How a new funding model will shift allocations from the Global Fund to Fight AIDS, tuberculosis, and malaria.
Policy makers deciding how to fund global health programs in low- and middle-income countries face important but difficult questions about how to allocate resources across countries. In this article we present a typology of three allocation methodologies to align allocations with priorities. We then apply our typology to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. We examined the Global Fund's historical HIV allocations and its predicted allocations under a new funding model that creates an explicit allocation methodology. We found that under the new funding model, substantial shifts in the Global Fund's portfolio are likely to result from concentrating resources in countries with more HIV cases and lower per capita incomes. For example, South Africa, which had 15.8 percent of global HIV cases in 2009, could see its Global Fund HIV funding more than triple, from historic levels that averaged 3.0 percent to 9.7 percent of total Global Fund allocations. The new funding model methodology is expected, but not guaranteed, to improve the efficiency of Global Fund allocations in comparison to historical practice. We conclude with recommendations for the Global Fund and other global health donors to further develop their allocation methodologies and processes to improve efficiency and transparency.
Victoria Y. Fan (vfan@post.harvard.edu) is an assistant professor in the Department of Public Health Sciences and Epidemiology at the University of Hawaii at Manoa, in Honolulu, and a research fellow at the Center for Global Development, in Washington, D.C.
Victoria Y
VY
Fan
Amanda Glassman is director of global health policy and senior fellow at the Center for Global Development.
Amanda
A
Glassman
Rachel L. Silverman is a policy analyst at the Center for Global Development.
Rachel L
RL
Silverman
D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000191:economics; D014943:Global Health / Q000191:economics*; D015658:HIV Infections / Q000628:therapy*; D061889:Healthcare Financing; D006801:Humans; D008288:Malaria / Q000628:therapy*; D017146:Models, Organizational; D040841:Resource Allocation / Q000379:methods / Q000458:organization & administration*; D014397:Tuberculosis, Pulmonary / Q000628:therapy*
AIDS/HIV; Financing Health Care; Health Economics; Health Spending; International/global health studies