Kerouedan D
Sciences Po Paris.
Med Trop (Mars). 2010 Feb;70(1):19-27.
The five-year evaluation of the Global Fund to fight HIV/AIDS, TB and malaria (GFATM) was carried out by a Consortium of several Universities and institutions, led by a consulting firm based in Washington DC. Evaluation focused on three study areas: (i) organizational efficiency and effectiveness of the Global Fund, (ii) effectiveness of the Global Fund partner environment, (iii) system effects of the Global Fund and impact of increased funding on the level of response to the three diseases. Findings can be summed up as follows: the Global Fund has been successful in mobilizing additional funding and in attracting new players. However, the demand-driven model used for allocation of funding is poorly adapted to epidemiological profiles with regard to population, persons at highest risk, and number of persons affected by the disease. The partner environment of the Global Fund, involving UN technical partners and institutions cooperating in development has failed to produce planned results due to weak institutional capacity of recipients and health systems overall, as well as little synergy and coordination work between international partners. Increased financial resources have allowed rapid expansion of prevention and care services for the three diseases. Spectacular results have been achieved against malaria in Eastern African countries, but little progress has been made in the collective effort to slow down the spread of HIV/AIDS. In preparation for the upcoming Replenishment Conference of the Global Fund and prior to any further decisions to expand the use of innovative financing instruments for development, the author of this article calls the attention of policy-makers on the need to ensure the development of accompanying strategies to increase the effectiveness and impact of these instruments.
由华盛顿特区一家咨询公司牵头、多所大学和机构组成的财团对全球抗击艾滋病、结核病和疟疾基金（全球基金）进行了为期五年的评估。评估聚焦于三个研究领域：（i）全球基金的组织效率和成效；（ii）全球基金合作伙伴环境的成效；（iii）全球基金的系统效应以及增加资金投入对三种疾病应对水平的影响。研究结果可总结如下：全球基金在筹集额外资金和吸引新参与者方面取得了成功。然而，用于资金分配的需求驱动模式在人口、高危人群以及受疾病影响人数的流行病学特征方面适应性较差。全球基金的合作伙伴环境涉及联合国技术合作伙伴以及参与发展合作的机构，但由于受援方和整体卫生系统的机构能力薄弱，以及国际合作伙伴之间协同和协调工作较少，未能产生预期成果。增加的财政资源使三种疾病的预防和护理服务得以迅速扩展。东非国家在抗击疟疾方面取得了显著成果，但在减缓艾滋病毒/艾滋病传播的集体努力中进展甚微。在筹备即将召开的全球基金增资会议以及在做出进一步扩大使用创新发展融资工具的任何决定之前，本文作者呼吁政策制定者关注确保制定配套战略以提高这些工具的有效性和影响力的必要性。
