The directors of the Global Fund to Fight AIDS, Tuberculosis and Malaria have appointed a highly regarded British expert on international health to head the newly formed organization.
In choosing Richard G.A. Feachem, a professor in the University of California system, the Global Fund's board rebuffed last-minute pressure by the U.S. delegation to reconsider its candidate. That person, George E. Moose, an American diplomat with extensive experience in Africa, had been highly regarded by the directors, but was not among the three finalists for the job.
According to several people with firsthand knowledge of the proceedings, the American delegation, which included Tommy G. Thompson, secretary of health and human services, made a forceful pitch for Moose.
The United States is the largest contributor to the fund, which was formed last year as the most concrete manifestation of the global movement demanding that state-of-the-art medical care, particularly for AIDS, be brought to the world's poorest people. The United States has provided $500 million of the $2.08 billion pledged to the fund, and legislation in Congress would add substantially to that contribution.
The Global Fund is a new model for massive assistance to the world's poor. It is not formally allied with either a government or an international agency, such as the United Nations or the World Bank. Instead, it's an independent entity, run by representatives of rich and poor countries, that will disburse money based on an agenda it alone formulates. Large donors, accustomed to exerting substantial control over how their contributions to overseas aid are spent, have greeted it with support and suspicion.
Feachem, 55, is director of the Institute for Global Health at the University of California campuses in San Francisco and Berkeley. Previously, he was a senior official of the World Bank's health program. He was dean of the London School of Hygiene and Tropical Medicine in the early 1990s.
The United States, which has one of the 18 seats on the Global Fund's board, was urging the appointment of Moose, ambassador to United Nations' agencies in Europe. Previously, he was assistant secretary of state for African affairs and ambassador to Benin and Senegal.
Many observers yesterday said the struggle over the appointment was the first big test of the fund's willingness to assert its independence.
"There is now evidence that the fund is making all its decisions independent of political pressure," said an official familiar with the board of directors meeting in New York this week. "I think everyone agrees that's a good sign. This is a win for the fund."
In addition to picking a director, the board is meeting to make its first round of grants from more than 300 applications submitted by governments and aid agencies in more than 100 countries. The awards will be announced today; a second round will be awarded in November.
People familiar with the fund's activities said that about 600 candidates were nominated for the executive director position. A search committee appointed by the board shortened that list to 12. The committee overwhelmingly favored Feachem and presented his name to the board this week.
The board has representatives from industrialized countries and developing countries in approximately equal numbers. (It also has representatives from two non-governmental organizations, one German and one Ugandan; and from two private entities, the Bill and Melinda Gates Foundation and Anglo American PLC, a mining conglomerate active in Africa.) It asked the search committee to offer more than one name for the executive director's job.
The committee then provided the two more candidates. They were Kathleen Cravero, an American official with UNAIDS, the AIDS organization run by the United Nations and the World Bank; and Ernest Loevinsohn, an official of the Canadian International Development Agency.
According to several people with firsthand knowledge of the proceedings, the American delegation, which included Tommy G. Thompson, secretary of health and human services, made a forceful pitch for Moose. He had been among the 12 finalists. After a long discussion, the board decided to convene in closed session Tuesday night.
There, it considered the merits of Feachem and Moose and eventually chose Feachem by consensus, not by counted vote, shortly before midnight.
"I have been personally and strongly reassured by the U.S. delegation on the board that I have their full support in taking the fund forward. And I am very grateful for that," Feachem said last night.
Bill Pierce, a spokesman for Thompson, said that the secretary believes there was "a good group of candidates" for the job, and that he "looks forward very much to working with Richard Feachem."
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