David Clinton
What Happens When Ministries Go Rogue?
Global Affairs Canada and the strange, wonderful world only they can see
This is an older (and longer) version of an article just published by the Macdonald-Laurier Institute.
Some may think of the people behind Global Affairs Canada (GAC – also known as Department of Foreign Affairs) as Canada’s brightest and best, executing a sophisticated and far-seeing foreign policy. They may be right. But the description that more readily comes to my mind is “completely out of control.” I may be wrong.
But if I am wrong, I’m not the only one. Vivian Bercovici – a former Canadian ambassador to Israel – quoted former Prime Minister Harper as saying “that in his 10 years in office, the most difficult department for his government to work with was Foreign Affairs.”
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What is it about GAC, and Western foreign services in general, that makes them so subversive? Bercovici puts it this way:
“In the postwar years, foreign-affairs bureaucracies in Western democracies ballooned in size. Foreign-service officers saw themselves as better-informed and -trained to manage diplomatic complexities than the elected officials they supposedly served. They also mastered the art of diffusing responsibility and outcomes among the many layers and offices engaged in any particular issue. As a practical matter, this means that neither success nor failure is attributed to individuals, resulting in a lack of accountability throughout the organization. It also means that internal sabotage of the will of government is more easily effected and concealed. Where authority and responsibility are blurred, accountability is impossible.”
All that’s well above my pay grade. But I’m perfectly capable of observing the work GAC actually does. So I’m going to discuss three specific GAC programs that seem to present some unhealthy processes and patterns. Perhaps they’ll help us reach useful conclusions.
GAC and the Global Fund
According to GAC’s Project Browser tool, between 2008 and 2022 Canada committed $3.065 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Which on the face of it is great. No one here is cheering for Team Malaria, right? But we should ask a couple of questions:
- Is the scale of the support appropriate given financial constraints back home?
- Was that money well spent?
I’m not going to even try to answer the first question: that’s something for Canadians to talk about as a society. For context though, GAC’s total annual budget for foreign aid funding seems to be in the neighborhood of $16 billion (of which around $2 billion goes to United Nations agencies). $16 billion would represent roughly 4 percent of total annual federal government expenditures.
However I do have a lot to say about question number two. First of all, the Global Fund to Fight AIDS, Tuberculosis and Malaria has been dogged by serious accusations of corruption and lack of transparency for more than a decade. That means there’s a good chance a substantial proportion of our money ended up moving through private Caribbean bank accounts on its way to cozy dachas in Sochi.
But I’m going to ignore that for now because we can’t be sure the funny business is still happening. And because if we canceled all government programs that were at risk of misuse we’d have to lay off the entire federal civil service. Which would be a very bad thing, because…well it just would.
Instead, I’ll focus on measuring the impact of our investment. What were the goals GAC set for its Global Fund contribution? Their own website fills us in:
“The expected results are defined by the “Global Fund Strategy 2017-2022”. This strategy includes the following targets, to be achieved by 2020: (1) 90% of persons living with HIV (PLHIV) know their status, 90% PLHIV who know their status and receiving treatment; and 90% of people on treatment have suppressed viral loads; (2) a 20% and 35% decline in TB incidence rate and TB deaths respectively, compared with 2015; and (3) at least a 40% reduction in malaria mortality rates and malaria case incidence, compared with 2015.”
The GAC planners obviously felt that spending $3 billion over five years or so was reasonable as long as, between 2015 and 2020, it contributed to a 35 percent decline in TB deaths, a 40 percent decline in malaria deaths, and the 90%-90%-90% formula for people with HIV. And I’ll admit that it’s a compelling argument.
The thing is though, that no one could have known whether we’d actually achieve those results. And given the built-in ambiguity of the program’s goals, it’s not we could ever know whether it was a success. The decision therefore was a gamble. And the table stakes were $3 billion belonging to Canadian taxpayers.
Should nameless, unelected planners have that much power over our money? Assuming that they’re genuine domain experts, then sure. Who else is better? But:
With great power comes great responsibility. (Nietzsche? Kant? Aristotle? Nope. Spiderman’s uncle)
Claiming to possess domain expertise isn’t free: if you break it, you own it. So if death rates happily fell during the program years then the planners should be rewarded for their service to humanity. But if they didn’t fall, or if they didn’t fall as much as predicted then, at the very least, people should lose their jobs.
