There has been a marked rise in new organisations such as public private partnerships (PPPs) within the global health sector, of which The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is perhaps one the most well-known. From its conception, it was hailed as a new breed of international institution which would be less bureaucratic, more transparent and more accountable to its stakeholders. However, the GFATM has unfortunately been plagued by corruption in its operations in several developing countries. In this note, we draw on case studies of GFATM experiences of corruption in Uganda and Zambia to argue that we should be cautious in welcoming this new form of global governance in regard to its ability to ensure transparency and accountability. This is because one of the key strengths of the PPP structure, is that it creates autonomy at the national level, which constitutes a weakness when there is corruption. Indeed, despite evidence of widespread corruption in the GFATM in both of our case study countries, the GFATM has been unable to effect successful prosecution of the culprits and recover money that has been siphoned off, as both the Ugandan and the Zambian governments have exhibited a lack of political will.
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Public private initiatives within international health often have a mix of both state and non-state parties all working together to achieve a common goal and to share resources and responsibilities. See UNGA (2005) Enhanced Cooperation between the United Nations and all Relevant Partners, in Particular the Private Sector, Report of the Secretary-General, UN Doc. A/60/214, at p. 4.
Other PPPs that have been institutionalised include the Global Alliance for Vaccines and Immunisations (GAVI), UNITAID, The Stop TB Partnership and The Medicines for Malaria Venture.
Uganda’s suspension from the Global Fund is not an isolated example. The GFATM has at some point suspended grants in numerous developing countries: Ukraine, Myanmar, Indonesia, Chad, Mali, Nigeria and South Africa.
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S. R. Sekalala: Research Fellow.
M. T. Kirya: Independent Researcher and Consultant on Corruption.
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Sekalala, S.R., Kirya, M.T. Challenges in Multi-Level Health Governance: Corruption in the Global Fund’s Operations in Uganda and Zambia. Hague J Rule Law 7, 141–151 (2015). https://doi.org/10.1007/s40803-015-0010-x
- Global governance
- Public private partnerships (PPPs)
- The Global Fund