There has been a proliferation of Global Funds in recent years, generally customised to plug specific gaps in the international system or to mobilise finance for a single issue.  There are now more than 100 global partnerships in health alone. 

They have been effective as vehicles for resource mobilisation, accounting for 3% of ODA in 2005, and may become increasingly important in the future as aid flows increase. 

Most Global Funds use a ‘vertical’ programming approach – that is, they implement a standard set of programmes in a specific sub-sector across all their countries of operation.  This approach is not consistent either with harmonisation with other donors or alignment with country strategies and systems.  In the health sector, there are widespread concerns that Global Funds are diverting resources away from basic sector-wide reforms.  These distortions tend to be the greatest in countries with weak planning and budgeting. 

In recent time, the major Global Funds in health have become more sensitive to criticisms of their aid practices.  In preparation for Accra, GFTAM is coordinating a study on learning and adaptation by global health programmes in response to the Paris Declaration.