
8423807
1532478

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

DTT Emerging Markets

Principal Recipent(s)

Principal Recipent(s)

The Consejo Tcnico de Asistencia

Mdico Social (CTAMS)

Fundacin Visin Mundial Guatemala

and TBC

Cuba

Guyana

HIV/AIDS
Round 2
11465129
11465129
11465129

HIV/AIDS, Malaria and Tuberculosis

Rounds 3 and 4
11663649
10937361

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

DTT Emerging Markets

Principal Recipent(s)

Principal Recipent(s)

The United Nations Development

Programme

The Ministry of Health and TBC

Dominican Republic

HIV/AIDS, Malaria and Tuberculosis

Rounds 1 and 3
40222156
40222156
29136244

HIV/AIDS and Tuberculosis

Rounds 2 and 3
17335590
17335590
1067253

KPMG

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

Fondation SOGEBANK and The United

Nations Development Programme

Asociacin Dominicana Pro-Bienestar

de la Familia (PROFAMILIA) and
Consejo Presidencial del SIDA
(COPRESIDA)

Ecuador

HIV/AIDS and Tuberculosis

Rounds 2 and 4
16355435
7453979

Local Fund Agent

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Public Health and TBC

Colombia

HIV/AIDS
Round 2
3482636
3482636
514282

Local Fund Agent

Local Fund Agent

Local Fund Agent

Consejo de las Amricas

Haiti

El Salvador

HIV/AIDS and Tuberculosis

Round 2
14775073
14775073
6080398

Honduras

HIV/AIDS, Malaria and Tuberculosis

Round 1
20470016
20470016
13679285
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The United Nations Development

Programme

Jamaica

HIV/AIDS
Round 3
7560365
7560365
2227456
Local Fund Agent

Pricewaterhouse Coopers

Local Fund Agent

Principal Recipent(s)

Local Fund Agent

KPMG

The Ministry of Health

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

The United Nations Development

Programme

The International Organization

for Migration (IOM)

47

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Global Fund Annual Report 2004

Approved Grants

Multi-country Americas (Andean)

Nicaragua

Malaria
Round 3
15909000

HIV/AIDS, Malaria and Tuberculosis

Round 2
8702180
8702180
4197622

Local Fund Agent

Local Fund Agent

TBC

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

TBC

Federacin NICASALUD

Local Fund Agent

Multi-country Americas
(CARICOM)

Panama

Principal Recipent(s)

Tuberculosis
Round 1
440000
440000
362973

The Ministry of Health, Population and

Hospital Reform

HIV/AIDS
Round 3
6100900
6100900
2188108

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

DTT Emerging Markets

Principal Recipent(s)

Principal Recipent(s)

The United Nations Development

Programme

The Caribbean Community Secretariat

\Multi-country Americas (CRN+)

HIV/AIDS
Round 4
1947094

Algeria

HIV/AIDS
Round 3
6185000
6185000
1561251
Pricewaterhouse Coopers

Chad

HIV/AIDS and Tuberculosis

Rounds 2 and 3
8644119
8644119
1580169
Local Fund Agent

Swiss Tropical Institute

Paraguay

Principal Recipent(s)

Tuberculosis
Round 3
1194902
1194902
433926

Fonds de Soutien aux Activits

en matire de Population

Local Fund Agent

Local Fund Agent

TBC

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

TBC

Alter Vida Centro de Estudios y

Formacin para el Ecodesarrollo

Multi-country Americas (Meso)

NORTH AFRICA +
THE MIDDLE EAST

Djibouti

HIV/AIDS
Round 4
7271400

Local Fund Agent

TBC

Peru

Principal Recipent(s)

TBC

Local Fund Agent

HIV/AIDS and Tuberculosis

Round 2
35872172
35872172
13939472

TBC

Local Fund Agent

Principal Recipent(s)

Pricewaterhouse Coopers

TBC

Principal Recipent(s)

HIV/AIDS
Round 4
2181050

Egypt

Tuberculosis
Round 2
2480219
2480219
354112

CARE Peru

Local Fund Agent

Suriname

Principal Recipent(s)

National Tuberculosis Control

Program of the Ministry of Health

Local Fund Agent

HIV/AIDS and Malaria

Rounds 3 and 4
5152382
2963950

TBC

Local Fund Agent

Principal Recipent(s)

Pricewaterhouse Coopers

TBC

Principal Recipent(s)

Multi-country Americas (OECS)

HIV/AIDS
Round 3
2553861

Medische Zending Primary Health

Care Suriname and TBC

Chemonics

Jordan

HIV/AIDS
Round 2
1778600
1778600
1497206
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The Ministry of Health

of the Government

Approved Grants

Global Fund Annual Report 2004

Mauritania

Yemen

India

Malaria and Tuberculosis

Round 2
1928786
1928786
959591

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
12239211
4159632
1661532

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2, 3 and 4
114128775
41514345
11166268

Local Fund Agent

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

KPMG

Principal Recipent(s)

Principal Recipent(s)

United Nations Office for Project

Services and The World Bank

The United Nations Development

Programme

The National Malaria Programme

at the Ministry of Public Health and
Population and TBC

Morocco

HIV/AIDS
Round 1
4738806
4738806
3909772
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The Ministry of Health

Principal Recipent(s)

The Department of
Economic Affairs and TBC

Iran (Islamic Republic of)

SOUTH ASIA
Afghanistan

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 4
5469995
3125605
1687514

HIV/AIDS
Rounds 2 and 3
9698000

Local Fund Agent

TBC
Principal Recipent(s)

Niger

Pricewaterhouse Coopers

TBC

HIV/AIDS and Malaria

Rounds 3 and 4
24548394
13290406
5104204

Principal Recipent(s)

Nepal

The Ministry of Health and TBC

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 4
10343005
6988925
948513

Local Fund Agent

Swiss Tropical Institute

Principal Recipent(s)

The Centre of International

Cooperation in Health and
Development (CCISD),
The National Multi-sectoral
Coordination Unit for the Fight
Against HIV/AIDS/STI and TBC

Local Fund Agent

Bangladesh

HIV/AIDS and Tuberculosis

Rounds 2 and 3
22653213
22653214
9349622

Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

DTT Emerging Markets

The Ministry of Health and TBC

Principal Recipent(s)

