Civil society and the private sector have played fundamental roles in the design and development of the Global Fund, as well as a critical part in advocating for multi-stakeholder participation in all areas of the Global Fund architecture. Throughout the evolution of the organization, civil society and private sector have encouraged governments to commit more resources to address the pandemics and to provide support for program implementation. Civil society and private sector organizations have proved effective members of the Global Fund Board, where they hold equal voting rights alongside donor and recipient governments, and Country Coordinating Mechanisms (CCMs), where they represent the needs of marginalized groups affected by the three diseases as well as improve the implementation of programs and services. Civil society has a proven role in accessing hard-to-reach communities, and in spreading prevention and treatment literacy. Private sector has often extended the services offered to their employees to neighbor communities and beyond.
From the beginning of the HIV pandemic in the early 1980s, people living with and affected by the virus became the driving force in drawing public attention to the new pandemic. This was achieved through grass-roots activism, which focused on advocacy campaigns targeting key government decision-makers. The campaigns emphasized the necessity for action as the numbers of people infected and dying rose at an alarming rate. After the introduction of highly active antiretroviral treatment in 1996, civil society activists fought to make sure that all those in need had access to lifesaving medications, irrespective of where they lived or how much money they had. Eventually, the campaigners achieved international commitment and increased resources from governments and multilateral organizations to combat HIV and AIDS. Global resources to fight the pandemic in developing countries increased from US$ 300 million in 1996 to US$ 8 billion in 2005.
In April 2001, at the Organisation of African Unity summit on HIV/AIDS, Tuberculosis and Other Infectious Diseases in Abuja, then UN Secretary-General Kofi Annan called for an additional US$ 10 billion per year to fight HIV and AIDS, and the creation of a global fund to mobilize these resources. This led to the conceptualization and development of the Global Fund, which opened for business in 2002
Civil society pressured bilateral donors to support the Global Fund and Southern governments to increase the portion of their gross national product dedicated to fighting the three diseases. Uniquely, this pressure came from both Northern and Southern civil society members and was key to the successful launch of Round 1, the Global Fund's first call for grant proposals. International recognition of this, together with their participation in the conceptualization and design of the Global Fund, gave civil society and private sector a sense of ownership: the Global Fund was an initiative that they had helped to create, fund and govern.
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