China – an odd position with the Global Fund

China has recently made the news because grants from the Global Fund have been frozen over non-adherence to GFATM procedures. As reported on Yahoo Health News a spokesperson for the Global Fund said, “We believe that the main recipient, the CDC (China Centers for Disease Control), had violated an accord of the Global Fund which said that a part of the financing accorded, at least 35 percent, must go through community organisations.” As Yanzhong Huang explained, “The (Chinese) government may like the Global Fund money, but it obviously does not like the Global Fund’s ideas as far as civil society is concerned.”

To date, China has been awarded 14 GFATM grants covering all three diseases. Generally the grants have performed well. These grants have a lifetime budget of nearly $2 billion of which nearly $1 billion has been approved.

Let us compare this scenario against the world economic picture. Last August the New York Times reported that, “After three decades of spectacular growth, China passed Japan in the second quarter to become the world’s second-largest economy behind the United States, according to government figures released early Monday.”

To date China has pledged $30 million to the GFATM, and paid $20 million. China is not the only recipient country to contribute. Even Nigeria, whose economy is nowhere near as large as China’s has pledged $29 million and paid $19 million. Other recipients who have provided some support range from Malaysia to Rwanda.

In the end when one looks at a $30 million pledge compared to $2 billion worth of gain by the second largest economy in the world, one wonders why China does not or can not shift over to the donor side of the equation completely.

The thoughts of Yanzhong Huang on how to deal with this situation might be construed as appeasement. “In order to encourage the participation of China’s civil society groups in global health, it is important to allay the fears of Chinese leaders.” A harsher approach might be to say that if China no longer received GFATM money, there may be no need to allay fears. As the world economy slows, more of the G20 countries need to think seriously about how they can step up to the donor table and behave as if it were better to give than receive.

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