International AIDS Conference in Barcelona, Spain.

Because this was the first round of funding from a
new organization, there were bound to be some problems with the process. Many NGOs participating
in the process said that the proposal form was too complicated and that the guidelines on how to fill
out the forms were insufficient. The proposal form and guidelines are being revised for the next
round of funding and should be released in advance of the XIV International AIDS Conference in
Barcelona, Spain.
The NGOs said that the timelines were very
tight and that the process was therefore too
rushed. This negatively affected the quality of
some proposals. The Global Fund has
indicated that countries will have at least two
months to prepare proposals for the next
round.
The NGOs also said that the call for proposals
should have been more aggressively
publicized, and that many organizations did
not have the opportunity to participate,
particularly in the rural areas of Africa where
Internet access is limited.
H ow F a s t S h o u l d t h e F u n d b e Mo v i n g ? There was some tension at the
Fund’s April 2002 Board meeting between delegations that wished to move quickly and approve as
many proposals as possible, and delegations that wanted to move more slowly. Developing countries
spoke of the need for a rapid response to the epidemic and wanted the Global Fund to send a clear
message to the world that it would respond as quickly and in as many different locations as possible.
Most developed countries and the private sector delegation urged a slower process to ensure that no
mistakes are made in disbursing funds and monitoring projects. The latter group wanted fewer
projects approved in the first round, but their view did not prevail.
A u t h e n t i c i t y o f C CMs During the first round, concerns were raised about whether
all of the proposals were coming from authentic CCMs. Because of the tight timelines, the CCMs hadto be formed in a hurry, so there was little consistency in the types of CCMs that resulted. Some of
the CCMs were more effective in including NGOs than others. At the Board meeting, several
delegations argued for a more rigorous approach to CCM verification. This issue was not resolvedThere appeared to be some
reluctance on the part of countries to request funding for antiretroviral treatments in their
proposals. It was difficult to obtain information about how many of the proposals included
antiretroviral treatment for HIV/AIDS. This issue was raised at the Board meeting by the NGO
delegations, the delegation of Communities Living with HIV, TB and Malaria, and the country
delegations from Brazil and France. In a briefing given prior to the Board meeting, civil society
delegations were told that only seven of the approved proposals specifically indicated the number of
people living with HIV/AIDS who would be covered by the provision of antiretroviral treatments. (The
seven proposals do not include the proposals requesting funding for antiretrovirals for the prevention
of mother-to-child transmission.) The seven proposals would provide treatment for less than 40,000
people.
At the Board meeting, there was a motion to require all countries to include treatment in their
proposals, and another motion to issue a specific call for treatment proposals. Neither motion passed.
However, the Board did adopt a motion requiring countries to justify their proposals, especially when
treatment is excludedOne of the goals of the Global Fund is to
maximize the number of lives saved per dollar spent. Concerns were raised about the inherent
tension between this goal and the investment required to treat HIV and other diseases in the
developing world. While some people may not view treatment programs as cost-effective in this
context, these programs nevertheless are a required component of a truly effective response to
HIV/AIDS.
T r e a tme n t Mo n i t o r i n g The delegation of the Communities Living with HIV,
Tuberculosis and Malaria expressed concerns that currently the Global Fund is not collecting
information on the number of people who will receive treatment in a given proposal, or on the
specific medications included in the proposal. The delegation moved that applicants provide such
information when they file their proposal and then on a yearly basis (for funded proposals). The
motion was defeated.