In 2016, Venezuelans living with HIV asked the Global Fund to Fight AIDS, Tuberculosis and Malaria for emergency aid. But despite an economic catastrophe, Venezuela’s high national income made it ineligible. Data on HIV that might have helped was censored or had never been gathered. The public debate around this case highlighted the growing use of indicators and data in global health finance. Mathematical models had shown that ending HIV was achievable through rapid scale-up of testing and treatment to meet the Sustainable Development Goal of “ending AIDS” by 2030. But funding for the global HIV response has leveled off, and was not enough to meet the goals everywhere. Bilateral and multilateral donors were targeting funds where they could have the greatest impact, especially in Sub-Saharan African countries where HIV prevalence is high and national incomes low. Donors also needed to show progress to the politicians who approve their budgets. Yet how progress is measured through indicators and data is contested, including by civil society. As an example of how indicators can become sites of contest and levers of political power, the chapter examines Global Fund corporate Key Performance Indicators (KPIs) on lives saved, service coverage, and health systems strengthening.

This chapter recalls the author’s earlier visit to a Chinese compulsory drug detention center to explore covert civil society counter-surveillance of a tightly restricted facility under multiple rings of state surveillance, and to reflect on the limits of international regimes of monitoring and accountability. While torture and forced labor were widely reported, the facility’s manager presented it to the author as a model detention center. Ten years later, as senior human rights advisor at the Global Fund, which then invested in HIV programs in similar centers in Viet Nam, the author was tasked with developing a corporate Key Performance Indicator on human rights. The process of putting in place systems of compliance to ensure that aid money was not financing human rights violations became a public challenge. The chapter asks what can be known, from Geneva, about what really happens in places situated within multiple circles of top-down surveillance and display? By engaging in monitoring, civil society and development organizations attempt to engage in their own forms of surveillance and discipline. Sometimes, what they encounter is a Potemkin effect: a sunny display intended to deflect accountability and hide grimmer realities.