The success of the fund since its launch has been unprecedented – 4.9 million lives saved, HIV treatment for 2.5 million and TB treatment for six million provided, as well as over 100 million malaria bed nets distributed. The Fund has also had a significant impact on strengthening weak health systems and reducing the number of deaths amongst women and children. There is no other global health initiative that is so central to saving lives throughout the world; in fact the Global Fund is essential to fulfilling the promises the West made to the world in the Millennium Development Goals (MDGs).
If we want to stop unnecessary deaths from Malaria, TB and AIDS; if we want to slash maternal and child mortality; we need a growing, fully-funded Global Fund.
A major factor in the success of the Fund is its demand-driven model, in which the amount of money the Fund gives out depends on how many sound applications are received from developing countries. At the establishment of the Fund donor nations, including the UK, made the commitment that no quality application should go unfunded. Therefore it is of great concern that at the current board meeting, some donors are advocating for a cap on the next funding round, to deal with chronically insufficient funds being received from donors.
This proposed cap is a contradiction to the demand-driven model, and would place a limit on the programmes that the Fund can support, before we even know what the need from countries is. In reality, this will mean that patients will simply be denied the essential services they need to survive.
Furthermore, the cap is being discussed in the midst of the Global Fund’s replenishment process which will determine the scale of impact the Fund will have over the next three years. The funding scenarios outlined, ranging from $13bn to $20bn, have each been calculated to be capable of saving different numbers of lives. However, even if the upper target is reached, we will still not be delivering enough resources to meet the MDG commitments on health. Anything less than $20bn will fall well short of the promises donors have made to fully-fund the Fund and will lead to a significant number of further unnecessary deaths.
This issue goes right to the heart of whether promises made to the most vulnerable in good times will be kept in bad. Around the world, civil society organisations, along with grassroots and patient networks have been sending strong messages to the board over the last few days, expressing their deep concern about what is being discussed.
The UK Stop AIDS Campaign, the UK Coalition to Stop TB (which is hosted by RESULTS), the Malaria Consortium and the Maternal Mortality Campaign have written urgently to the three main party leaders asking them to recommit the UK to its promise to the developing world by contributing its fair share of the Global Fund’s replenishment – £847m over the next three years – and maintaining the central premise of the Fund that no quality application should go unfunded.