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Background Principal Recipients (PRs) receive money from the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) to manage and implement programs. However, little research has gone into understanding their opinions and experiences. This survey set out to describe these, thereby providing a baseline against which changes in PR opinions and experiences can be assessed as the recently introduced new funding model is rolled out. Methodology An internet based questionnaire was administered to 315 PRs. A total of 115 responded from 69 countries in Africa, Asia, Eastern Europe and Latin America. The study was conducted between September and December 2012. Findings Three quarters of PRs thought the progress update and disbursement request (PU/DR) system was a useful method of reporting grant progress. However, most felt that the grant negotiation processes were complicated, and that the grant rating system did not reflect performance. While nearly all PRs were happy with the work being done by sub-Recipients (92%) and Fund Portfolio Managers (86%), fewer were happy with the Office of the Inspector General (OIG). Non-government PRs were generally less happy with the OIG's work compared to government PRs. Most PRs thought the Global Fund's Voluntary Pooled Procurement system made procurement easier. However, only 29% said the system should be made compulsory. When asked which aspects of the Global Fund's operations needed improvement, most PRs said that the Fund should re-define and clarify the roles of different actors, minimize staff turnover at its Secretariat, and shorten the grant application and approval processes. All these are currently being addressed, either directly or indirectly, under a new funding model. Vigorous assessments should nonetheless follow the roll-out of the new model to ensure the areas that are most likely to affect PR performance realize sustained improvement. Conclusions Opinions and experiences with the Global Fund were varied, with PRs having good communication with Fund Portfolio Managers and sub-Recipients, but being unhappy with the grant negotiation and grant rating systems. Recommendations included simplifying grant processes, finding performance assessment methods that look beyond numbers, and employing Local Fund Agents who understand public health aspects of programs. [ABSTRACT FROM AUTHOR]

The article focuses on research which examined the pay structures of health workers in the public sector of sub-Saharan Africa, the adequacy of the pay structures, the management of public sector pay, and the fiscal and macroeconomic factors that effect pay policy in the public sector. Researchers found that pay structures vary across countries in complex ways and that health workers commonly use other sources of income to supplement their formal pay. They suggest that in order to optimize the distribution and mix of health workers policy interventions to address their pay and incomes are needed.

The article discusses partnerships in medical research between wealthy countries and poor countries in Africa. The authors note the poor economies of African countries have hindered research that that partnerships between wealth countries and African research facilities are symbiotic, providing resources to poor countries and disease information to wealthy countries. The authors suggest wealthy countries receive a greater amount of partnership funds and comments that biomedical research receives more attention than public health research. They recommend policy-makers participate more in research and note that universities in poor countries may have to balance research with educational goals.

Discusses the access to antiretroviral drug treatment in Africa. Demand of treatment for patients with HIV and AIDS in Africa; Challenges in meeting these demands; What should and should not be done in approaches to providing treatment.