The Global Fund to Fight AIDS, Tuberculosis, and Malaria: U.S. Contributions and Issues for Congress

Tiaji Salaam-Blyther
Specialist in Global Health


The Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund, or the Fund) was established in 2002 as a public-private partnership that could provide significant financial support for global responses to HIV/AIDS, tuberculosis (TB), and malaria. As of May 28, 2010, the Global Fund has committed to grant roughly $19.3 billion for related programs in 144 countries. These funds have been used to treat more than 2.5 million HIV-positive people, about 6 million people infected with active TB, and 107.8 million cases of malaria, saving nearly 5 million lives. 

The United States has strongly supported the Global Fund since making a founding pledge in 2001, serving on several Global Fund boards, donating more to the Global Fund than other country, and increasing those contributions annually since FY2005. Donors will meet on October 4, 2010, to make their pledges for the Global Fund over the next three years. Should the United States provide 25% of the Global Fund's budget, as it has done on average since the Global Fund was founded, annual U.S. donations would reach between $3.25 billion and $5 billion in each year from 2011 through 2013. Many urge Congress to meet the Global Fund's budget request, in large part because key donors have begun to follow the lead of the United States in setting their annual contributions. Although the 111th Congress has continued to support the Fund, it has begun to consider other factors that might affect appropriations levels. Such issues include the following: 

• Priorities of the Obama Administration—When President Barack Obama announced the Global Health Initiative (GHI), he expressed his intent to reshape U.S. global health policy so that global health efforts were better integrated and coordinated. The GHI also emphasizes other health priorities, such as neglected tropical diseases and maternal and child health. The FY2011 budget request for GHI includes a $50 million decrease for the Global Fund from FY2010-enacted levels and a 3% increase for bilateral and multilateral HIV/AIDS programs. 

• Funding trends for HIV/AIDS—Health experts have long debated the appropriate balance of funding for HIV/AIDS prevention and treatment efforts. The debate has been reignited, as evidence indicates that international goals to ensure universal access to AIDS prevention, treatment, and care will not likely be met. Some question whether the massive funds spent on AIDS treatment would be better spent on less expensive health efforts that keep those living with HIV healthy. HIV/AIDS advocates warn that divestment from AIDS treatment will lead to colossal death tolls, as seen in the early years of the epidemic. 

• Role of the Global Fund in U.S. global health policy—When the Global Fund was established, U.S. bilateral investments were relatively small. Since then, U.S. bilateral investments in HIV/AIDS and malaria programs have grown significantly, particularly through the President's Emergency Plan for AIDS Relief (launched in 2003) and the President's Malaria Initiative (launched in 2005). As U.S. investments in these programs continue to grow, some question what role the Global Fund will play in U.S. global health policy. 

This report provides background information on the Global Fund, summarizes key findings on the Global Fund's progress through 2009, outlines U.S. funding for the Fund, and analyzes issues Congress might consider as it debates the appropriate level of support to provide the Fund.


Date of Report: August 3, 2010
Number of Pages: 41
Order Number: R41363
Price: $29.95

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