Fortunately, with the hindsight allowed us by historical data, we can easily see how things worked out. Unfortunately, it looks like the fine folk at GAC stepped on a rake.
Our World in Data numbers give us a pretty good picture of how things played out in the real world. Tragically, Malaria killed 562,000 people in 2015 and 627,000 in 2020. That’s a jump of 11.6 percent as opposed to the 40 percent decline that was expected. According to the WHO, there were 1.6 million tuberculosis victims in 2015 against 1.2 million in 2023. That’s a 24.7 percent drop – impressive, but not quite the required 35 per cent.
I couldn’t quickly find the precise HIV data mentioned in the program expectations, but I did see that HIV deaths dropped by 16 percent between 2015 and 2019. So that’s a win.
But it’s clear that the conditions underlying the GAC wager were not met.
To be fair, GAC reporting in 2023 claims that: “Since 2002, (their) efforts have contributed to a significant decline in deaths caused by AIDS (‑70%), TB (‑21%) and malaria (‑26%).” – but those figures are unsourced, badly outdated, and completely fail to account for program spending subsequent to 2015.
The government gambled more than $3 billion of taxpayer funds and lost the bet. To date, they have yet to apologize, assure us that they’re busy reassessing their future commitments, or publicize their plans for the individuals who so carelessly lost our money.
For that matter, were those individuals even GAC employees? It’s possible that the decision was made by representatives of the uber-expensive contract consulting firm, McKinsey. When will that information become public?
GAC and the World Food Programme
The Global Fund deal was one bad multilateral bet. Were there others? Sure. Over the five years between 2016 and 2021 GAC entrusted a total of $125 million with the UN World Food Programme to provide emergency food aid. Africa represented 60 percent of the program’s target, and the one policy marker designated as a “significant objective” was gender equality. The programs expected results included:
- Improved access to food and nutrition assistance for food-insecure populations
- Increased ability of the World Food Programme to provide appropriate responses to humanitarian crises
Overall, the “expected ultimate outcome is the reduced vulnerability of crisis-affected people, especially women and children.” Unfortunately, here too, the numbers moved in the wrong direction. As the graph shows, numbers from Our World in Data show that the percentage of people across the African continent who lack the minimum daily caloric intake – despite years of declines – has been climbing steadily precisely through the GAC’s program timeline. Malnutrition went from 15 to 19.7 percent since 2013.
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I’ll admit that I can’t be sure I’m not oversimplifying things here. There could well have been powerful geopolitical or macro economic changes behind surges in malaria and malnutrition. Perhaps those crises would have been even worse had Canadian funding not been in place. Global events seldom have easy explanations.
But what I can see is a fairly consistent pattern. GAC spends hundreds of millions and billions of dollars on multi-year agreements with multilateral organizations. Key success indicators are rarely met. Persistent rumors of corruption and incompetence (and worse) often hover above the largest aid organizations. But there’s never any evidence of comprehensive program and mandate assessments within GAC itself. They might happen, but they’re not telling us. And that’s a problem.
Note: I received no response to repeated efforts to reach GAC officials for comment on these programs.
GAC and the United Nations Relief and Works Agency
The government of Canada – through GAC – has long been among the major financial supporters of The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). Leading up to the Hamas massacre on October 7, 2023, the 75 year-old United Nations agency had a yearly budget of more than 900 million U.S. dollars, and had long been accused of antisemitism, corruption, and complicity in war crimes.
At various points long before the current war, the Netherlands, Switzerland and the Unites States had all felt compelled to suspend payments to UNRWA over related concerns. The Harper government cut funding to UNRWA in 2010, but Prime Minister Trudeau restored it in 2016. Canada briefly froze funding to UNRWA in January 2024 due to the organization’s connections to the October 7 attacks but once again restored payments in March.
I’m curious to know what the quarter billion dollars that Canada has donated to UNRWA since 2016 was used for and what safeguards the government imposed to ensure we weren’t facilitating criminal or genocidal behavior.
In fact, the official record of Canada’s parliament includes the unanimous agreement of the Standing Committee on Foreign Affairs and International Development from Thursday, February 4, 2021, when they declared:
“That the committee express its deep concern about certain educational materials circulated to students by UNRWA during the pandemic in error that violates the values of human rights, tolerance, neutrality and non-discrimination, at a time when UNRWA is receiving funding from the Government of Canada, and report this motion to the House”
It’s noteworthy that the final version of the text included the phrase “in error”. That addition was not agreed to unanimously, because it would suggest that the copious educational material openly promoting extreme nationalism and violence against Jews somehow only found its way into classrooms by some weird accident. (Someone might have left a window open and the wind blew book-filled boxes in. Could of happened to anyone.)