Pakistan

Bangladesh Rural Advancement

Committee (BRAC) and The Economic
Relations Division of the Ministry of
Finance

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 3
17632567
17632567
6596026

Bhutan

Local Fund Agent

KPMG

Pricewaterhouse Coopers

Malaria and Tuberculosis

Round 4
1561525

Principal Recipent(s)

Local Fund Agent

Sri Lanka

The United Nations Childrens Fund,

World Vision Somalia and TBC

TBC

Malaria and Tuberculosis

Rounds 1 and 4
10261140
8057620
5419444

Somalia

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
24496356
14491712
6951128
Local Fund Agent

Sudan

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
49595585
18698422
6969278
Local Fund Agent

KPMG
Principal Recipent(s)

The United Nations Development

Programme and TBC

Local Fund Agent

Principal Recipent(s)

TBC

Principal Recipent(s)

The National AIDS Control Programme

on the Behalf of the Ministry of Health

Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

Lanka Jatika Sarvodaya Shramadana

Sangamaya, The Ministry of Health
and TBC

49

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Global Fund Annual Report 2004

SUB-SAHARAN AFRICA

Approved Grants

Cameroon

Equatorial Guinea

HIV/AIDS, Malaria and Tuberculosis

Rounds 3 and 4
40913717
40913717
11078036

HIV/AIDS
Round 4
4402427

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

TBC

Local Fund Agent

Principal Recipent(s)

Principal Recipent(s)

TBC

CARE International and The Ministry

of Public Health

TBC

Central African Republic

HIV/AIDS and Malaria

Rounds 2 and 3
10742543
10742543
4811220

Angola

HIV/AIDS, Malaria and Tuberculosis

Rounds 3 and 4
60280400

Principal Recipent(s)

TBC

Benin

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 3
17294520
17294520
9929522

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 4
25520634
14927818
6782857

Eritrea

Local Fund Agent

Local Fund Agent

KPMG

Local Fund Agent

Pricewaterhouse Coopers

Principal Recipent(s)

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

The United Nations Development

Programme and TBC

The Ministry of Health

Africare and The United Nations

Development Programme

Botswana

HIV/AIDS
Round 2
18580414
18580414
9019119

Comores

HIV/AIDS and Malaria

Rounds 2 and 3
2220231
2220231
1019768

Ethiopia

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 4
149350582
104261422
45739466
Local Fund Agent

KPMG

Local Fund Agent

Principal Recipent(s)

Local Fund Agent

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

Association Comorienne pour le

Bien-Etre de la Famille (ASCOBEF)

The Federal Ministry of Health,

The HIV/AIDS Prevention
and Control Office and TBC

The Ministry of Finance and

Development Planning

Burkina Faso

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 4
22135793
22135793
7522237

Congo (Democratic Republic)

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 3
66175203
66175203
10468928

Gabon

HIV/AIDS and Malaria

Rounds 3 and 4
10574124
10574124
2219758
Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

Local Fund Agent

Pricewaterhouse Coopers

Principal Recipent(s)

Chemonics

Principal Recipent(s)

Principal Recipent(s)

The United Nations Development

Programme

The United Nations Development

Programme

The United Nations Development

Programme

Burundi

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 4
20556301
18669126
10459514

Cte dIvoire

HIV/AIDS and Tuberculosis

Rounds 2 and 3
21993054
21993054
7948437

Gambia

HIV/AIDS and Malaria

Round 3
11907243
11907243
2723624
Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

Local Fund Agent

Pricewaterhouse Coopers

Principal Recipent(s)

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

CARE Cte dIvoire and The United

Nations Development Programme

The Department of State for Health

and The National AIDS Secretariat

Conseil National de Lutte Contre le

SIDA (National AIDS Council),
The Ministry of Public Health and TBC

Approved Grants

Global Fund Annual Report 2004

Ghana

Liberia

Multi-country Africa (RMCC)

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 4
30459896
11898529
8127193

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 3
24333125
24333125
5061000

Malaria
Round 2
7090318
7090318
4997501

Local Fund Agent

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Health and TBC

The United Nations Development

Programme

The Medical Research Council

Madagascar

HIV/AIDS, Malaria and Tuberculosis

Round 2
30707125
30707125
1168462

Guinea

HIV/AIDS and Malaria

Round 2
11698205
11698205
2784814

Namibia

Local Fund Agent

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2, 3 and 4
47463190
28159130
14617790

Pricewaterhouse Coopers

Local Fund Agent

Pricewaterhouse Coopers

Principal Recipent(s)

Pricewaterhouse Coopers

Principal Recipent(s)

The Ministry of Public Health

Principal Recipent(s)

The Ministry of Health

and Social Services

Guinea-Bissau

HIV/AIDS, Malaria and Tuberculosis

Rounds 3 and 4
4556179
4556179
808095
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The United Nations Development

Programme

Catholic Relief Services, Population

Services International, Scrtariat
Excutif du Comit National
de Lutte Contre le VIH/SIDA,
UGP-CRESAN and TBC

Malawi

HIV/AIDS and Malaria

Rounds 1 and 2
62623500
41751500
26253844
Local Fund Agent

Kenya

Pricewaterhouse Coopers

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2 and 4
137021819
55049108
36403313

Principal Recipent(s)

Local Fund Agent

HIV/AIDS, Malaria and Tuberculosis

Rounds 1 and 4
28249252
2023424
945120

KPMG
Kenya Network of Women With AIDS,
Principal Recipent(s)

The Ministry of Finance, Sanaa Art

Promotions and TBC

The Registered Trustees of the National

AIDS Commission Trust and TBC

Mali

KPMG
Principal Recipent(s)

National Action Committee on AIDS

and The Yakubu Gowon Center for
National Unity and International
Cooperation

Rwanda

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 3 and 4
42261643
42261643
23111551
Local Fund Agent

Crown Agents
The Ministry of Health

The Ministry of Health and TBC

The Ministry of Finance and

Development Planning

Local Fund Agent

Principal Recipent(s)

HIV/AIDS and Tuberculosis

Round 2
12557000
12557000
5365581

Principal Recipent(s)

HIV/AIDS and Malaria

Rounds 1, 2 and 4
69629535
69629535
11677006

KPMG
Principal Recipent(s)

