Fund to fight key diseases running low

RICHARD FEACHEM, SAN FRANCISCO, USA

 A study just published in the Lancet, a British medical journal, found that malaria killed 1.2 million people in 2010. That is nearly double the World Health Organization’s official estimate.

 Compounding this tragic news is that the Global Fund to Fight AIDS, Tuberculosis and Malaria — the largest and arguably the most effective financier of malaria control — is running out of money. It has suspended new grants until 2014 — grants that would have provided millions of families with protective bed nets, life-saving medicines and vital health-care services.

 Unless we make a concerted and immediate effort to support the Global Fund, the tremendous gains it has made in the past decade will be lost. The United States should convene an emergency donor meeting to address the Global Fund’s resource gaps and ensure that it can operate at full capacity.

 Ten years ago, HIV/AIDS, tuberculosis and malaria were crushing burdens on development, killing over 6 million people a year and draining billions of dollars from the global economy. In the developing world, HIV was a death sentence. Only about 50,000 Africans were on anti-retroviral treatment. After five decades of spotty results, aid was still primarily directed by Western technocrats with little accountability for results.

 The Global Fund was created in 2002 to change all of this. It had two fundamental goals: to mobilize massive new resources against HIV/AIDS, tuberculosis and malaria, and to shatter old development-assistance models by being transparent, accountable and demand-driven. On both, the Global Fund has been an unambiguous success.

To date, the Global Fund has disbursed $15 billion to programs in 150 countries. These grants have provided 230 million insecticide-treated bed nets and 170 million antimalarial treatments. While the new data have counted adult malaria deaths, increasing the total number of deaths reported, it also shows that these investments have saved more than half a million lives. Taking everything into account, malaria deaths actually decreased, from 1.8 million in 2004 to 1.2 million in 2010.

 Global Fund investments have also provided antiretroviral treatment for 3.3 million people living with HIV/AIDS. Nearly half of all people currently on AIDS treatment in low- and middle-income countries depend in some way on the Global Fund to stay alive.

   Further, its grants have let health officials treat 8.6 million cases of tuberculosis, saving more than 4 million lives. Thanks in large part to these efforts, the number of tuberculosis deaths has reached lowest point in 10 years.

   Through all of this, the Global Fund has remained true to its founding principles. Grant recipients — not donors — lead the process of identifying and addressing national health challenges. Civil-society groups, public officials and the private sector are equal partners in developing sound proposals and implementing effective programs. Scores of sensitive documents are published online, including extensive and detailed financial information.

 This is why the Global Fund’s model has been consistently validated by diverse organizations. Just last month, Publish What You Fund, a project of the nonprofit Global Campaign for Aid Transparency, ranked the Global Fund second among 58 donors surveyed for its commitment to transparency. And last year, the Global Fund earned top marks in the Department for International Development’s aid review for its “excellent track record for delivering results” that provided, “very good value to the … taxpayer.”

 The news of malaria’s revised death toll, and the striking downward trend in annual deaths, show that we need the Global Fund now more than ever. Yet instead of planning to end malaria, we are praying that our families and friends survive the next rainy season.

 Instead of creating the AIDS-free generation that President Obama envisions, we face scenarios in which millions now on treatment may be left for dead. Instead of modeling the elimination of tuberculosis, we are worrying about the rising tide of drug resistance.

   It is time for governments to take an honest look at their foreign-aid programs. They would be hard-pressed to find a better return on investment than what we have seen from the Global Fund. After 10 years, the Global Fund has unequivocally proven to be responsive, innovative and highly effective in its approach to aid. The United States should convene an emergency donor conference to mobilize new resources for the Global Fund. This is an investment we must continue to make.

 

Richard Feachem M.D.  is director of the Global Health Group at the University of California at San Francisco and formerly the founding executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. This article of his ran in the Provincial Journal and Richard is kind enough to allow this article to be posted in the Universal Health Blog.