On results reporting and evidentiary standards: spotlight on the Global Fund

The Lancet
May 11, 2019 Volume 393 Number 10184 p1911-2008


On results reporting and evidentiary standards: spotlight on the Global Fund
Rocco Friebel, Rachel Silverman, Amanda Glassman, Kalipso Chalkidou
Examining publicly available documents for 2018, it is our judgment that the Global Fund’s results reporting is insufficiently rigorous to inform the allocation of scarce resources (results reports from previous years are no longer available through the Global Fund website, making it difficult to compare this document to previous iterations). Most obvious is the question of attribution. In its results reporting and communication materials, the Global Fund conflates two ideas about its own nature. First, the Global Fund is presented as a partnership, encompassing every funder, government, non-governmental organisation, implementer, and private actor involved in treating or preventing the three diseases in eligible countries. And second, the Global Fund operates as a standalone funding instrument with an annual budget of roughly $4 billion. The results reporting explicitly takes credit for the accomplishments of the partnership, including bilateral mechanisms like the President’s Emergency Plan for AIDS Relief and the President’s Malaria Initiative, plus domestic government investments. However, the replenishment will advocate for investment in the Global Fund as a funding instrument, attracting resources that could otherwise be channelled elsewhere in the partnership through alternative bilateral or multilateral mechanisms. How can results reporting without direct attribution to the Global Fund as a standalone institution support continued institutional investment? With domestic resources growing faster than development assistance for some priority conditions, such as HIV/AIDS, attribution across all payers—national, international, public, and private—becomes even more difficult to justify…