Civil society has played a fundamental role in the design and development of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), as well as a critical part in advocating the necessity for multi-stakeholder participation in all areas of the Global Fund architecture. Throughout the development and evolution of the Global Fund, civil society has encouraged governments to commit more resources to address the most devastating infectious diseases and to provide support for program implementation. These organizations have been effective voices on the Global Fund Board, as they hold equal voting rights alongside donor and recipient governments; on Country Coordinating Mechanisms (CCMs), representing the needs of vulnerable and marginalized groups infected and affected by the three diseases as well as in implementation, where civil society has a proven and effective role in targeting hard-to-reach communities and in prevention and treatment literacy.

From the beginning of the HIV/AIDS pandemic in the early 1980s, civil society became the driving force in drawing public attention to the impact of HIV/AIDS on their families, friends and communities. This was achieved through targeted advocacy campaigns aimed at key decision-makers and governments, demonstrating the necessity for action and treatment as the number of individuals infected and dying rose at an alarming and seemingly un-abating rate. Eventually civil society was able to gain international commitment and resources from governments and multilateral organizations to combat HIV and AIDS. Global resources to fight HIV/AIDS increased from approximately US $2 billion in 2001 to around US$ 8 billion in 2006.

In April 2001, at the Organization of African Unity (OAU) Summit on HIV/AIDS, Tuberculosis and Other Infectious Diseases in Abuja, then-United Nations Secretary-General Kofi Annan called for an additional US$ 10 billion per year to fight HIV/AIDS and the creation of a global fund to mobilize these resources.

This led to the conceptualization and development of the Global Fund — an organization whose core purpose would be to raise and rapidly disburse greatly-increased resources to finance the prevention, treatment, care and support of people living with or affected by HIV, TB and malaria. Civil society perceived this as an opportunity to secure access to urgently-needed treatment and care for millions of people globally. The momentum grew, pushing the Global Fund to be distinct from previous UN initiatives - more streamlined, less bureaucratic and, most importantly, based on equal stakeholder involvement from every sector.

Civil society again quickly became organized internationally, applying concerted pressure on governments of low-income countries and bilateral donors to support the Global Fund and to increase the portions of their countries’ gross national product dedicated to fighting the three diseases. Uniquely, this pressure came from both Northern and Southern civil society members and succeeded in launching the Global Fund’s first call for grant proposals (Round 1) in 2002. The internationally recognized role that civil society played in launching Round 1 and in participating in the conceptualization and design of the Global Fund led to a sense of ownership; the Global Fund was an initiative that they had helped to create, fund and govern.

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