At a roundtable organised on Wednesday by the Council on Foreign & Relations here, Zewdie stated that after being forced to weather a & scandal last year and the ongoing international economic downturn, & the Global Fund is once again receiving substantial & commitments from & bilateral donors.&

A day after the news was officially disclosed to the Global Fund's & governing board, Zewdie announced new or renewed multi-year funding & promises from Germany, Japan, Spain and the UK. The Global Fund's & most significant donor, the United States, has maintained its backing & throughout the difficulties of the past year. &

"Dr. Zewdie delivered a clear message that the Global Fund's & transformation is well underway, with a strong new focus on & impeccable grant management," Mark Isaac, interim president of & Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, & told IPS.&

"She also underscored how critical ongoing U.S. leadership is to & ensuring support from other nations and to reaching those most in & need around the world with lifesaving services." &

The Global Fund began operating in 2002 with the expressed aim of & operating differently from other such multilateral funders. It was to & be a simple, straightforward organisation with a simple, & straightforward mandate: to disburse funding with the aim of treating & and preventing HIV/AIDS, tuberculosis and malaria. &

Quickly attracting some of the biggest names in international & philanthropy and celebrity, the impact and example of the Global Fund & on global health over the past decade would be difficult to & overstate. As of last year, the organisation had approved funding of & some 23 billion dollars. Today, it is operating in 150 countries, & with a particular focus on sub-Saharan Africa. &

Further, the Global Fund's activities have been on the increase. & Around 80 percent of its funding dispersal has taken place within the & last five years. &

Today, it is the world's largest grant-making body working on the & three diseases under its remit. &

Alongside this massive ramping up, however, the Global Fund has & inevitably become a complex behemoth. "When the Global Fund was & created, it was supposed to be simple," Zewdie said in Washington. & "It's nothing like that now."&

The Global Fund's complexity appears to have led to an inability to & adequately oversee its massive operations. &

In January 2011, the Associated Press news agency, utilising data & from the Global Fund's own inspector general, published allegations & that the Global Fund was losing tens of millions of dollars due to & mismanagement and corruption. According to that data, up to two-& thirds of grant monies for certain projects was being lost to various & types of fraud. &

Additional allegations of poor oversight and shoddy management came & to light following the initial publication. &

The news led the European Commission and several European countries & to announce that they would be withholding nearly 450 million & dollars, pending investigation. &

The results quickly amassed, with the most dramatic ramification & coming in November 2011. At that time, because some 2.2 billion & dollars in pledged donor contributions had not materialised, the & Global Fund's governing board announced that it would be cancelling & the next scheduled round of grant dispersal.&

Since then, many have begun warning that the significant strides that & have been made in recent years against each of these diseases were in & danger of being rolled back. Zewdie's comments on Wednesday coincided & with the marking of World Malaria Day, the theme of which this year & is "Sustain Gains, Save Lives", clearly underlining the building & anxiety.&

The Global Fund has been adamant that, although the mid-term future & of its efforts has been in danger during the contribution slowdown, & the multi-year structuring of its programmes means that on-the-ground & services have not experienced negative impacts.&

According to a new report funded in part by the Clinton Health Access & Initiative, however, 91 percent of cases of malaria resurgence over & the past eight decades have been due to weakened control programmes, & typically due to funding cuts.&

The recent turnaround in donor sentiment is undoubtedly motivated at & least in part by significant restructuring plans being implemented & within the Global Fund. &

The agency is currently halfway through a twofold plan aimed at & dealing with issues of complexity and mismanagement. Zewdie reported & that while the Global Fund's grant-making monies used to be evenly & split between administrative and programmatic costs, an expedited 60-& day overhaul resulted in administrative costs being cut down to a & quarter of the total.&

In addition, the agency has moved to shift its focus to what those & areas deemed "high impact", following a realisation that resources & were not going only to those countries most in need. The total number & of staff – previously around 600 – will also be reduced.&

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