In the end, only the four Conservative members of the committee opposed the “in error” phrasing.
The motion was originally inspired by a report published by the Institute for Monitoring Peace and Cultural Tolerance in School Education (IMPACT-se). That report documented many instances of the glorification and promotion of violent Jihad, martyrdom, and terrorism within UNRWA educational materials.
As it turns out, it’s now clear that not only was the content created by UNRWA and included in their curricula by design, but it’s still being printed and widely taught in UNRWA schools (when they’re operational). The agency’s only practical response to the criticism was to remove references from their public-facing website.
Further research by IMPACT-se in the aftermath of the October 7 attacks has revealed how, for instance, “13 UNRWA staff members have publicly praised, celebrated or expressed their support for the unprecedented deadly assaults on civilians.” The report also documents how at least 18 UNRWA graduates have “died carrying out acts of terror.”
Of course, our concerns go far beyond education. Since the start of Israel’s land offensive in Gaza, it’s become painfully obvious that UNRWA schools and hospitals have been used as rocket launching areas, weapons storage facilities, and access points for Hamas military tunnels – all clear war crimes. It’s difficult to imagine how a reasonable person could conclude that UNRWA officials – and those providing program oversight – were not aware of those violations.
More recently, the UN itself admitted that at least nine of its employees “might have” been involved in the October 7 massacres and will be fired.
GAC – at least in its public statements – hasn’t ignored the problem. In June of 2023, they announced that:
“Canada will remain closely engaged with UNRWA and continue to exercises (sic) enhanced due diligence for all humanitarian and development assistance funding for Palestinians. This work includes ongoing oversight, regular site visits, a systematic screening process and strong anti-terrorism provisions in funding agreements.”
The problem is that subsequent credible revelations have demonstrated that the “oversight” and “regular site visits” promised by GAC either never happened, were an embarrassing failure…or something much worse.
Canadians have a right to know how their money is spent. It would be helpful if the government, and Global Affairs Canada in particular, would at the very least tell us exactly how they’re going to fix these messes.
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A few days ago, Public Services and Procurement Canada tabled their audited consolidated financial statements of the Government of Canada for 2024. This is the official and complete report on the state of government finances. When I say “complete”, I mean the report’s half million words stretch across three volumes and total more than 1,300 pages.
Together, these volumes provide the most comprehensive and authoritative view of the federal government’s financial management and accountability for the fiscal year ending March 31, 2024. The tragedy is that no one has the time and energy needed to read and properly understand all that data. But the report identifies problems serious enough to deserve the attention of all Canadians – and especially policy makers.
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Following the approach of my Parliamentary Briefings series, I uploaded all three volumes of the report to my AI research assistant and asked for its thoughts. Each one of the observations that came out the other end is significant and, in calmer and more rational times, could easily have driven a week’s worth of news coverage. But given the craziness of the past few weeks and months, they’re being largely ignored.
With that in mind, I’ve made this special edition of the Parliamentary Briefings series fully accessible to all subscribers.
We begin with a summary of the purpose and scope of the three uploaded volumes of the Public Accounts of Canada for 2023–2024:
Volume I: Summary Report and Consolidated Financial Statements
- Purpose: Provides a high-level overview of the federal government’s financial performance, presenting the consolidated financial statements audited by the Auditor General. It serves as the primary accountability report.
- Scope:
- Audited financial statements.
- Analysis of revenues, expenses, and the accumulated deficit.
- Overview of assets, liabilities, and financial position.
- Discussion of economic context, risks, uncertainties, and ten-year comparative financial data.
Volume II: Details of Expenses and Revenues
- Purpose: Presents the financial operations of the government, broken down by ministries and agencies, for detailed accountability.
- Scope:
- Financial transactions segregated by ministry.
- Details of appropriations, revenues, and transfer payments.
- Summary tables on ministerial expenditures by type, object, and other dimensions.
- Appendices providing additional details on budgetary authorities and their sources.
Volume III: Additional Information and Analyses
- Purpose: Offers supplementary analyses and financial data beyond what is included in the first two volumes, focusing on revolving funds, professional services, and shared-cost programs.
- Scope:
- Financial statements of revolving funds (e.g., Passport Canada, Canadian Grain Commission).