Pricewaterhouse Coopers

Nigeria

Local Fund Agent

Lesotho

Local Fund Agent

Local Fund Agent

Mozambique

HIV/AIDS, Malaria and Tuberculosis

Round 2
51112173
51112173
16384567

Sao Tome & Principe

Malaria
Round 4
1941359

Local Fund Agent

TBC

Local Fund Agent

Principal Recipent(s)

DTT Emerging Markets

TBC

Principal Recipent(s)

The Ministry of Health and

The National AIDS Council (CNCS)

51

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Global Fund Annual Report 2004

Approved Grants

Senegal

Tanzania

Zambia

HIV/AIDS and Malaria

Rounds 1 and 4
34030997
10285714
4669629

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 3 and 4
198703195
41310110
14468386

HIV/AIDS, Malaria and Tuberculosis

Rounds 1 and 4
121995782
74945056
52896603

Local Fund Agent

Local Fund Agent

Local Fund Agent

KPMG

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

Principal Recipent(s)

The Ministry of Health, The National

AIDS Council and TBC

The Ministry of Finance, The Ministry

of Health and TBC

Sierra Leone

Tanzania (Zanzibar)

HIV/AIDS, Malaria and Tuberculosis

Rounds 2 and 4
23240195
2569103
1800067

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2, 3 and 4
7946063
7946063
4955405

The Central Board of Health,

The Churches Health Association
of Zambia, The Ministry of Finance,
Zambia National AIDS Network
and TBC

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

The Sierra Leone Red Cross Society

and TBC

The Ministry of Health and Social

Welfare and Zanzibar AIDS
Commission

South Africa

HIV/AIDS and Tuberculosis

Rounds 1, 2 and 3
65030986
56616986
28876905

Togo

Local Fund Agent

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
37762054
19417956
11062168

KPMG

Local Fund Agent

Principal Recipent(s)

Pricewaterhouse Coopers

The National Treasury, The Provincial

Health Department of the Western Cape
and TBC

Principal Recipent(s)

Swaziland

Uganda

HIV/AIDS, Malaria and Tuberculosis

Rounds 2, 3 and 4
48356500
31959700
8768790

HIV/AIDS, Malaria and Tuberculosis

Rounds 1, 2, 3 and 4
201007993
134575845
37965273

Local Fund Agent

Local Fund Agent

Pricewaterhouse Coopers

Pricewaterhouse Coopers

Principal Recipent(s)

Principal Recipent(s)

The National Emergency Response

Council on HIV/AIDS and TBC

The Ministry of Finance, Planning and

Economic Development and TBC

The United Nations Development

Programme and TBC

Zimbabwe

HIV/AIDS and Malaria

Round 1
17016250
6716250
1415000
Local Fund Agent

Pricewaterhouse Coopers
Principal Recipent(s)

The Ministry of Health and Child

Welfare and TBC

Fifteen-year old Venda

Mamba is now the
head of this family of
six children who lost
their parents to AIDSrelated illnesses.

54

Global Fund Annual Report 2004

List of Board Members

2004

An international, multi-sectoral,
23-member Board (18 voting and
five non-voting) governs the
Global Fund, approves grants and
mobilizes external resources to meet
the Global Funds financial needs.

Eastern Europe (Romania)

France (Luxemburg, Spain)

Dr. Ovidiu Brinzan

Minister of Health
Romania

Mrs. Mireille GUIGAZ

Ambassadeur en mission pour
la lutte contre
le VIH/sida et les maladies
transmissibles
Ministry of Foreign Affairs
France

Eastern Mediterranean Region

(Pakistan)

Mr. Ejaz Rahim

Federal Secretary Health
Government of Pakistan
(until May 2004)

VOTING MEMBERS
Canada (Germany, United
Kingdom, Switzerland)

Mr. Tariq Farook

Federal Secretary Health
Government of Pakistan

Dr. Ernest Loevinsohn

Director General
CIDA/PAHMD
Canada

(from May to November 2004 )

Communities (NGOs
representative of the
Communities Living with
the Diseases)

(from November 2004)

Ms.Anandi Yuravaj
Program officer
India HIV/AIDS Alliance
India

Dr. Manto Tshabalala-Msimang

Minister of Health
South Africa

Developed Country NGO

Dr. Lieve Fransen

Head of Unit
Human and Social Development
Directorate General for Development
European Commission
Belguim

Dr. Hlne Rossert-Blavier

Director General
AIDES Federation
France

Developing Country NGO

Ms. Rita Arauz Molina

President
Foundation Nimehuatzin
Nicaragua

Mr. Syed Anwar Mahmood

Federal Secretary Health
Pakistan

Eastern and Southern Africa

(South Africa)

European Commission (Belgium)

Italy

Mr. Giuseppe Deodato

Director-General Development
Cooperation
Ministry of Foreign Affairs
Italy

Japan

Mr. Shigeki Sumi

Deputy Director General
Multilateral Cooperation Department
Ministry of Foreign Affairs
Japan

Latin America + Caribbean

(Barbados)

Dr. Carol Jacobs

Chairman National HIV/AIDS
Commission
Prime Ministers Office
Barbados

Point Seven Group

(Sweden Denmark, Ireland,
Netherlands, Norway)

Mr. Lennarth Hjelmker

Director,Ambassador
Department for Global
Development (GU)
Ministry of Foreign Affairs
Sweden

List of Board Members

Private Foundations

Dr. Helene D. Gayle

Director HIV/AIDS and TB
Bill and Melinda Gates Foundation
Executive Offices
United States

Private Sector

Global Fund Annual Report 2004

EX OFFICIO MEMBERS
WITHOUT VOTING RIGHTS
UNAIDS

Dr. Peter Piot

Executive Director
UNAIDS

Mr. Rajat Gupta

Senior Director
Worldwide McKinsey & Company
United States

WHO

South-East Asia (India)

World Bank

Mrs. Sushma Swaraj

Union Minister
Ministry of Health and Family Welfare
India

Mr. Geoffrey Lamb

Vice President
Consessional Finance
and Global Partnerships
The World Bank
United States

(until June 2004)

Dr.Anbumani Ramadoss
Union Minister
Ministry of Health and Family Welfare
India

Dr. Jong-Wook Lee

Director-General
WHO

BOARD-DESIGNATED
NON-VOTING SWISS MEMBER

(from June 2004)

