NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Friday, March 8, 2013

Amid an increasingly complex fiscal environment in Washington (i.e. the newly-triggered sequester and the soon-to-expire FY13 continuing resolution), I can’t help but think about the tough trade-offs the Office of Management and Budget (OMB) must be considering as they finalize the President’s FY14 budget request to Congress, expected to be released in mid-March. From an economics perspective, I appreciate careful consideration of these trade-offs. But from a health economics perspective, I have concerns about what cuts will mean for critical US investments in the global fight against AIDS, TB and Malaria. For reasons that have mostly to do with timing, coming in low on the Global Fund for AIDS, TB and Malaria request for FY14 could spell disaster.

After a year-long period of upheaval, the Global Fund — and its new executive director, Mark Dybul — is well positioned to consolidate gains from a myriad of recent reforms, including a strengthened fiduciary and financial system, and a new funding model designed to improve the process for grant proposal and allocation. Together, these changes have won back the confidence of many of the Fund’s donors and stakeholders.

And just in time, as these stakeholders will be asked to make new commitments to replenish the Global Fund later this year. These pledges determine the amount of funding that will be available to Global Fund grant recipients for the next three years — and will also dictate the Global Fund’s ability to realize the potential gains from their reforms.