The Global Fund under Peter Sands

The Lancet
Mar 10, 2018 Volume 391 Number 10124 p911-998  e7-e8

The Global Fund under Peter Sands
The Lancet
Within the space of a few short weeks, the reputation of Peter Sands, incoming Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, has gone from respected to reckless according to some critics. In an Offline column last November, The Lancet’s Editor offered an unreserved welcome to Sands, praising his “credibility” and “refreshing new vision”. Sands had assiduously built a compelling argument for governments to take the economic costs of infectious diseases more seriously. His background as the former CEO of Standard Chartered strengthened his case still further. But then Heineken hit the headlines.

Before Sands had even taken up his appointment, he was being implicated in the decision by the Global Fund to enter into partnership with, among others, the alcohol beverage manufacturer, Heineken. Photographs of Sands shaking hands with company executives caused dismay among global health advocates. An open letter from a group of civil society organisations, led by Katie Dain (Executive Director of the NCD Alliance and a member of WHO’s Independent Global High-Level Commission on NCDs), pointed out that such an alliance “redirects attention from the costs of harmful use of alcohol and positions Heineken to governments, the public, and the global community as a legitimate partner in implementing sustainable development solutions”.

Peter Sands’ response has been robust. He accepts that the broader global health community is sceptical of the value of partnerships with businesses such as Heineken. He is willing to listen to critics. But he is also unapologetic about engaging with the private sector. Partnerships with business will be his signature raison d’être.

Sands is pursuing a strategy of constructive disruption at the Global Fund. A shake-up is welcome. The Global Fund needs new energy and thinking. But alienating large parts of the global health community, with whom the Global Fund should be forging productive alliances, is an error. Sands needs to take a remedial course on global health diplomacy and balance his passion for the private sector with respect for the pluralism of the global health community. The diversity of global health is a strength for the Global Fund. Draw on it, don’t dismiss it.