Washington

Members of the new Global Fund to Fight AIDS, Tuberculosis and Malaria were set to meet in New York this week to decide how best to distribute its first round of funding.

But its governing board is already facing some tough questions about how it has managed the ambitious international project during its debut year.

The fund was launched last July, when leaders of world's eight most powerful nations pledged to contribute US$1.3 billion between them for public-health projects — including some applied research — aimed at countering the three diseases, which between them kill about six million people each year. Further public and private donations have since built the fund up to $1.9 billion.

A technical review panel vets grant proposals before the governing board makes the final decisions. Fund supporters say these provisions should make for a rational, fair and expeditious grant-application process.

But some scientists and government officials charge that the fund was slow to issue clear guidelines for grant proposals. Interested parties were then given only two months to develop proposals for the first round of grants, worth up to $400 million, to be disbursed at the New York meeting.

“We probably did it too fast and didn't give enough information out,” concedes Bill Steiger, a health-department official involved in running the fund in the United States.

The fund has also not determined how it will evaluate the success of projects that it does support, despite requests from anxious donor governments that it does so.

Scientists say that the formation of the technical review panel — set up just weeks before it met in Geneva in March to look at 322 grant proposals — was rushed.

“People are worried that if they rush the money into the hands of countries that are not prepared to spend it effectively, it's going to be just as bad as not spending it at all,” says Richard Chaisson, director of the Center for Tuberculosis Research at Johns Hopkins University in Baltimore. Chaisson was invited to serve on the review panel but says that he was unable to do so because of the short notice he was given.

“We have to get it right this time,” says Gail Cassell, vice-president for infectious diseases at Eli Lilly, an Indiana-based drug company. “I fear that, because we are expected to do it so rapidly, we won't.”

The fund's supporters say they had to move quickly to meet the expectations of donors. “There has been enormous pressure for us to move fast and to show that this can work,” says Anders Nordstrom, the fund's interim director. He says that most of the criticism comes from scientists and officials in rich, donor countries, not from the poor countries that have to deal with the diseases.

And while the fund is being attacked for imperfections resulting from its haste to swing into action, other critics argue that its war chest is too puny to tackle the diseases. They point out that Kofi Annan, the secretary general of the United Nations, who pushed for the creation of the fund, has said that between $7 billion and $10 billion in extra aid is needed to combat AIDS alone.

“The amount of money that donors have contributed so far is quite unimpressive,” says Amir Attaran of Harvard University's John F. Kennedy School of Government. But government officials say that the private and public sectors will increase their investment once they see that their initial money has been wisely spent.