- Expenditure details on acquisitions, transfer payments, and public debt charges.
- Analyses of federal-provincial shared-cost programs and claims against the Crown.
- Miscellaneous financial and operational data for broader transparency.
The Audit: Based on these documents, could you identify the most serious threats to Canada’s economic stability?
From the Public Accounts of Canada 2023–2024, several serious threats to Canada’s economic security can be identified. These threats emerge from the broader fiscal and economic analyses, contingent liabilities, and uncertainties highlighted in the documents.
1. Growing Public Debt and Debt Servicing Costs
- Observation: Canada’s public debt charges increased significantly in 2024, rising by 35.2% year-over-year, largely due to higher interest rates on debt. The total accumulated federal debt stood at $1.24 trillion, representing 42.1% of GDP, up from 41.1% the previous year.
- Risk: Rising debt servicing costs reduce fiscal space for critical public investments, making the economy vulnerable to future economic shocks or downturns.
2. Contingent Liabilities and Indigenous Claims
- Observation: The government recorded $16.4 billion in contingent liabilities related to Indigenous claims in 2024, reflecting ongoing efforts to address past injustices. These liabilities have been increasing at an average annual growth rate of 30% since 2016.
- Risk: The unpredictable nature and scale of these liabilities could create significant financial pressures if settlements or court decisions require substantial payouts.
3. Legacy Costs from the COVID-19 Pandemic
- Observation: The government recorded $4.7 billion in pandemic-related expenses for 2024, including write-offs for expired vaccines and provisions for unrecovered loans and benefits.
- Risk: These costs highlight vulnerabilities in emergency financial planning and expose the government to further financial risks if similar large-scale public health crises occur.
4. Economic Pressures from High Inflation and Interest Rates
- Observation: Inflation returned to the Bank of Canada’s 2% target by mid-2024 after 41 consecutive months above this threshold. However, elevated interest rates (peaking at 5%) contributed to a softening economy.
- Risk: Prolonged periods of high interest rates could suppress household and business spending, slowing economic growth and increasing the likelihood of a recession.
5. Climate Change and Environmental Commitments
- Observation: Significant spending is allocated to addressing climate change, with over $1 billion dedicated to environmental programs in 2024, including pollution pricing proceeds and clean energy initiatives.
- Risk: Canada’s reliance on resource-intensive industries and increasing costs to meet climate targets create economic vulnerabilities, particularly in regions heavily reliant on fossil fuels.
6. Global Economic Instability
- Observation: Global supply chain disruptions, energy price volatility, and geopolitical events (e.g., Russia’s invasion of Ukraine) significantly impacted Canada’s economy, with slower GDP growth (1.5% in 2023) and reduced trade.
- Risk: External shocks could exacerbate domestic economic challenges, such as rising import costs or reduced demand for Canadian exports.
7. Labor Market and Productivity Challenges
- Observation: While job creation remained positive, population growth outpaced employment gains, leading to an increase in the unemployment rate to 6.5% by October 2024. Productivity improvements have been uneven.
- Risk: Labor shortages in key sectors and declining workforce participation among certain demographics (e.g., aging population) could undermine economic resilience.
8. Dependence on Resource Revenues
- Observation: Volatile global commodity prices impacted nominal GDP growth, with gains slowing to 2.9% in 2023 after double-digit growth in prior years.
- Risk: Fluctuations in resource revenues leave Canada exposed to external shocks, particularly in provinces like Alberta and Saskatchewan, heavily reliant on oil and gas.
These challenges underscore the need for proactive fiscal and policy measures to safeguard economic stability, manage liabilities, and address emerging risks.
The Audit: What would you recommend as the three most urgent areas to address to avoid deepening the economic crisis?
1. Manage Rising Public Debt and Debt Servicing Costs
- Why It’s Urgent: The rapid increase in public debt charges (35.2% in 2024) is crowding out fiscal space for essential programs. The federal debt, at 42.1% of GDP, has become a significant liability, with interest rate fluctuations posing an ongoing threat.
- Recommendations:
- Introduce stricter fiscal discipline by prioritizing expenditures that yield long-term economic benefits (e.g., infrastructure, innovation).
- Develop a comprehensive debt reduction strategy to stabilize the debt-to-GDP ratio in the medium term.
- Explore debt refinancing strategies to lock in lower interest rates where feasible.
