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  • Ghana receives first Global Fund grants

After a faltering start, the Global Fund to Fight AIDS, Tuberculosis and Malaria — a public-private partnership set up last year by leaders of the world's eight most powerful nations — has signed its first two grant agreements.

The grants will provide US$4.2 million and US$2.3 million for programmes in Ghana against AIDS and tuberculosis, respectively. But a US$12-million grant for a Tanzanian malaria programme to encourage the use of impregnated bed-nets, which was also due to be signed last week, has stalled over political disagreement over how the money should be handled.

The Ghanaian grants, which were finalised on 22 November, will provide antiretroviral therapy and tuberculosis treatment as well as funds for mother-to-child transmission prevention programmes and 16 HIV/AIDS counselling and testing centres.

"We must work together to fight these diseases," says Chrispus Kiyonga, chairman of the Fund's Board. "Ghana shows the world that public and private partners can work together to deliver international assistance from donors and to deliver results on the ground in developing countries."

The Tanzanian agreement would have allowed pregnant women vouchers to purchase bed nets at reduced cost. But the deal fell through after Tanzania's Finance Ministry said it would control the money instead of the Health Ministry, as designated in its original proposal.

''It's important that the fund be held accountable. We are better off for not signing the agreement,'' a fund official, speaking on condition of anonymity, told the Boston Globe. 'What happened is disappointing, but at the same time, I'm happy the fund will not acquiesce for the sake of signing a grant agreement.''

But others argue that, in principle, it is important to begin releasing the money as soon as possible. “There must be financial accountability but this cannot be put before saving millions of lives,” says Fred Binka, a malaria scientist at the University of Ghana.

The Global Fund has given initial approval for, but not yet finalised, grants of US$616 million for 40 countries in its first call for proposals. Ironically, it is criticism of the haste with which the initial proposals were called for that has led to the delay in finalising grants for the chosen projects (see Global fund attacked for excessive haste).

Richard Feachem, executive director of the Fund, has said that his “first priority has been disbursement of this first round”. To this end he has chosen four “fast track” countries as the first recipients of the 40 approved proposals: Ghana, Tanzania, Sri Lanka and Haiti.

The four have been chosen because of the prevalence of all of the three diseases in each, their common use of a public and private mix in health service provision, and their use of different local fund agents who are charged with managing and monitoring the grants — “the Global Fund’s eyes and ears”, says Feachem.

A grant for HIV/AIDS in Haiti should be signed "any time now", says Mariangela Bavicchi, external relations manager at the Global Fund. Tuberculosis and malaria agreements in Sri Lanka are also expected to be signed within the next few weeks, but Bavicchi says that no new timetable had been set so far for the Tanzanian deal.

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