Understanding Financial Development

I just attended a seminar with Sir Richard Feachem, a man I had not heard of until today. Sir Feachem led The Global Fund from its inception in 2002 to March this year.

Within the world of public health, the 3 big diseases - HIV/AIDS, TB, and malaria have never really held any professional interest for me. Sure, in a 'person of the global community' sense I've been intrigued and concerned. But it's such a LARGE problem that it seems too overwhelming. From a microbial standpoint I'm fascinated - the evolution of these bugs in response to pressures of therapy and treatment is pretty remarkable. But I've always had this deeply secret belief that it was just too hard to work in these areas of public health. The stories are intriguing, but I can't fathom working on the ground floor of these 3 diseases.

I don't know that I feel any differently about these diseases now versus an hour ago, before the seminar, however, I'm absolutely blown away by the caliber of people working in this field. Sir Feachem was entrancing - a bit like a celebrity. He reminded me of Paul Farmer, but in a much larger sense. I can see Sir Feachem rubbing elbows with Bono, not in a schmaltzy, 'I'm a person with a lot of money "doing" things for Africa', but in a real, "let's actually talk business here people" manner.

Financial development and the activities of organizations like GAVI, The Global Fund, The World Bank, The Clinton Foundation, and The Millennium Challenge always seemed out of my reach. It's a whole side of public health that I don't know too much about. But Sir Feachem broke it down to day in an easily accessible manner. These organizations still seem out of my reach, but I think I understand them a little bit more now.

His description of the ways that the Global Fund is different and innovative in the field of financial development were tangible and made a lot of sense.

1. They are demand driven. They don't seek proposals from countries, they don't advise countries on what proposals to submit. The countries (and they are currently funding programs in 136 of the 142 low income and middle-income countries (World Bank definition) in the world) develop their proposals to submit. Seems like an obvious way to do things, but apparently its an innovative approach.

2. They operate on performance based funding. You don't get money if you don't show results agreed to in the 'contract' between the Global Fund and the country. If your results fall below a certain threshold it gets pulled. Again, a seemingly obvious way to operate, but also innovative in this field since they have actually pulled funding. They are serious.

3. They are transparent. All the details on every program and monies in and monies out is detailed on their website.

4. There is no political overlay - no political trump card that can be played. They are based in Switzerland and can operate with the neutrality of the Swiss when confronting corruption. And they can (and do) pull funding from corrupt countries.

They are also innovative in their partnering with the private sector. Of their 20 voting members of the board, one is a private sector representative. They are partnered with the RED campaign. He showed us his RED motorola, his RED watch and wallet from Armani, and he was, of course, wearing a red tie. But hey - I'm a child of consumerism - I get the message. And when I left the seminar I wanted to buy a red phone. And only wear clothes from Bono's clothing line - which I know isn't AIDS specifically, but promotes sustainable employment in developing areas of the world, particularly Africa. And sustainable employment is another side of the disease-life-prevention triad. Yeah, I made that triad up. You need a stable economy to promote healthy people.

Anyway, it was a very fascinating seminar and so accessible that I wanted to share some of it with you. Maybe it isn't such a hopelessly overwhelming problem when there are enough people doing things in this manner tackling the problem.