USA

Mr. Tommy G. Thompson

Secretary of Health and
Human Services
Department of Health and
Human Services
United States

West + Central Africa (Cameroon)

Mr. Urbain Olangueno Awono

Minister of Public Health
Cameroon

Western Pacific Region (China)

Dr. Huang Jiefu

Vice Minister of Health
China

Mr. Edmond Tavernier

Managing Partner
Tavernier Tschanz
(Attorneys-at-Law)
Switzerland

55

56

Global Fund Annual Report 2004

Technical Review Panel

2004

The Technical Review Panel is an

independent, impartial team of experts
appointed by the Board to review
applications requesting support from
the Global Fund and to make
recommendations to the Board for
approval. The Technical Review Panel
guarantees the integrity and consistency
of an open and transparent proposals
review process.
TRP members assigned to Round 3 are noted
with an asterisk (*)

HIV/AIDS EXPERTS

Dave Burrows
Director
AIDS Projects Management Group
Sydney
Australia

Alex Godwin Coutinho*

Director
The AIDS Support Organization
Uganda

Peter Godfrey-Faussett
Reader in Infectious and
Tropical Diseases,
London School of Hygiene and
Tropical Medicine
United Kingdom

Hakima Himmich
President
Moroccan Association of
Fight against AIDS
Morocco

David Hoos*
Assistant Professor of Epidemiology
Colombia University
Mailman School of Public Health
United States

Michel Kazatchkine
Director
National Agency for AIDS Research
France

Kasia Malinowska-Sempruch*
Director of International
Harm Reduction Programme
Open Society Institute
Poland

Godfrey Sikipa
Senior HIV/AIDS and Infections
Diseases Specialist
RTI International
Zimbabwe

Suniti Solomon*
Director
YRG Care
India

Papa Salif Sow

Department of Infectious Diseases
Fann Hospital
Senegal

Stefano Vella
Director
Istituto Superiore di Sanita (ISS)
Italy

TUBERCULOSIS EXPERTS

Rosmini Day*
Manager
National Tuberculosis Programme
Indonesia

Paula Fujiwara
Deputy Executive General
International Union against
Tuberculosis and Lung Diseases
United States

Fabio Luelmo
Medical Officer, Global Tuberculosis
Programme (retired)
World Health Organization
Argentina

Pierre-Yves Norval
Medical Officer, Stop TB department
World Health Organization
France

Antonio Pio
Consultant in Public Health
and Respiratory Diseases
Argentina

Technical Review Panel

Global Fund Annual Report 2004

MALARIA EXPERTS

CROSS-CUTTING EXPERTS

Andrei Beljaev
Associate Professor
The Chair of Tropical and
Parasitic Diseases
Russian Medical Academy of
Postgraduate Training
Russian Federation

John Mulenga Chimumbwa

East Africa RBM Focal Point
UNICEF
Zambia

Mary Ettling
Malaria Team Leader
Bureau of Global Health
United States Agency for
International Development
United States

Giancarlo Majori
Director
Istituto Superiore di Sanita
Italy

Jane Elizabeth Miller*

Manager of Malaria Programs
Population Services International
United Kingdom

Jonathan Broomberg
General Manager: Strategy
and Health Policy
Discovery Holdings Limited
South Africa

Malcolm Clark
Principle Program Associate
Center for Pharmaceutical Management
Management Sciences for Health
United Kingdom

Daniel Denolf*
Managing Director and
Technical Advisor
World Bank/BMZ
Belgium

Kaarle Olavi Elo

Acting Assoc. Director for Asia-Pacific
Middle East and North Africa
UNAIDS
Finland

Sarah Julia Gordon*

Director
Ministry of Health
Guyana

Wilfred Griekspoor
Director Emeritus,
McKinsey & Company
Board Member, Mdecins
Sans Frontires Holland
The Netherlands

Leenah Hsu
Manager of South East Asia Health
and Development Programme
United Nations Development
Programme
United States

Danguole Jankauskiene*
Assoc. Prof.,Vice-Dean of Public
Management Department
Mykolas Romeris University Vilnius
Lithuania

Rima Shretta*
Consultant
Management Sciences for Health
Kenya

Richard Skolnik
Executive Director
Harvard School of Public Health
Presidents Emergency Plan
for AIDS Relief
United States

David Peters
Deputy Director of Health
Systems Program
Johns Hopkins University
Bloomberg School of Public Health
Canada

Wiput Phoolcharoen*
Director of Health Systems
Research Institute
Ministry of Public Health
Thailand

Glenn Post
Senior Medical Officer
Office of HIV/AIDS
US Agency for International
Development
United States

Jayasankar Shivakumar
International Consultant
former World Bank Country
Director for Thailand
India

Stephanie Simmonds
Sarajevo Hospice
United Kingdom

Michael James Toole

Center for International Health
Burnet Institute
Australia

57

58

Global Fund Annual Report 2004

The Global Fund

Secretariat

The Secretariat of the Global Fund

continued to benefit in 2004 from the
services of many individuals, including
those on short-term contracts and
secondments. Based in Geneva, the
Secretariat is led by Richard Feachem,
Executive Director July 2002. Listed
below are those who have either been
recruited through international
competition to fixed-term (two-year)
contracts or who worked at the Global
Fund for at least six months in 2004.
For each individual, his or her country
of origin is also indicated.
An askerisk (*) indicates those individuals who left
before 31st December 2004. A double asterisk (**)
specifies secondees.

