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Stakeholders' opinions and expectations of the Global Fund and their potential economic implications

Galárraga, Omara,b; Bertozzi, Stefano Ma,b,c

doi: 10.1097/01.aids.0000327618.01362.6a
Section I: Informing Scale-up and Resource Allocation

Objectives: To analyse stakeholder opinions and expectations of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and to discuss their potential economic and financial implications.

Design: The Global Fund commissioned an independent study, the ‘360° Stakeholder Survey’, to canvas feedback on the organization's reputation and performance with an on-line survey of 909 respondents representing major stakeholders worldwide. We created a proxy for expectations based on categorical responses for specific Global Fund attributes' importance to the stakeholders and current perceived performance.

Methods: Using multivariate regression, we analysed 23 unfulfilled expectations related to: resource mobilization; impact measurement; harmonization and inclusion; effectiveness of the Global Fund partner environment; and portfolio characteristics. The independent variables are personal and regional-level characteristics that affect expectations.

Results: The largest unfulfilled expectations relate to: mobilization of private sector resources; efficiency in disbursing funds; and assurance that people affected by the three diseases are reached. Stakeholders involved with the fund through the country coordinating mechanisms, those working in multilateral organizations and persons living with HIV are more likely to have unfulfilled expectations. In contrast, higher levels of involvement with the fund correlate with fulfilled expectations. Stakeholders living in sub-Saharan Africa were less likely to have their expectations met.

Conclusions: Stakeholders' unfulfilled expectations result largely from factors external to them, but also from factors over which they have influence. In particular, attributes related to partnership score poorly even though stakeholders have influence in that area. Joint efforts to address perceived performance gaps may improve future performance and positively influence investment levels and economic viability.

From the aCenter for Evaluation Research and Surveys, National Institute of Public Health (INSP)/Mexican School of Public Health, Cuernavaca, Mexico

bInstitute of Economic and Business Research (IBER), University of California, Berkeley, California, USA

cCenter for Teaching and Economic Research (CIDE), Mexico City, Mexico.

Correspondence to Stefano M. Bertozzi, National Institute of Public Health (INSP)/Mexican School of Public Health, Av. Universidad 655, Cuernavaca, Morelos C.P. 62508, Mexico. Tel: +52 777 329 3069; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.