The study, which examined funding primarily from the Global Fund and the (U.S.) President’s Emergency Fund for AIDS Relief (PEPFAR), was conducted by the Foundation for AIDS Research (amfAR) and the John Hopkins Bloomberg School of Public Health. The study focused on grants from Rounds 5-9 in eight countries: China, Ethiopia, Guyana, India, Mozambique, Nigeria, Ukraine and Viet Nam. The study also looked at three regional grants, one in the Americas, one in South Asia and one in West Africa. A report on the study, entitled “Achieving an AIDS-Free Generation for Gay Men and Other MSM,” was released in January 2012 and is available here. The researchers caution that the findings from this relatively small sample may not be generalizable to the entire Global Fund grant portfolio.
The study also found evidence that MSM-targeted activities are “deprioritised” during grant negotiations in many countries. The researchers said that in these countries the amount of money earmarked for activities targeting MSM was reduced between the budget included in the proposal (the “requested budget”) and the budget approved by the Global Fund Board (the “approved budget”); or between the approved budget and the budget negotiated during the signing of the agreement (the “final budget”). In some cases, the researchers said, reductions occurred at both stages. The researchers referred to these reductions as “attrition.”
The most extreme example of attrition in the study was a Round 8 grant from Guyana. The CCM requested $4.6 million; this was reduced to $3.9 million in the approved budget; and it stayed at $3.9 million in the final budget. However, the money earmarked for activities targeting MSM went from $50,072 (requested) to $45,781 (approved), and then to $1,875 (final budget), an attrition rate of 96%.
Similarly, in a Round 6 regional proposal from West Africa, the total budget went from $45.6 million (requested) to $31.4 million (approved), and then $38.8 million (final budget). The amount earmarked for activities targeting MSM went from $1.2 million (requested) to $0.1 million (final budget); the researchers said that it was not clear at which stage the funding for activities targeting MSM was reduced.