Today is the 10th anniversary of
the founding of the Global Fund for
HIV, TB and Malaria. This was an
initiative promoted by then UN General Secretary Kofi Annan in 2002 to put
significant funding into fighting the three biggest communicable diseases
afflicting the developing world.
Sadly, it is a tenth anniversary with quite
a shadow cast over it. After nearly a decade funding a steady increase in
provision of treatment, care and prevention initiatives in all three diseases,
the Global Fund had received pledges and projected contributions of $11.7
billion in 2010 for the time period 2011-13, but subsequently several donors
(mainly form the EU, and in particular the Eurozone) have reneged on their
pledges or delayed in coughing up the promised cash as the wrestle with their
own economic crises. The Fund is still disbursing some $10 billion of
previously approved grants between 2011 and 2013, but no new grants will be made until 2014 unless some or all the
previously promised funding arrives.
This means that in the Democratic Republic of the Congo for instance,
28,000 people with HIV who were meant to start life-saving treatment by 2014
may now be unable to.
The irony of this is that the British
Government had
found the Global Fund to be one of the most effective, transparent and
accountable mechanisms for funding effective treatment and prevention that
was saving lives on a major scale. So much so it had agreed to
double its funding last year (although the UK has also drastically cut back its
bilateral funding for HIV & AIDS at the same time) In fact, the Global
Fund is being widely recognised as one of the most effective mechanisms
for delivering the Millennium
Development Goals (certainly with respect to the fourth goal, which was to
reduce the spread of these three diseases, and to see number of infected and
dying decrease significantly by 2015).
Now, the MDGs and the Global Fund are not
without their critics, and others have seen corruption and inefficiency or
skewed priorities where some have seen transparency and effective resource
allocation. TB HIV
and malaria are not the only major health problems facing developing countries. Other illnesses, particularly non-communicable disease such as diabetes and cancer,
as well as less fatal but no less debilitating parasitical diseases are major but still largely neglected issues. And by focussing so much money and energy
into a few illnesses, wider health issues were in danger of being
neglected. We
have not been above agreeing with these reservations in this blog. However,
there can be no major doubt that the funding crisis facing the Global Fund will
mean millions will not get on to treatment programmes, and that this will
inevitably cost lives.
Other recent
research has shown that in all areas, funding for health related
development is in decline, despite clear evidence that it works. The problem is that so
many donor nations are in severe economic decline, and that other issues
such as climate change, food and water security and sustainable economic
development have become more fashionable.
In this instance at least it is the fickleness of donors and the public of
wealthy nations that looks set to wreck progress on the health of the poor
rather than feckless developing countries frittering away aid. The Coalition Government here in the UK, much
to its credit, has been one of the few to buck this trend, but even it is
facing an increasingly hostile climate of public and press opinion against its
policy on overseas aid, and increasing political opposition from within the
governing Tory party itself.
But the evidence is there to see. Maternal
and infant mortality are reducing, the rates of HIV infection and AIDS related
deaths are going down dramatically, and similar stories can be told around so
many global health issues. And in many of
these it is national initiatives resourced by the Global Fund that have plaid a
significant role.
We may need to
rethink how we fund and support the development of health systems in the
developing world in the long term, but we cannot just sit back now and
watch a decade of progress collapse. It
is a mark of our humanity what we do with our resources when time gets tough.
If we forget our neighbour in need when times get tough, what does that say of
us?
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