The Global Fund Is Alive and Well, But Global Health Progress Is in Peril

The Global Fund has disbursed over $14 billion in 150 countries to continue the progress towards dramatically reducing the number of people who die from malaria, TB and AIDS.
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The rumors of the Global Fund to Fight AIDS, Tuberculosis and Malaria's demise are greatly exaggerated.

I will not get into all the predictions of ruin and misery in the news headlines during the week since we announced that we would not be organizing a new funding round before 2014. But let me make a few facts crystal clear:

The Global Fund will disburse around $10 billion in our current funding period, between 2011 and 2013; $2 billion more than what it disbursed between 2008 and 2010. This
includes disbursing money to new, ambitious programs. Efficiencies we have achieved in
the past three funding rounds and in other areas will allow several countries to increase the
number of patients receiving AIDS or tuberculosis treatment. So more people -- not less -- will be given access to treatment in the coming two years.

With the exception of one smaller country which has reduced its pledge by a few million dollars, all donors who made pledges for the 2011 -2013 period have kept their pledges and have signaled that they are continuing to strive to pay in the pledges in full in the coming
years.

The Global Fund has disbursed well over $14 billion to more than a thousand grants in
150 countries during the 10 years it has been in existence. The vast majority of grants have
delivered important results, helping to save millions of lives.

Yet there are still reasons for concern among all those who care about global health and the fight against the three diseases. The Global Fund had originally hoped to have nearly US$12 billion available for this three-year period.

Because some traditional donors did not pledge and because of the difficult economic outlook
in virtually all donor regions it is uncertain at this point whether all pledges will be turned into contributions on time. In addition decreasing interest rates are resulting in diminishing investment income from our trustee account (which affects the return on all the money that is already paid in).

Because of these uncertainties it would be irresponsible to continue promising opportunities for
additional funding when we are not sure we will have the money needed.

Many countries have counted on this extra funding opportunity to do their part in achieving the
global health goals the world aspires to by 2015. No additional funding for the coming two years would mean slowing down or even stalling the tremendous progress we have seen in the fight against infectious diseases over the past decade.

This is made worse by the fact that many other financing sources are drying up. Overall development aid to fight HIV and AIDS has been reduced by ten percent since 2009, and many ministries of health and non-governmental organizations have been looking to the Global Fund to replace some of this lost funding.

The timing couldn't be worse as the world for the first time has a real opportunity to achieve critical breakthroughs in the fight against the AIDS, TB and malaria. The fight does not stand still: we either win this fight or we lose it. Hundreds of millions of bed nets are protecting nearly half of Africa's children against malaria, but every three or four years they must be replaced. Doctors and nurse around the world have been able to reassure the millions who do not yet have access to AIDS or multi-drug resistant TB treatment that the queues are getting shorter. What if they get longer again?

The Global Fund is doing its part to cope with the difficult situation. Over the coming 12 months, we are transforming the way we award and manage grants to make sure all the money is spent as efficiently as possible to reach the maximum health impact in the countries and for the populations who need it the most.

While we will not stop funding to countries because the risk of corruption or other loss is high, we are organizing ourselves to make sure we manage that risk as tightly as possible. We will reassure donors that their money is safe and is invested as efficiently as humanly possible through the Global Fund.

We will continue our strong efforts to mobilize as many resources as possible. We will speak
tirelessly about the need to invest in global health: to continue the progress towards ending deaths from malaria, controlling TB and AIDS and dramatically reducing the number of people who die from these diseases. We will warn about the catastrophic consequences of failing to do so. We will appeal to new fast-growing world powers to take on their part of the responsibility to finance this fight.

The Global Fund has set as a goal to help save 10 million lives between today and 2016. The
postponement of new funding is a setback to that goal. But with a successful transformation responding to the recommendations of the High Level Panel, and with the help of our donors, this goal is still possible.

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