Interview with Dr Carol Jacobs
"Bringing the Face of the Pandemics Into the Board Room"
In the run-up to the eleventh Board meeting in Geneva 28 – 30 September 2005, Dr Carol Jacobs, the incoming Chair of the Global Fund Board, spoke about her expectations and challenges for the Board.
Short Biography - Back to the 11th Board Meeting page
- Having seen you chairing the session of the last Board meeting and seen
you being very active over the past few months in the replenishment process and
in other issues, Board members may forget that this really is your first Board
meeting as Chair of the Global Fund. How would you characterize your role and
style as Chair?
- I see myself as facilitating the process of governance. I am very comfortable
with the Global Fund philosophy of trying to achieve things through consensus
rather than through divisive debate. Tommy Thompson achieved this very well.
My goal is to maintain this tradition.
I am one of these people who tend not to want to reinvent the wheel but instead aim to build on the good things that already are in place. However, I see the need for the Board to have more time for discussion of what are becoming very demanding and complex issues. I am working with the Secretariat to manage the heavy agenda in a way that also allows for Board members to air their views properly. I realize the sensitivity of that, as Chair you have to manage time, but I have tried to give some more time around issues that people feel are very important and want to really engage in. We’ll see how it works.
Of course, while seeing myself mainly as a facilitator, I also have a responsibility to bring – when I can – a developing world perspective to the Board.
- The Global Fund governance differs from most other multilateral financial institutions. Does that present particular challenges for you as Chair?
- What is unique about the Global Fund’s governance is that through its recipient participation (I hate that word “recipient”: it not only implies a differential in status; it is also an inaccurate description of many members and delegations) it brings a number of countries and groups to the table which normally do not have equal decision-making power in multilateral financial institutions. But more than that, it brings the face of the diseases right into the Board room and that clearly influences the debate and the decisions. Elsewhere, it is very easy for donors to just sit and discuss line items and forget that they represent real lives.
What has been achieved in the Global Fund in a very short space of time is ownership of the process by everyone around the table. You don’t always get that, and instead, people feel that they are not part of the process and they shout from the outside. The Global Fund has managed to ensure that countries and other stakeholders feel part of its structure. Bringing the communities on as a voting member was a great step forward. The decision to bring communities with the diseases into the decision-making was absolutely critical to effective governance.
- On the other hand, what challenges does this governance structure represent?
I think the major challenge is not to raise people’s expectations that we may not be able to meet. We can easily increase demand for Global Fund resources exponentially; it is challenging to meet that increase in demand both in terms of available resources and in ensuring that available resources are effectively used. Given my position as a representative from the south, voicing this is risky, but I believe it is a difficult but important balance for us to manage.
- What do you mean by resources being “effectively used”?
- I feel strongly that although the Global Fund is a financial institution which is designed to raise money and to get monies to countries quickly, our responsibilities don’t stop there; we can’t do this in a vacuum. We must also do whatever we can to ensure that the money is put to effective use at country level. I fully buy in to the Global Task Team work and I believe that we need to engage all partners at the Board to ensure that capacity is there in the countries to implement programs well. In this context, I am also fully supportive of the Early Alert and Response System although we must still see it as a work in progress. This is a way to signal to countries early that they are not meeting indicators and need assistance in removing bottlenecks. The Secretariat has done a wonderful job on this so far, but is not a perfect process yet. On Phase 2, we will reflect where we can do things better; be fairer to countries. I am not suggesting for one minute that we dilute the performance-driven aspect of the Global Fund, which is important to our donors and to all of us, but we must have in our minds the human face of these diseases and not just see these grants as line items in our budget.
- Are you concerned about the income levels of the Global Fund and what that means for our future ability to grow or even stay at this level?
- I have major concerns about our Replenishment; we did very well in the Replenishment process, but we still have a real gap for 2005 and a long way to go for 2006 and 2007.
We have to identify the additional funding. There is a lot of funding out there that we haven’t tapped into. There are blocks of countries we haven’t tapped into yet, and I know the Secretariat is aware of these and is developing strategies and policies to reach these countries. There is more public money out there that we haven’t tapped into yet, and I see big money in the private sector and private foundations for health issues. Many of these entities have not yet been sensitized to the value-added from contributing to the Global Fund.
This is really an area of concern for me. The Global Fund Board brings all partners around the table, and the private sector is part of it. I am not in any way trying to belittle what the private sector and private foundations have done, but I do think that they have a lot more to do. Now that we are looking at specific strategies for private sector contributions produced by the private sector, and we have a liaison person from the Global Business Coalition within the Secretariat, we have taken some big steps in the right direction. I don’t see the private sector as a silent partner, I think the private sector does need to step up and make some major monetary contributions.
- What is the best way of securing more money? Is it ensuring high performance, or is it to focus on the resources needed to battle the diseases? ^
It is partly performance and it is also public relations, you need for people to understand what you are doing and what their money is doing and the difference it is making. The public relations aspect of this is very important. Of course you need to achieve performance, but in a system of performance based funding, if countries are giving major sums of money, they want to know where the money is going and what it is doing. The Global Fund needs to be more visible and better known – in the south as well as in the north.
