This thesis explores how the Global Fund’s standardized funding stipulations and expectations impact HIV/AIDS programs in Sierra Leone. Situating funding mechanisms within the current trajectory of international healthcare delivery and financing, I argue that the Global Fund’s business-oriented financing approach has shaped Sierra Leonean program targets towards data production and digitization, allowing the Global Fund to make decisions ‘from a distance.’ Drawing on three months of ethnographic fieldwork in Freetown, Sierra Leone, I demonstrate how: 1) contradictions between weak infrastructure and Global Fund expectations impact HIV program practices; 2) the Global Fund’s data requirements and timeframes create asymmetries and disconnects in-country; and 3) audit and accountability technologies in HIV programs can become practices unrelated to health outcomes.
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Thesis advisor: Erikson, Susan L.
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