Having recently been through a triple crisis (fiduciary, financial and managerial), the Global Fund is undergoing a process of “transformation.” Several reports and articles have been published about how the Global Fund should change. However, there has been generally little discussion about how the transformation of the Global Fund should accommodate its commitments and responsibilities towards aid effectiveness (AE) and health systems strengthening (HSS). This report changes that by first providing a detailed history of the Global Fund's engagement with AE and HSS, and by then discussing how AE and HSS should inform the Global Fund’s transformation agenda.
The triple crisis that has hit the Global Fund has left its various AE and HSS initiatives hanging in the balance. Three themes that are currently influencing the Global Fund’s transformation agenda are shifting the Global Fund back towards becoming more vertical, top-down and donor-centric; even more concerned with the selective delivery of selective services; and increasingly concerned with being able to attribute results to itself. The three themes are: (1) financial austerity; (2) stronger performance-based funding; and (3) fiduciary risk and financial management.