Fatiha Terki
Fund Portfolio Manager
Algeria

Karmen Bennett
Fund Portfolio Manager
Australia

Nicole Gloor
Assistant to the Executive
Directors Office
Australia

Patricia Kehoe
Contract Specialist
Australia

Peita Sexton
Assistant to the Chief Operations Officer
Australia

Angela Smith
Fund Portfolio Manager
Australia

Taufiqur Rahman
Cluster Leader
Bangladesh

Maria Kirova
Fund Portfolio Manager
Bulgaria

Csarie Sebititaweho-Camara
Assistant
Burundi

Robert Bourgoing
Communications Officer
Canada

Brigitte Caron
Assistant
Canada

Erica Weikle*
Receptionist
Canada

Susan Oleary
Resource Mobilization Officer
Canada / United Kingdom

Julie Archer
Communications Officer
Canada / Ireland

Susan Scott *
Assistant
Canada / United Kingdom

Marguerite Samba-Maliavo
Fund Portfolio Manager
Central African Republic

Nagwa El-Abd
Assistant
Egypt

Seble Abebe
Assistant
Ethiopia

Olivier Faure-Vincent
Finance Officer
France

Sabine Gabriel
Manager, Contracts
France

Secretariat

Roberto Garcia*
Fund Portfolio Manager
France

Michel Lavollay**
Senior Director
France

San Hamilton-Rousset
Assistant
France / United Kingdom

Michle Young
Assistant
France / United Kingdom

Beatrice Bernescut
Assistant
France / USA

Christoph Benn
Director, External Relations
Germany

Doris Dcruz-Grote**
CCM Coordinator
Germany

Nicole Delaney
Special Assistant to
the Chief of Operations
Germany

Tina Draser
Fund Portfolio Manager
Germany

Marion Hachmann-Gleixner
Program Officer
Germany

Martina Niemeyer
Assistant Operational Partnerships
Germany

Florian Prem
Manager Information Management
Germany

Christina Schrade
Advisor to the Executive Director
Germany

Bernhard Schwartlander
Director, Strategic
Information & Evaluation
Germany

Urban Weber
Cluster Leader
Germany

Global Fund Annual Report 2004

Hans Zweschper
Proposals Manager
Germany

Esther Odartey-Wellington
Executive Assistant
Ghana

William Wilson*
IT Officer
Ghana

Linden Morrison
Fund Portfolio Manager
Guyana

Marie-Stephane Gruenert
Assistant
Haiti

Marton Sziraczki
Program Officer
Hungary

Nazir Ahmed
Receptionist
India

Prerna Banati
Strategic Information Officer
India

Sudha Venkatram
Program Officer
India

Paul Lalvani
Manager, Procurement Services
India / USA

Houtan Afkhami
Assistant
Iran / USA

John Burke
Chief Administrative Officer
Ireland

Anne-Marie Byrne
Assistant
Ireland

Aisling Campbell
Human Resources Assistant
Ireland

Danielle Ferris
Assistant, Board Relations
Ireland

Barry Greene
Chief Financial Officer
Ireland

Julia Van Riel-Jameson

Administration Officer
Ireland

Mariangela Bavicchi**
Donor Relations
Italy

Bartolomeo Migone
Senior Legal Officer
Italy

Carl Manlan
Program Officer
Ivory Coast

Marie-Claire Ouattara
Assistant
Ivory Coast

Wilfred Thalmas
Assistant
Ivory Coast

Naboundou (Bintou) Toure

Assistant
Ivory Coast

Emiko Naka*
Manager
Japan

Mikiko Sawanishi
Fund Portfolio Manager
Japan

Eiichi (Ben) Seki**

Director, Portfolio Support & Policy
Japan

Hind Khatib Othman

Cluster Leader
Jordan

Jacqueline Adhiambo
Human Resources Assistant
Kenya

Annett Odhiambo
Assistant
Kenya

Roselyne Souvannakane
Fund Portfolio Assistant
Laos

59

60

Global Fund Annual Report 2004

Sandra Irbe
Fund Portfolio Assistant
Latvia

Doumit Abi-Saleh
Manager, Information Technology
Lebanon

Joseph Shaheen
PDF Forms Developer
Lebanon

Patricia Chatsika
Human Resources Assistant
Malawi

Aleph Henestrosa
Fund Portfolio Manager
Mexico

Sandii Lwin
Fund Portfolio Manager
Myanmar

Karin Nasheya
Assistant
Namibia

Lee Obomeghie*
Fund Portfolio Manager
Niger

Kingsley Moghalu
Manager, Global Partnerships
Nigeria

Elizabeth Hoff
Cluster Leader
Norway

Jon Liden
Head, Communications
Norway

Nilofar Mohideen Bawa

Finance Assistant
Pakistan

Arletty Pinel
Senior Advisor,
Grant Performance & Development
Panama

Valery Chernyavskiy
Fund Portfolio Manager
Russia

Mabingue Ngom
Cluster Leader
Senegal

ElHadj (As) Sy
Director, Operations
Policy & Country Support
Senegal

Sanja Gohre
Communications Officer
South Africa

Ntombekhaya Matsha
Officer, Private Sector & Civil Society
South Africa

Dianne Stewart
Manager, Board Relations
South Africa

Adele Sulcas
Private Sector Partnerships Officer
South Africa

Ricardo Lacort Monte*

Technical Officer
Spain

Rajesh Anandan
Manager, Private Sector Partnerships
Sri Lanka

Chrishan Thuraisingham
Fund Portfolio Manager
Sri Lanka

Ruwan De Mel
Manager Financial Support
Sri Lanka / Australia

Marie-Louise Rosencrantz*
Fund Portfolio Manager
Sweden

Anouk Affolter*
Assistant
Switzerland

Anne Eberle
Assistant
Switzerland

Gladys Lopatka
Assistant
Switzerland

Martin Straub*
Manager, Performance Matrix
Switzerland / Australia

Geofrey Bash*
Assistant
Uganda

Secretariat

Vinand Nantulya
Senior Technical Advisor
Uganda

John Ochero
Program Officer
Uganda

Tim Clark
Manager, Publications & Multi-Media
United Kingdom

Philippa Dobre-Carey
Assistant
United Kingdom

Anne Duke
Director, Human Resources
United Kingdom

Richard Feachem
Executive Director
United Kingdom

Hillary Hughes*
Fund Portfolio Manager
United Kingdom

Daniel Low-Beer
Senior Manager, Strategic
Information & Evaluation
United Kingdom

Mike Marchment**
Advisor, Operations Management
United Kingdom

David Powell
Fund Portfolio Manager
United Kingdom

Kate Thomson*
Civil Society Officer
United Kingdom

David Ball
Senior Finance Officer
United Kingdom / Switzerland

Duncan Earle
Cluster Leader
USA

Eric Godfrey
Senior Finance Officer
USA

Nicole Gorman
Program Officer
USA

Secretariat

Brad Herbert**
Chief of Operations
USA

Thomas Hurley
Cluster Leader
USA

Toby Kasper
Assistant
USA

Catherine Lijinsky
Assistant
USA

Alfred Nimocks* **
Event Coordinator
USA

Dexter Roberts
Assistant
USA

Paul Schumacher
Program Officer Analyst
USA

Jessie Schutte-Aine
Fund Portfolio Manager
USA

David Sullivan
Legal Officer
USA

Liz Tung
Operational Policy Officer
USA

Mark Willis
Fund Portfolio Manager
USA

Dustin Cosentino*
Assistant
USA / Canada

Nankhonde Kasonde
Fund Portfolio Manager
Zambia

Eleanor Tembo
Assistant
Zambia

Dorcas Mapondera
Assistant
Zimbabwe

Vector control through spraying with

insecticides forms part of a malaria
prevention program in Sri Lanka.

