Special Advisor for Global Health Partnerships Addresses Complexities of Global Health Funding

Shatreen Masshoor, Yale College ’12

As part of the Global Health Seminar series, Special Advisor for Global Health Partnerships under the U.S. Department of State, John Monahan recently spoke at Yale. During his talk, he highlighted that the U.S. is the largest donor to the Global Fund, in their partnership with the Global Fund to Fight AIDS, tuberculosis and malaria. With 3.2 million people receiving antiretroviral treatment, 8.2 million cases of tuberculosis treated and detected, and over 190 million bed nets distributed, the Global Fund results are staggering.

As a student interested in global health, I had never realized the interdependence of U.S. government bilateral programs and Global Fund initiatives. For example, the Global Fund allows for purchases of antiretroviral drugs, while PEPFAR (President’s Emergency Plan for AIDS Relief) has programs that support test kits, training, and delivery of these antiretrovirals to patients.

Juxtaposed with these examples of successful initiatives were questions about the Global Fund. In recent months, the Global Fund was rocked by scandal regarding mismanagement of funds. Monahan addressed this by discussing how the High-Level Independent Review Panel on Fiduciary Controls and Oversight Mechanism was convened. This panel was formed to assess the current management of funds within the Global Fund and to make recommendations. Monahan echoed the panel’s sentiment that the “failure of the Global Fund would be a global health catastrophe.” Both the panel and Monahan recognized that three trends would create change within the Global Fund: austerity, accountability, and innovation.

After hearing Monahan speak, I emerged with a better understanding of the relationship between the United States and the Global Fund, as well as a sense that the Global Fund is attempting to reform itself. As such powerful players in the global health field, both the United States government and the Global Fund must be self-reflexive and open to reform, to ensure sustained advances in global health.

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