- Impact: Reducing debt servicing pressures will free up resources for critical investments and improve Canada’s fiscal resilience.
2. Mitigate the Economic Impact of Contingent Liabilities
- Why It’s Urgent: Contingent liabilities related to Indigenous claims have grown exponentially (30% annually since 2016), creating fiscal unpredictability and potentially overwhelming future budgets.
- Recommendations:
- Accelerate settlement negotiations to limit litigation costs and interest on outstanding claims.
- Establish a transparent reserve fund specifically for contingent liabilities, ensuring predictable future payouts.
- Increase collaboration with Indigenous communities to address systemic issues and prevent further claims.
- Impact: Resolving liabilities promptly will reduce fiscal uncertainty and demonstrate Canada’s commitment to reconciliation.
3. Address Structural Labor Market and Productivity Challenges
- Why It’s Urgent: Despite job creation, rising unemployment (6.5% in late 2024) and productivity stagnation threaten long-term economic growth. Labor shortages in critical sectors further exacerbate vulnerabilities.
- Recommendations:
- Expand skilled immigration programs to address labor shortages in healthcare, technology, and green industries.
- Increase investment in workforce retraining programs, particularly for sectors undergoing automation or transition due to climate policies.
- Promote workplace flexibility and childcare access to increase labor force participation, particularly among women and aging workers.
- Impact: Enhancing workforce productivity and participation will strengthen the economic foundation and support GDP growth.
Rationale for Prioritization
These areas represent the most immediate threats to economic security and fiscal stability. Addressing them proactively can reduce vulnerabilities and position Canada for sustainable growth.
The Audit: What are the most surprising and disturbing details in these documents?
1. Rapid Growth of Public Debt Charges
- Detail: Public debt charges increased by 35.2% year-over-year to $47.3 billion, representing one of the fastest-growing expense categories. This reflects a combination of higher interest rates and the significant size of Canada’s debt.
- Why Disturbing: Such a rapid increase in debt servicing costs could divert funds from essential public services and programs. It also signals limited fiscal flexibility in the event of future economic shocks.
2. Ballooning Contingent Liabilities
- Detail: The federal government recorded $16.4 billion in expenses for Indigenous contingent liabilities in 2024. This is part of an ongoing surge, with liabilities increasing by 30% annually since 2016.
- Why Disturbing: While reconciliation efforts are vital, the sheer scale and rapid growth of these liabilities are fiscally unsustainable without structural changes or dedicated funding mechanisms. The risk of further liabilities emerging adds to fiscal uncertainty.
3. Significant Write-offs and Provisions for Pandemic Programs
- Detail: The government wrote off $1.2 billion in expired COVID-19 vaccines and therapeutics and recorded $3.5 billion in provisions for unrecovered pandemic-era loans.
- Why Disturbing: These figures highlight inefficiencies in planning and administration during the pandemic response, leading to substantial financial losses. The scale of unrecovered funds also raises questions about accountability in the deployment of emergency programs.
4. Rising Unemployment Despite Job Creation
- Detail: While 475,000 jobs were created in 2023, the unemployment rate rose to 6.5% by late 2024 due to population growth outpacing employment gains.
- Why Surprising: Despite strong job creation, an inability to keep pace with population growth signals structural issues in labor force integration. This poses a risk to Canada’s economic competitiveness and social cohesion.
5. Declining Corporate Income Tax Revenues
- Detail: Corporate income tax revenues decreased by 0.7%, driven by reduced taxable income despite an overall increase in total revenues.
- Why Surprising: The decline in corporate tax revenues during a period of economic recovery raises concerns about potential tax avoidance, economic inequality, or over-reliance on other revenue streams, such as personal income taxes.
6. Substantial Environmental and Climate Spending
- Detail: Over $1 billion was allocated to environmental programs, including pollution pricing proceeds. However, the documents note Canada’s slow progress toward net-zero targets and risks to resource-dependent provinces.
- Why Disturbing: While necessary, this spending may be insufficient given the scale of the climate challenge. The mismatch between spending and measurable progress on climate goals risks long-term environmental and economic consequences.
7. Unanticipated Costs of Indigenous Reconciliation
- Detail: Beyond contingent liabilities, the government is facing unpredictable settlement costs due to increasing litigation and the complexity of claims. These have already exceeded $60 billion since 2016.
- Why Disturbing: The ongoing financial impact of these settlements reflects Canada’s historical neglect of Indigenous issues. Resolving these claims is essential, but the lack of predictability or dedicated funding highlights systemic shortcomings in reconciliation strategies.