Supplies for outreach activities are divided

and packaged in a warehouse distribution
center in Bishkek, Kyrgyzstan.

Global Fund Annual Report 2004

Financial
Statements
2004
64

Report of the Independent Auditors

65

Statement of Financial Position

66

Statement of Activities

67

Statement of Cash Flows

68

Statement of Changes in Funds

69

Notes to the Financial Statements

63

64

Global Fund Annual Report 2004

Report of the Independent auditors

Financial Statements

Global Fund Annual Report 2004

Statement of Financial Position

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements

Statement of Financial Position

at 31 December 2004
In thousands of US dollars

Notes

2004

Restated
2003

ASSETS

Cash and bank balances

Funds held in trust

2.4, 3.1
2.4, 2.5, 3.1, 3.2

1881

225

2205078

1'741'968

Promissory notes

2.6, 3.3

237449

62460

Contributions receivable within one year

2.6, 3.4

93239

104182

5706

2'699

2543353

1911534

129204

146837

2672557

2058371

919047

610'885

4235

303

923282

611188

191040

272'340

Total LIABILITIES

1114322

883'528

FUNDS

1558235

1174843

Total LIABILITIES and FUNDS

2672557

2058371

Prepayments and miscellaneous receivables

Contributions receivable after one year

2.6, 3.4

Total ASSETS

LIABILITIES and FUNDS

Liabilities
Undisbursed grants payable within one year

2.7, 3.6

Accrued expenses

Undisbursed grants payable after one year

2.7, 3.6

The notes represent an integral part of the Statement of Financial Position

65

66

Global Fund Annual Report 2004

Statement of Activities

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements

Statement of Activities
for the year ended 31 December 2004
In thousands of US dollars

Notes

2004

Restated
2003

2.6, 3.5

1254688

1416650

33819

28'235

1288507

1444885

854368

1'063'304

50747

32'555

905115

1'095'859

383392

349026

INCOME
Contributions
Bank and trust fund income

2.9

Total INCOME

EXPENDITURE
Grants

2.7, 3.7

Operating expenses
Total EXPENDITURE

INCREASE IN FUNDS for the year

3.8

The notes represent an integral part of the Statement of Activities

Financial Statements

Global Fund Annual Report 2004

67

Statement of Cash Flows

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements

Statement of Cash Flows

for the year ended 31 December 2004
In thousands of US dollars

Notes

2004

2003

1101008

1330862

34329

28930

1135337

1359792

CASH FLOWS FROM OPERATING ACTIVITIES

Contributions received

3.5

Bank and trust fund income

Grants disbursed
Payments to suppliers and personnel

3.7

(
(

627506
43065

)
)

(
(

231,200
36,889

)
)

670571

268,089

CASH FLOWS FROM OPERATING ACTIVITIES

being the net increase in cash and cash equivalents

464766

1'091'703

CASH AND CASH EQUIVALENTS

at beginning of the year

2.4, 3.1

1'742'193

650'490

2.4, 3.1

2206959

1'742'193

CASH AND CASH EQUIVALENTS

at end of the year

The notes represent an integral part of the Statement of Cash Flows

68

Global Fund Annual Report 2004

Statement of Changes in Funds

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements

Statement of Changes in Funds

at 31 December 2004
In thousands of US dollars

Notes

Restated
2003

2004

FUNDS at the beginning of the year

as previously reported
Prior periods effect of change in accounting policy

727'108

FUNDS at the beginning of the year, restated

INCREASE IN FUNDS for the year
as previously reported
Change in accounting policy
INCREASE IN FUNDS for the year

FUNDS at the end of the year

98709

2.2, 2.6, 3.5

2.2, 2.6, 3.5

1174843

825817

383392

300898

48128

383392

349026

1558235

1174843

50
1558185

50
1174793

1558235

1174843

Attributed as follows:
Foundation capital
General Funds

The notes represent an integral part of the Statement of Changes in Funds

Financial Statements

Global Fund Annual Report 2004

Notes to the Financial Statements

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
1. Activities and Organization
The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is an
independent, non-profit foundation that was incorporated in Geneva, Switzerland on 22
January 2002. The purpose of the Global Fund is to attract and disburse additional resources
to prevent and treat AIDS, tuberculosis and malaria. The Fund provides grants to locallydeveloped programs, working in close collaboration with governments, non-governmental
organizations, the private sector, development agencies and the communities affected by
these diseases.
The Global Fund has been founded on the following principles:

Rely on local experts to implement programs directly;

Make available and leverage additional financial resources to combat the three
diseases;

Support programs that reflect national ownership and respect country-led

formulation and implementation processes;

Operate in a balanced manner in terms of different regions, diseases and

interventions;

Pursue an integrated and balanced approach covering prevention, treatment and

care, and support in dealing with the three diseases;

Evaluate proposals through independent review processes based on the most

appropriate scientific and technical standards that take into account local realities and
priorities;

Seek to establish a simplified, rapid, innovative grant-making process and operate in

a transparent and accountable manner based on clearly defined responsibilities. One
accountability mechanism is the use of Local Fund Agents to assess local capacity to
administer and manage the implementation of funded programs.

Financial contributions to the Global Fund are held in the Trust Fund for the Global Fund to
Fight AIDS, Tuberculosis and Malaria (the Trust Fund) until disbursed as grants or for
operating expenses. The Trust Fund is administered by the International Bank for
Reconstruction and Development (the World Bank), as Trustee. The responsibilities of the
Trustee include management of contributions and investment of resources according to its
own investment strategy. The Trustee makes disbursements from the Trust Fund only upon
written instruction of the Global Fund.
Most contributions are received directly in the Trust Fund. Some contributions for the benefit
of Global Fund are also received by the United Nations Foundation and are held in trust for
the Global Fund until subsequently transferred to the Trust Fund.
Personnel and administrative services to support the operations of the Global Fund are
provided by the World Health Organization (WHO) under an agreement between WHO
and the Global Fund. The Global Fund bears in full the cost of these personnel and services.
Funds remitted to WHO for this purpose are treated as funds held in trust by WHO for the
benefit of the Global Fund until an expenditure obligation is incurred.
These financial statements were authorized for issuance by the Board on 22 April 2005.

