ACTION commends recent Global Fund figures, but highlights risk to progress

Today, the Global Fund to Fight AIDS, Tuberculosis and Malaria released its newest impact figures. Thanks to the generosity of donors and the efforts of health workers all over the world, over the past 10 years the Global Fund has supported countries and implementers to:

- Put more than 3.6 million people on antiretroviral therapy (ART) to treat and prevent the spread of HIV
- Treat more than 9.3 million people for tuberculosis (TB)
- Distribute 270 million insecticide-treated bed nets to prevent malaria.

This is historic progress, achieved because governments, foundations, and the private sector provided unprecedented support to the Global Fund throughout its first decade. Yet, despite these successes, the Global Fund’s future is fragile. In November of last year, the Global Fund cancelled its 11th round of funding, putting the life-saving work of Global Fund supported countries and implementers at risk. In May, the Global Fund’s board passed a decision to “turn the tap” back on so that resources can ideally flow in early 2013; however new funding model options being discussed which suggest country ‘envelopes’ or ‘caps’ threaten to undermine critical elements of the Global Fund’s historic success.

By putting a limit on country ambition, caps and envelopes could undo the most important aspects of country-driven Global Fund supported work, distorting investments and leading countries to limit their own demand. Rather than identifying what is needed to fight the epidemics in particular country contexts, countries will ask for what they think might be possible. Ambitious progress against the diseases will stall at the very moment when we are gaining ground and beginning to see an end to the three diseases.

ACTION’s new publication, The Global Fund: Progress At Risk, also released today, provides specific examples of where the fight against TB will slow unless donors contribute needed resources. ‘Progress at Risk’ also suggests recommendations for actions that will enable the Global Fund to continue create a strong new funding model and continue to make progress in the fight against TB and TB-HIV.

Countless people across dozens of other countries are working to eliminate the epidemics of HIV/AIDS, TB, and malaria. Yet, because of funding uncertainties the Malawian government, which planned to expand TB treatment to 15,000 additional children, must now place those plans on hold. Likewise, Tanzania’s TB grant expires in November 2012. Without new resources, an estimated 68,000 people with TB will go undiagnosed, including 6,000 children.

As the Global Fund enters its second decade, we need additional resources, including a robust new replenishment in 2013.  The Global Fund also must ensure that the new funding model is designed to ensure meaningful engagement by all country stakeholders in proposal development and implementation, is driven by quality expression of country demand, rewards ambition and results, and leverages domestic investments.

Done well, the new funding model will improve country strategies, meet country needs, and accelerate progress on all three diseases. Done poorly, we stand to lose the single greatest tool we have to fight these three killer diseases.