-Finally, additionality questions may be posed as between donors. The focus of this particular storm con-cerns the activities of the GFATM and PEPFAR. Many have complained that PEPFAR diverts U.S. resources away from GFATM, a multi-lateral agency, to a bilateral and highly politicised program. Questions of donor additionality are not confined to HIV/AIDS. Cohen [17] , in looking at the involvement of GPPPs in health R&D, reports that, in expert interviews, researchers complain that the new availability of philanthropic funds for medical research is "crowding out" funding that would have been received from government agencies such as the U.S. National Institutes for Health.