First round of payments from the Global Fund.

1 Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg Br 1991; 73: 53–56. 2 Barrett DS. Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg Br 1991; 73: 833–37. 3 Skinner HD, Barrack RL, Cook SD. Age-related decline in proprioception. Clin Orthop 1984; 184: 208–01. A recent consensus statement from 12 major health non-governmental organisations defines several moves that are required from the Fund if it is to meet its potential in promotion of access to health care in developing countries. The Fund should publicise its strong support for the Doha declaration, and issue guidelines to help countries make appropriate use of the provisions outlined in the declaration in their proposals. Efforts to introduce legislation to support equity pricing, and the use of the TRIPS safeguards, if relevant, should be supported by the Fund working with relevant intergovernmental organisations. An explicit commitment should be made to support the provision of quality products by the most affordable and most sustainable means, including systematic equity pricing through tiered pricing systems and the use of generic supplies, accessed where necessary through the issue of voluntary or compulsory licences. This should form part of the criteria by which proposals are considered. WHO’s work on pre-qualification of suppliers of affordable medicines will facilitate the best use of funding and should be supported by the Fund. Furthermore, the Fund should collaborate with intergovernmental bodies in development and use of global or regional bulk purchase mechanisms for these medicines. The Doha declaration makes clear that the TRIPS agreement should be implemented in a way that ensures the right to protect public health and, in particular, to promote access to medicines for all who need them. Indicators for measurement of the success of the Global Fund should include its role in promotion of the practical application of these rights by national governments. *Tom Ellman, Nathan Ford, Ruairi Brugha