The Global Fund Finally Commits Future to Sands: Public Health Watch

The Global Fund to Fight AIDS, Tuberculosis, and Malaria named a former banker, Peter A. Sands, as its new executive director in November 2017.

Questions regarding a finance executive’s expertise in infectious diseases aside, the move seems straightforward enough—at least on the surface. However, to date, through the course of its 15-year history, everything involving the Global Fund has been anything but simple.

Indeed, in its coverage of the appointment, The New York Times noted that the organization, which was founded by then-United Nations Secretary-General Kofi Annan and other world leaders, has often struggled to raise sufficient funds to “fulfill its mission.” Initially, the Global Fund was expected to have an annual budget of roughly $8 billion; however, in the years since, it has barely raised half of that amount from donors, the largest of which is the United States.

Furthermore, the Global Fund faced accusations in 2011 that it had evolved into, as the Times puts it, a “swollen bureaucracy” that allowed “aid recipients [to] pilfer funds.” Sands’ predecessor as executive director, American infectious disease specialist and diplomat Mark R. Dybul, MD, has been credited with “strong financial and risk management” during his time in charge, and the Fund appears to put the allegations of malfeasance behind them. Dr. Dybul’s term expires at the end of this year.

Although the organization seems to have turned itself around—it claims to have saved 22 million lives in the developing world since its inception—the appointment of Sands, a native of Great Britain and the former CEO of Standard Chartered Bank, has opened some old wounds. In a commentary published in The Lancet on November 25, 2017, Editor-in-Chief Richard Horton, FRCP, FMedSci, alleges that the search that ultimately resulted in Sands taking the post was “not a tidy process” that initially ended in “ignominious failure.” A report in The Guardian of Nigeria suggests that an early candidate for the position called US President Donald Trump a “fascist” on Twitter, while another had links to a large drug manufacturer that has done business with The Global Fund.

In the end, though, Dr. Horton in his commentary describes the Fund board’s decision to appoint Sands “welcome.” He cites a presentation made by the incoming executive director in which he called on countries to “prioritize health security in budgets and increase domestic resource mobilization.”

When contacted by Contagion^®, a spokesperson for The Global Fund acknowledged the lack of success of the selection process in its early stages, but added, “The Board of the Global Fund selected Peter Sands because he has exceptional management and financial experience, and a strong interest in global health issues, [and]… experience in running complex organizations with a global reach and that disburse large sums of money...”

In a statement provided to Contagion^® by The Global Fund, Sands said, “The most powerful argument that the Global Fund can bring to donors is impact: millions of lives saved along with a massive economic burden lifted and significant economic development in communities that have been held back by these diseases. We can do more in making the economic case. The starting point, of course, needs to be the human impact, but if we can underpin it with an economic case, we can make it all the more powerful. If we get this right, we can rid the world of the epidemics of AIDS, tuberculosis, and malaria, and that is an extraordinarily inspiring goal. My vision is that by 2022, when we are celebrating the 20th anniversary of the Global Fund, that we’re not just celebrating the millions of lives that have been saved—and of course that’s a huge thing to celebrate—but we can also claim confidently to be firmly on track to ridding the world of the epidemics of AIDS, tuberculosis, and malaria.”

Ambitious indeed. Here’s hoping Sands’ appointment heralds a new era for the Global Fund. The world certainly needs it.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.