Public HealthThe Global Fund: managing great expectations
Section snippets
Approach
We are tracking early implementation of the Global Fund in four sub-Saharan African countries: Mozambique, Tanzania, Uganda, and Zambia. Table 1 summarises the burden of disease due to HIV/AIDS, tuberculosis, and malaria in these countries and the outcome of country applications for Global Fund support. We selected these countries on the basis of high burden of disease and poverty, submission of proposals to the Global Fund in round one, support from senior government officials, and study
Participant's views
After three application rounds, all four countries were approved for high levels of support to fight the three diseases (table 1). Despite the positive effect that additional money could have on resource-starved systems, the Global Fund received a mixed welcome in these countries. Governments and non-governmental organisations (NGOs) were most positive. For example, a government respondent in Zambia reported that “the beauty of the process from a country perspective is that it is country led.
Early lessons
The Global Fund is an evolving initiative, which has made a major financial commitment to help countries to tackle HIV/AIDS, tuberculosis, and malaria. Still at an early stage, it is too soon to estimate its effectiveness. Rapid learning and applying lessons to get country-level processes right, are essential to achieving the Fund's goals. For example, the Fund now acknowledges that countries operating sector-wide approaches were not always clearly informed that this was a channel through which
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