69

70

Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
2. Significant Accounting Policies
2.1 Statement of Compliance
The financial statements have been prepared in accordance with and comply with the
International Financial Reporting Standards issued by the International Accounting
Standards Board (IASB) and interpretations issued by the International Financial
Reporting Interpretations Committee (IFRIC).
These standards currently do not contain specific guidelines for non-profit
organizations concerning the accounting treatment and presentation of the financial
statements. Consequently Statement of Financial Accounting Standard (SFAS) 116:
Accounting for Contributions Received and Contributions Made has been applied
in respect of the recognition of contributions and grants.
2.2 Basis of Presentation
The financial statements are presented in US dollars, the Global Funds operating
currency, rounded to the nearest thousand. Management elected not to operate and
report in Swiss Francs, the domestic currency, as its cash flows are primarily in US
dollars.
The financial statements are prepared under the historical cost convention. The fair
value of non-current contributions receivable, promissory notes and undisbursed
grants has been determined as indicated in Notes 2.6 and 2.7.
The preparation of the financial statements requires that management make estimates
and assumptions that affect the reported amounts of assets and liabilities, disclosure
of contingent liabilities at the date of the financial statements, and reported amounts
of income and expenses during the reporting period. If in the future such estimates
and assumptions, which are based on managements best judgment at the date of the
financial statements, deviate from actual circumstances, the original estimates and
assumptions will be modified through the statement of activities as appropriate in the
year in which the circumstances change.
In 2004, the Global Fund has changed its accounting policy for the recognition of
contributions receivable, as further described in Note 2.6. This change in accounting
policy has been accounted for retrospectively. Comparative information in these
financial statements has been updated to reflect this change. The cumulative impact
of this change is an increase on prior years Funds of USD 147 million
(2002 : 99 million) as detailed in the Statement of Changes in Funds.
2.3 Foreign Currency
All transactions in other currencies are translated into US dollars at the exchange rate
prevailing at the time of the transaction. Monetary assets and liabilities in other
currencies are translated into US dollars at the year-end rate.

Financial Statements

Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
2. Significant Accounting Policies (continued)
2.4 Cash and cash equivalents
The Global Fund considers that cash and cash equivalents include cash and bank
balances and funds held in trust that are readily convertible to cash within three
months.
2.5 Funds held in Trust
The financial statements include funds that are held in trust solely for the benefit of
the Global Fund by the World Bank, the World Health Organization and the United
Nations Foundation.
Assets held in trust by the World Bank are maintained in a commingled investment
portfolio for all of the trust funds administered by the World Bank. These
investments are actively managed and invested in high-grade instruments according
to the risk management strategy adopted by the World Bank. The objectives of the
investment portfolio strategy are to maintain adequate liquidity to meet foreseeable
cash flow needs, preserve capital (low probability of negative total returns over the
course of a fiscal year) and maximize investment returns.
The returns on funds held in trust are accounted for on an accruals basis.
2.6 Contributions
In accordance with SFAS 116 contributions governed by a written contribution
agreement are recorded as income when the agreement is executed. Other
contributions are recorded as income upon receipt of cash or cash equivalents, at the
amount received.
Contributions are considered received when remitted in cash or cash equivalent, or
deposited by a sovereign state as a promissory note, letter of credit or similar
financial instrument.
Contributions receivable under written contribution agreements executed on or
before the date of the statement of financial position but which have not been
received at that date are recorded as an asset and as income. Contributions and
promissory notes receivable later than one year after the date of the statement of
financial position are discounted to estimate their present value at this same date. In
previous years, contributions receivable later than one year after the date of the
statement of financial position were not recorded as an asset or income; in the light of
favourable collection experience and to better reflect the Global Funds financial
position, such contributions are recorded as an asset and as income in 2004, as
mentioned in Note 2.2.
Foreign currency exchange gains and losses realized between the date of the written
contribution agreement and the date of the actual receipt of cash and those
unrealized at the date of the statement of financial position are recorded as part of
Contribution income.

71

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Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
2. Significant Accounting Policies (continued)
2.6 Contributions (continued)
Non-cash contributions donated in the form of goods or services (in-kind
contributions) are recognized at the time of receipt and reported as equal
contributions and expenses in the Statement of Activities, at their estimated economic
value to the Global Fund.
2.7 Grants
All grants are governed by a written grant agreement and, in accordance with SFAS
116, are expensed in full when the agreement is executed.
Grants or portions of grants that have not been disbursed at the date of the statement
of financial position are recorded as liabilities. The long-term portion of such
liabilities represents amounts that are due to be disbursed later than one year after
the date of the statement of financial position, discounted to estimate its present value
at this same date.
2.8 Local Fund Agent Fees
Fees to Local Fund Agents to assess local capacity prior to and during grant
negotiation, and to manage and monitor implementation of funded programs as
grants are disbursed, are expensed as the work is completed.
2.9 Bank and Trust Fund Income
Bank and trust fund income includes deposit interest on bank balances and realized
gains and losses on investments and currencies on funds held in trust.
2.10 Employee Benefits
All personnel and related costs, including current and post employment benefits, are
managed by the WHO and charged in full to the Global Fund, apart from
insignificant incidental costs borne directly by the Global Fund. There are no
unfulfilled obligations for employee benefits outside of the Global Funds obligations
to the WHO.

