Study Details

Global Health: Global Fund has Improved its Documentation of Funding Decisions but Needs Standardized Oversight Expectations and Assessments


Contact Director of International Affairs and Trade David M. Gootnik 


May 2007



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United States Government Accountability Office (GAO)


Governance, funding

Study Type

A review of secondary data supplemented with analysis of Global Fund grants and interviews with Global Fund (GF) staff.


The aim of the report is to assess documentation of the information used to support performance-based funding decisions; progress in implementing a risk assessment model and early warning system; oversight of the performance of Local Fund Agents (LFAs), which monitor grant progress in recipient countries.


To do this, GAO interviewed key officials from the GF Secretariat and reviewed GF documents, including key source documents from grant files. They also analyzed two separate random samples of grant decisions from the GF. The first sample consisted of 80 grants that were assessed for performance-based funding disbursements between January 1 and October 1, 2006. The second sample consisted of 45 grants that were assessed for phase 2 grant-renewal.


This US Government Accountability Office report identifies improvements made by the Global Fund in terms of documenting information, but notes that it still has limited access to important information that would assist it to assess LFA performance more effectively.

  • The GF has improved its documenting of information used to support its decisions for disbursements and grant renewals.
  • The GF has recognized the need for a more comprehensive approach to risk management, and has begun developing a risk assessment framework that includes an early alert and response system to address poorly performing grants.

Conclusions /

The Executive Board of the GF should (a) establish standardized expectations for LFA performance and (b) require systematic assessments of LFA performance and the collection and analysis of performance data.


Further information can be obtained from Aisling Walsh or from Neil Spicer, or from any of the individual country researchers.

Last Updated: Friday 16th November 2007