Last June Radut Stefan’s life turned upside-down. He became very ill, was forced to leave his job and delay his wedding. Stefan was diagnosed with multidrug resistant TB (MDR-TB), which requires two years of treatment. He has endured terrible side effects from the medication in hopes of making a full recovery. Now he’s terrified it was all in vain.
Stefan lives in Romania, which relies on the Global Fund to Fight AIDS, Tuberculosis and Malaria to supply anti-TB medication. In six months Romania’s grant will run out. Stefan fears the medicine will run out as well.
Facing a $2 billion USD shortfall, the Global Fund decided to cancel Round 11, its upcoming funding round. The Fund has set up transitional funding for programs facing disruption in low income countries. But countries considered middle income are unable to apply. Luckily, Romania is able to apply for TB funding because of its high disease burden, but there are no guarantees it will be approved and cannot be used to expand treatment.
Despite being classified as an upper-middle income country, many Romanians still live in extreme poverty. The country’s health system is grossly underfunded and without support of the Global Fund Stefan worries patients like him will lose access to life saving TB treatment. “This will be a disaster,” he declares. “It will be like we went through torture for nothing. I will be TB positive again. In a few years I’ll die.”
Silvia Asandi, the head of Romanian Angel Appeal Foundation, a non-profit organization supporting orphans and vulnerable children, believes people in middle income countries will be the first casualties of the Round 11 cancellation. Middle income countries in Eastern Europe are home to the fastest growing epidemic of drug-resistant TB. Without new funding to combat disease, rates of MDR-TB are likely to skyrocket. Without new funding, Asandi estimates at least 1,000 people with MDR-TB will go undiagnosed, and continue to spread the disease amongst their community. She’s unaware of other groups who could fill the gap, “no other donors apart from the Global Fund are providing financial support for our TB program.”
Eight thousand miles away in Tanzania, clinician Leah Mtui faces the same concerns- how will her patients be affected by the Round 11 cancellation? Mtui works at Pasada, a faith-based NGO that provides free TB and HIV care. She says the need for services is increasing, “We were planning to scale up services through Global Fund support.”
The Global Fund finances 39 percent of Tanzania’s TB programs. The current grant runs out in November. While Tanzania is eligible to apply for transitional funding, without money to scale up treatment, hundreds of thousands of lives are at stake. Without new resources, an estimated 68,000 TB cases in Tanzania will go undiagnosed and 260,000 people won’t have access to life saving AIDS medication.
At Pasada, the supply of services can barely keep up with the demand for treatment. Last year Pasada treated over 1200 people with TB. But Mtui warns, “TB is infectious. Each infectious case can transmit to up to ten people - that’s a lot of people we’re not treating.” She was hoping to use Round 11 funding to scale up diagnosing and treating TB and HIV. Now they might be forced to scale back. This does not sit well for Mtui and her colleagues. Pasada’s staff, most of whom are unpaid volunteers, often use their own money to help patients when funds are low.
Despite the enormous effort by Pasada and other groups, many patients go without lifesaving care. “My patients have to choose between taking medicine [and] having food,” Mtui explains. She pauses for a moment, and then tells donors, “Please don’t make them choose.”
Mtui extends an invitation for international donors to visit her clinic. She wishes she had the opportunity to meet with donors face to face and ask them why they cancelled funding. “This World TB Day the message is ‘stop TB in my lifetime’ - to let people living in a world without TB,” she declares. “If we want to meet this target, [we need] to increase funding rather than cancel it.”
For more information about the human impact of the Round 11 cancellation visit http://www.action.org/blog/post/human_impact_of_global_fund_round_11_cancellation
See ACTION’S press release calling for an Emergency Donor Meeting This World TB Day, Global Fund Emergency Donor Meeting Critical for Continued TB Successes
 Source: unpublished data from the Stop TB Partnership
 Source: unpublished data from Tanzania Ministry of Health