Wednesday’s panel session on the impact of the Global Fund to fight AIDS, TB and Malaria had three particular emphases: the promotion of human rights; the future role the Global Fund need to play in AIDS responses; and what might be achieved through a replenishment of the Fund's accounts, estimated to occur in October 2010.

 Michel Kazatchkine, the Executive Director of the Global Fund, pointed to the importance of using the words “Global Fund,” “impact” and “human rights” together. The challenge, however, was moving from rhetoric to action, particularly where rights were concerned. This was despite the fact that the Global Fund has become a powerful vehicle for human rights, both through its ability to promote the reduction of inequalities between rich and poor and between North and South.

 As Kazatchkine suggested: “Let’s be clear. There is a lot we could do more and better.”

Joanne Csete of Columbia University’s Mailman School of Public Health focused on dilemmas facing funders like the Global Fund when committing “to both country-driven processes and human rights.” Despite its best intentions and its good work, Csete reflected on the challenges experienced by the Global Fund. In particular, of its representation and inclusion of people living with HIV, its potentially tokenistic commitments, and the scaling up of controversial programs, such as methadone maintenance for injection drug users.

For Lithuania’s Raminta Stuikyte, the existent progress and impact of the Global Fund could be seen as fragile. This is because some of the Fund’s resources are limited. Often the Global Fund is the only donor to a country or a region, and is only able to fund a very small proportion of applicants.

Kazatchkine indicated, “We need to do two things: build community advocates so that the board has a remit, and make funding decisions outside the economic and financial realities of the current economic crisis." To this, moderator, Morolake Odetoyinbo reflected: “It is as if where money is concerned we are saying ‘which life is the most important, and which life is the most important for saving?’”

The discussions reflected that the Global Fund is not only about money, it is also about the way the system works. The Global Fund allows civil society and national leaders to come together. One implication of a reduction in funds to civil society within the context of the Global Fund through changes to funding eligibility and criteria is to limit both the contributions from civil society as well as its collaborations with others.

An additional limitation of the current Fund structure relates to the Country-level Community Coordinating Mechanisms (CCMs) and the ways in which conflicts of interest are possible, particularly between those who are both recipients of funds and representatives of civil society. CCMs are seen as  a potential hotbed of such conflicts of interest due to the role of financial and other resources.

How then, the panel debated, would one involve community, recipients and representatives of civil society when such potential compromises and conflicts exist?  With only limited time remaining, there was no readily apparent answer.

 Kazatchkine did suggest, however, that community via their representations on the board of the Global Fund do have a say in how future developments evolve.