8. Softened GDP Growth and Inflation Challenges
- Detail: Real GDP growth slowed to 1.5% in 2023, and inflation remained high throughout the year, only reaching the Bank of Canada’s 2% target by mid-2024.
- Why Disturbing: The prolonged inflationary period and sluggish growth signal a fragile recovery. These economic conditions could exacerbate income inequality and lead to further fiscal strain.
9. High Provisions for Unrecovered Loans
- Detail: Provisions of $3.5 billion were recorded for emergency loans provided during the pandemic. The government continues to face difficulties in recovering these funds.
- Why Disturbing: This provision raises serious questions about the efficiency of loan administration and the government’s ability to safeguard public funds during emergencies.
10. Heavy Dependence on Volatile Resource Revenues
- Detail: Nominal GDP growth slowed to 2.9% in 2023, largely due to easing commodity prices after a surge in 2022. Resource dependence remains a key economic vulnerability.
- Why Surprising: Despite global shifts toward renewable energy, Canada’s reliance on resource revenues remains high, posing long-term risks to economic diversification and stability.
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Canadian Taxpayers are funding programs in foreign countries with little effect
Back in early November I reached out to Global Affairs Canada (GAC) for a response to questions I later posed in my What Happens When Ministries Go Rogue post. You might recall how GAC has contributed billions of dollars to the Global Fund to Fight AIDS, Tuberculosis and Malaria, only to badly miss their stated program objectives. Here, for the record, is my original email:
I’m doing research into GAC program spending and I’m having trouble tracking down information. For instance, your Project Browser tool tells me that, between 2008 and 2022, Canada committed $3.065 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The tool includes very specific outcomes (like a drop of at least 40 per cent in malaria mortality rates). Unfortunately, according to reliable public health data, none of the targets were even close to being achieved – especially in the years since 2015.
Similarly, Canada’s $125 million of funding to the World Food Programme between 2016 and 2021 to fight hunger in Africa roughly corresponded to a regional rise in malnutrition from 15 to 19.7 percent of the population since 2013.
I’ve been able to find no official documentation that GAC has ever conducted reviews of these programs (and others like it) or that you’ve reconsidered various funding choices in light of such failures. Is there data or information that I’m missing?
Just a few days ago, an official in the Business Intelligence Unit for Global Affairs Canada responded with a detailed email. He first directed me to some slightly dated but comprehensive assessments of the Global Fund, links to related audits and investigations, and a description of the program methodology.
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To their credit, the MOPAN 2022 Global Fund report identified five areas where important targets were missed, including the rollout of anti-corruption and fraud policies and building resilient and sustainable systems for health. That self-awareness inspires some confidence. And, in general, the assessments were comprehensive and serious.
What initially led me to suggest that GAC was running on autopilot and ignoring the real world impact of their spending was, in part, due to the minimalist structure of the GAC’s primary reporting system (their website). But it turns out that the one-dimensional objectives listed there did not fully reflect the actual program goals.
Nevertheless, none of the documents addressed my core questions:
- Why had the programs failed to meet at least some of their mortality targets?
- Why, after years of such shortfalls, did GAC continue to fully fund the programs?
The methodology document did focus a lot of attention on modelling counterfactuals. In other words, estimating how many people didn’t die due to their interventions. One issue with that is, by definition, counterfactuals are speculative. But the bigger problem is that, given at least some of the actual real-world results, they’re simply wrong.
As I originally wrote:
Our World in Data numbers give us a pretty good picture of how things played out in the real world. Tragically, Malaria killed 562,000 people in 2015 and 627,000 in 2020. That’s a jump of 11.6 percent as opposed to the 40 percent decline that was expected. According to the WHO, there were 1.6 million tuberculosis victims in 2015 against 1.2 million in 2023. That’s a 24.7 percent drop – impressive, but not quite the required 35 per cent.
I couldn’t quickly find the precise HIV data mentioned in the program expectations, but I did see that HIV deaths dropped by 26 percent between 2015 and 2021. So that’s a win.
I’m now inclined to acknowledge that the Global Fund is serious about regularly assessing their work. It wouldn’t be fair to characterize GAC operations as completely blind.
But at the same time, over the course of many years, the actual results haven’t come close to matching the programs objectives. Why has the federal government not shifted the significant funding involved to more effective operations?
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