10

Financial Statements

Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements

3. Details relating to the financial statements

In thousands of US dollars
3.1 Cash and Cash Equivalents

Cash and bank balances

Funds held in Trust

2004
1881
2205078
2206959

2003
225
1741968
1742193

2004
2192288
12154
636
2205078

2003
1729149
12567
252
1741968

2004
216201

2003
52773

21248
237449

9687
62460

237449
237449

62460
62460

2004
201516

Restated
2003
236420

20927
222443

14599
251019

93239
129204
222443

104182
146837
251019

3.2 Funds held in Trust

World Bank
World Health Organization
United Nations Foundation

3.3 Promissory Notes

Promissory notes to be encashed

Unrealized gains on foreign currency
promissory notes to be encashed

Maturing in 2004
Maturing in 2005

3.4 Contributions receivable

Contributions receivable*
Unrealized gains on foreign currency
contributions receivable
Total contributions receivable
Receivable within one year
Receivable after one year

* Comprises amounts receivable under written contribution agreements executed on or

before 31 December 2004 and 2003 respectively that had not been received at that date.

11

73

74

Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
3. Details relating to the financial statements (continued)
In thousands of US dollars
3.5 Contributions

Governments
Private sector
Total contributions

Cash received including encashed

promissory notes
Increase in promissory notes
to be encashed
Increase / (decrease) in contributions receivable
Contributions in kind
Total contributions

2004
1195170
59518
1254688

Restated
2003
1314795
101855
1416650

1101008

1330862

174989

10620

28575 )
7266
1254688

75168
1416650

The effect of the change in accounting policy for contributions, as referred to in notes 2.2 and
2.6, is an increase in contributions of USD 48 million for the year ended 31 December 2003
(2002: USD 99 million).

3.6 Undisbursed grants payable

Payable within one year

Payable after one year

2004
919047
191040
1110087

2003
610'885
272'340
883225

2004
627506
226862
854368

2003
231200
832104
1063304

3.7 Grants
Disbursed in the year
Movement in undisbursed grants
Grant expense

12

Financial Statements

Global Fund Annual Report 2004

75

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
3. Details relating to the financial statements (continued)
In thousands of US dollars
3.8 Operating expenses
2004
Secretariat expenses
Personnel
Trustee fee
Administrative services fee
Other professional services
Travel and meetings
Communication materials
Office rental
Office infrastructure costs
Other

2003

16854
2150
982
3521
4673
7728
754
1376
533
38571
12176
50747

Local Fund Agent fees

9793
1870
900
2078
3750
966
509
998
1572
22436
10119
32555

Included in Operating expenses above are contributions in kind amounting to

USD 7.3 million which have been attributed to Other professional services for
USD 0.7 million and to Communication materials for USD 6.6 million. In 2003,
contributions in kind were not included in the financial statements as they were not
material.
3.9 Personnel
As described in Note 1, personnel to support the operations of the Global Fund are
provided by the WHO under an agreement between the WHO and the Global Fund.
At 31 December 2004 there were 127 personnel assigned to the Global Fund
(2003: 96). Of these, 74 (2003: 55) are assigned under fixed-term contracts, typically of
two years duration. All other personnel are assigned under contracts of shorter
duration.
3.10Taxation
The Global Fund is exempt from tax on its activities in Switzerland.
3.11Commitments
At 31 December 2004, the Global Fund has the following outstanding operating lease
commitments:
Year
2005
2006
2007
2008
2009
Beyond 2009

Office space
988
677
677
677
677
1635

Office equipment
19
19
19
15
7
-

Vehicle
1
-

5331

79

13

76

Global Fund Annual Report 2004

Notes to the Financial Statements (continued)

The Global Fund to Fight AIDS, Tuberculosis and Malaria

Financial Statements
4. Financial Instruments
As described in Note 2.5, those funds held in trust by the World Bank, acting as Trustee for
the Global Fund, are actively managed and invested in a commingled investment portfolio in
accordance with the investment strategy established for all trust funds administered by the
World Bank.
Other than those funds held in trust by the World Bank, as mentioned above, the Global Fund
employs the following risk management policies to financial instruments:
Currency risk: The risk that the value of a financial instrument will fluctuate due to
changes in foreign exchange rates. The Global Fund does not hedge its exposure risk on
foreign exchange as it operates primarily in US dollars.
Interest rate risk: The risk that the value of a financial instrument will fluctuate due to
changes in market interest rates. The Global Fund does not use derivative financial
instruments to reduce its exposure risk on interest from variable rate bank balances and
funds held in trust.
Market risk: The risk that the value of a financial instrument will fluctuate as a result of
changes in market prices whether those changes are caused by factors specific to the
individual security or its issuer or factors affecting all securities traded in the market. The
Global Fund has assigned the management of market risk primarily to the Trustee, and
does not use derivative financial instruments to reduce its market risk exposure on other
financial instruments.
Credit risk exposures: Credit risk results from the possibility that a loss may occur from
the failure of another party to perform according to the terms of a contract. The Global
Fund does not use derivative financial instruments to reduce its credit risk exposure.
The Global Funds maximum exposure to credit risk in relation to cash and bank balances,
funds held in trust, promissory notes and contributions receivable is the carrying amount
of those assets as indicated in the statement of financial position. The Global Fund places
its available funds with high quality financial institutions to mitigate the risk of material
loss in this regard. With respect to the Global Funds contributions receivable,
management believes these will be collected as they result from mutually signed
contribution agreements primarily with governments.

5. Comparative financial information

Certain comparative balances have been itemized for compliance with the current year
presentation. Except for the effect of change in accounting policy as identified under Notes
2.2 and 2.6, there is no other impact on the Statement of Changes in Funds.

14

Credits
Cover: Didier Ruef, www.pixsil.com. P2 Gideon Mendel. P4 Gary Hampton. P6 John Rae.
P13 Yoshi Shimizu. PP14/15 Gideon Mendel. P17 Jan Van der Hombergh, WHO. P18 Pierre
Virot, WHO. P20 John Rae. P23 John Rae. P29 Credit Yoshi Shimizu. P30 John Rae. P39 Virginia
Arnold, WHO. P42 Yoshi Shimizu. P53 Gideon Mendel. P61 John Rae. P62 John Rae. P77 John
Rae.
This Page
A Global Fund grant finances testing and treatment of sexually transmitted diseases
and HIV at Hospital Dermatovenerlogic outside Chisinau, Moldova.
Design
Giampietro+Smith, New York

THE GLOBAL FUND

TO FIGHT AIDS, TUBERCULOSIS & MALARIA
53 Avenue Louis Casa
1216 Cointrin
Geneva, Switzerland
+ 41 22 791 1700 (phone)
+ 41 22 791 1701 (fax)
www.theglobalfund.org
[email protected]

Cover Photograph: Didier Ruef