Key Takeaways: The Global Fund’s 38th Board Meeting

The following are some key takeaways from the Global Fund’s 38th Board Meeting, held on November 14-15, in Geneva.

1. Selection of Peter Sands as new Executive Director

The main action of the November 14-15, 2017, Global Fund Board meeting was selecting a new Executive Director: Peter Sands. Originally from the United Kingdom, Mr. Sands worked for the UK government’s Foreign and Commonwealth Office before joining McKinsey and Company. He held both director and executive positions at Standard Chartered Bank. Subsequently, he joined the National Academy of Medicine’s Commission on Global Health Risk Framework as Chairman. During his tenure as the Chair of the World Bank Group’s International Working Group on Financing Preparedness earlier this year, he contributed to the report, “From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at a National Level.” Succeeding Dr. Mark Dybul, who completed his term in May, and taking over from Interim Executive Director Marijke Wijnroks, Sands was selected by the Global Fund Board with broad support from a field of four finalists including Anil Soni of Mylan, Dr. Frannie Leautier, formerly of the World Bank, and Simon Bland of UNAIDS.

Friends will assist with Mr. Sands’ introduction to the Washington community and Capitol Hill.

2. Countries To Fund, and Their Ownership

One major area of discussion was criteria and conditions for grants from the Global Fund, which total approximately $4 billion each year.

• Eligibility: The Board discussed a policy of considering income level as a primary indicator for grant eligibility (along with disease burden), excluding countries of middle-income status and above, and those in the G-20.  After deliberations, it appears likely that this policy will be affirmed at the next Board meeting.
• Domestic Finance: Requiring co-financing has spurred $1.7 billion of domestic investment by implementing nations for 2015-2017, and $3.4 billion more for 2018-2020. Following through on penalties for noncompliance, the Fund plans to dock three countries’ allocations.
• Transition: On preparing nations for graduating from grants (based on GNI level), several Board constituencies spoke out on human rights, Country Coordinating Mechanisms (CCMs), and civil society’s vital role in viable transitions.

3. Accountability

Continued progress on accountability was a central theme:

• Codifying Policy: The Board adopted a Fraud and Corruption Policy evolving from longstanding practice, bolstering prevention – to accompany audits and successful recovery of misused funds (e.g. $2.8 million of them from Nigeria).
• Whistleblowers: The “I Speak Out Now!” Campaign has documented efforts to encourage whistleblowers to come forward without fear to identify misuse of funds in implementing countries.
• CCM Conflict of Interest Policy: The Board adopted a policy to deter conflicts of interest arising between authorities, partners, and civil society in CCMs.

4. Budget and Strategic Priorities

The Board reviewed progress on the 2017-2022 Strategy, and adopted a 2018 budget premised on:

• Putting grants first (constituting 88 percent of resources for 2017-2019), with Board approvals based on weighing “risk appetite” (assessing which nations need investments despite governance challenges and other risks).
• Holding the operating budget to an average of $300 million over the next three years (2017-2019), while approving for 2018 an increase of up to $12 million for a move into a new facility. To be shared with Gavi, the Vaccine Alliance (which is also sharing the cost), as well as partners such as Stop-TB Partnership, the new facility will save the Fund an estimated $57 million within 10 years, breaking even on outlays within five years.
• Not enlarging staff, but seeking efficiencies by continuing Wijnroks’ “Fit for the Future” initiative.

5. The Board’s Central Role

The Board sustained or adopted practices to leaven its unique multi-stakeholder governance. These include:

• Leaders: The Board articulated a strategy of selecting its leadership as a package, choosing people to serve as Board officers with complementary qualities rather than choosing each in isolation.
• Voice for New Donors: It adopted a policy to attract new public sector donors (including some previous grant recipients) by offering a rotating Board seat.
• Same Oversight, Less Paper: It backed the streamlining of documents shared with Board Committees for their oversight and decisions in order to prioritize staff effectiveness.

6. Initiatives

Among initiatives the Interim Executive Director and her team highlighted were:

• Missing TB cases: The Fund will prioritize finding the 40 percent who don’t get care among the 10 million new active TB cases that occur each year. (Eighty percent of those missing are in 14 African and Asian nations.)
• Gender: The Fund is scaling efforts to reach and empower vulnerable adolescent girls and young women – advancing the HER Voice Fund in 13 Eastern and Central African nations. PEPFAR’s Global AIDS Coordinator, Amb. Deborah Birx, hailed close coordination and synergies between the DREAMS partnership for women and girls, and these Global Fund efforts.