Response from the Global Fund
Victor Bampoe a, Amy Clancy a, Maya Sugarman a, Jon Liden a & Mary Ann Lansang a
a. The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de Blandonnet 8, 1214, Vernier, Geneva, Switzerland.
Correspondence to Mary Ann Lansang (e-mail: MaryAnn.Lansang@theglobalfund.org).
Bulletin of the World Health Organization 2012;90:70-70. doi: 10.2471/BLT.11.096990
The Global Fund to Fight AIDS, Tuberculosis and Malaria appreciates the interest in the relationship between the public and private sector.1 The Global Fund, as a public–private partnership, encourages the private sector to engage in all aspects of its work, ranging from mobilization of resources, implementation of grants and governance of funds. The Global Fund stresses that partnerships with the private sector are critical to expanding the resources available to effectively fight HIV and AIDS, tuberculosis and malaria.2,3 The Global Fund does not endorse the actions, practices or policies of any corporation or industry beyond the field of the fight against these three diseases. Conversely, it does not have any objections to collaborating with corporations (with the exception of tobacco, producers of arms and those involved in pornography) that conduct, finance or otherwise support evidence-based, effective interventions to prevent, treat or provide care for any of the three diseases.
As clarification, the model of the Global Fund is based on the concept of country ownership. Countries determine their own programmatic priorities, implementation strategies and submit requests for funding based on identified funding gaps. One of the central channels of country ownership is the Country Coordinating Mechanism, which is made up of representatives from both the public and private sectors including governments, multilateral or bilateral agencies, nongovernmental organizations, academic institutions, private businesses and people living with the diseases. In its mandate as the Country Coordinating Mechanism, the Resource Mobilization Committee of South Africa submitted a Round 9 HIV proposal focusing on HIV prevention and care and support activities. This proposal was reviewed by the Global Fund’s Technical Review Panel, an independent panel of international experts on health and development, for soundness of approach, feasibility and potential for sustainability and impact.
A portion of the Round 9 funding is directed towards a cost-sharing programme that is implemented jointly by SABMiller, the South African Business Coalition on HIV/AIDS (SABCOHA) and the Government of South Africa. This programme focuses on the provision of HIV counselling and testing, training and peer education in taverns and shebeens, and psychosocial support for caregivers. The Global Fund regards this cost-sharing programme as an important endeavour to mobilize greater resources for the fight against HIV and recognizes the contribution that SABMiller and SABCOHA can make in reaching at-risk populations with prevention and care and support activities.
The Global Fund’s primary commitment is to those affected by HIV/AIDS and to interventions that reach populations most at risk. The Global Fund of course does not endorse excessive drinking and it understands well the risks associated with alcohol consumption. Researchers estimate that more than 85% of locations where individuals meet new sexual partners in South Africa are shebeens and other alcohol-serving establishments.4 However, studies have shown that even brief interventions in bars and taverns can result in reduced risky sexual behaviours.5–8 The Global Fund considers men attending alcohol-serving establishments to be a key target population, and sees these establishments as viable and dynamic locations for intervention.
The Global Fund supports South Africa’s implementation strategy to collaborate with SABMiller and SABCOHA as an innovative approach to address the HIV/AIDS epidemic. As is the case with other programmes it supports, the Global Fund will monitor the performance of the grant and expects an evaluation of the programme in line with its system of performance-based funding.
The Global Fund welcomes any discussion about the efficacy of interventions and programmes it supports, including the points made in this paper. However, we do not recognize any “conflict of interest” – as the term is generally used – in the situation regarding the Round 9 HIV grant to South Africa.
- Matzopoulos R, Parry CDH, Corrigall J, Myers J, Goldstein S, London L. Global Fund collusion with liquor giant is a clear conflict of interest. Bull World Health Organ 2012; 90: 67-69.
- Jakarta Declaration on Health Promotion into the 21st century. In: Fourth International Conference on Health Promotion: New players for a new era-leading health promotion in the 21st century, Jakarta, 21–25 July 1997. Available from: http://www.who.int/hpr/NPH/docs/jakarta_declaration_en.pdf [accessed 15 November 2011].
- Adelaide Statement on Health in All Policies: moving towards a shared governance for health and well-being. In: International Meeting on Health in All Policies, Adelaide, 13–15 April 2010. Available from: http://www.who.int/social_determinants/hiap_statement_who_sa_final.pdf [accessed 15 November 2011].
- Weir SS, Pailman C, Mahlalela X, Coetzee N, Meidany F, Boerma JT. From people to places: focusing AIDS prevention efforts where it matters most. AIDS 2003; 17: 895-903 doi: 10.1097/00002030-200304110-00015 pmid: 12660537.
- Kelly JA, Murphy DA, Sikkema KJ, McAuliffe TL, Roffman RA, Solomon LJ, et al., Community HIV Prevention Research Collaborative, et al. Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Lancet 1997; 350: 1500-5 doi: 10.1016/S0140-6736(97)07439-4 pmid: 9388397.
- Morisky DE, Stein JA, Chiao C, Ksobiech K, Malow R. Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: a multilevel analysis. Health Psychol 2006; 25: 595-603 doi: 10.1037/0278-618.104.22.1685 pmid: 17014277.
- Kalichman SC, Simbayi LC, Vermaak R, Jooste S, Cain D. HIV/AIDS risks among men and women who drink at informal alcohol serving establishments (Shebeens) in Cape Town, South Africa. Prev Sci 2008; 9: 55-62 doi: 10.1007/s11121-008-0085-x pmid: 18264762.
- Morojele NK, Kachieng’a MA, Mokoko E, Nkoko MA, Parry CD, Nkowane AM, et al., et al. Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Soc Sci Med 2006; 62: 217-27 doi: 10.1016/j.socscimed.2005.05.031 pmid: 16054281.