The launch of the global fund to fight AIDS , Tuberclosis and Malaria provided a golden opportunity to achieve major break through in the response towards these three diseases , the major drugs cost burden have been removed from the countries mostly affected by these diseases , now more than 500 programmes are funded with global fund in 136 countries around the world . But , with provision of huge funding opportunities for programmes through the global fund mechanism , it is a high time for the global fund to enhance and improve sustainability component in the proposals for funding for the following reasons : 1. In the light of the competing priorities and humanitarian needs especially on the emergency part , and other issues like global warming and the global raise of fuel and food prices , donors will soon get fatigued and may not be interested to further fund these long term projects , especially if not a tangible , sustainable impact were reported , this may lead to sudden withdrawal of funding which will negatively affect the success which was acheived before . 2. Countries will be very much dependant on the GF grants to solve thier health probelms , all the health system in the country will be very dependant and thier capacity will even continue to deteriorate , esepcially when it comes to advocacy and intra govermental negotiation with the policy makers , the sudden withdrawal of funds , especially those allocated for procurement and supply of the essential durgs of the three diseases , will be a very painful weaning process . Sustainability could be improved through three major components : 1- Each successful proposal should have a local contribution from the Goverment : This is very important since it will enhance the partnership concept and will make all states responsible and accountable in the fight against these diseases , In many countries the provision of huge sum of money from the global fund , has lead - unfortunately- to decrease national goverment expenditure on the diseases which are funded by GF , the goverments thinks that since these programmes of the three diseases are well funded - long term funds- by the global fund , then they should redirect their limitted resources to other diseases or programmes which are under funded or not funded , which is very dangerous strategy ( e.g : in one of the African countries , efforts to conduct national survey on HIV/AIDS failed because the goverment didn't pay it's contribution , this further lead to donors be more reluctant to support this important initiative since they see the goverment is not willing to support - when they have resources from the oil revenues that brings lots of money to the national treasury ) , since they consider the GF grants are continoues funds and not really considering the phasing out of these grants , having the local contribution as a pre condition for successful proposals will help to change the mind set of goverment officials and gradually taking over responsibilities , to make it affordable the local contribution should not exceed 5-10% of the total grants , but it will help in sustainbility since the goverments will be keen to follow up and keep the positive impact that was achieved after the project phased out . 2- Enhancement and strengthening of the Monitoring and evaluation system : Although it is an essential part of each successful project , and all proposals are requested to elaborate the monitoring and evaluation system and the link to the national M&E frame work ( three ones principle ) , but from expereinces most of the efforts were directed towards monitoring the process , the activities and sometimes the outputs or results , the M&E officers in PR , SRs are all busy monitoring thier implmentation and achieving the pre set targets , the qualitative part is very minimal and almost no emphasis on evaluating the impact of such intervention , some people may argue that these projects are just starting and need some time before embarking on evaluation , and the response for this should be first all evaluations and review activities should be clearly spelled out in the plan of action , plus a mid term review ( not only to see whether the targets were achieved or not , but also to see the current impact of these results achieved , how are they contributing to the GOAL of the project ) . 3- Involvement of the local private sector : since most of the expenses of the GF grants are directed towards procurement and supply of medicines for the three diseases , the local private sector should be encouraged to enter the production market of these products ( without jeopardizing the quality ) and could be supported by allocating some money for local procurement , this will avail these supplies in countries and will make it easier and affordable for the goverments to take over responsibilities after the project phases out . I think if we managed to find modalities to put the three above components into action , this will greatly improve the sustainability of the impact of these projects .