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GLOBAL: Fund gets results, but will it get funding?

Photo: Manoocher Deghati/IRIN
In Tanzania, the Global Fund has 103,000 HIV-positive mums receive PMTCT to date, up from just 1,800 in 2003
Johannesburg, 8 March 2010 (PlusNews) - Achieving targets to eliminate mother-to-child transmission of HIV and halve tuberculosis rates hang in the balance as donor commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria Fund come up for review.

For the past seven years, the Geneva-based Global Fund has made some of the largest contributions to health aid in history, said the Fund's executive director, Michel Kazatchkine.

International donors will meet in October 2010 to decide whether, and how much money, they will give the international financing organization. Kazatchkine said progress so far had put the world on track to reaching important health milestones by 2015, but reaching these goals would depend on renewed funding.

"The next replenishment will be absolutely key to where the world will be in 2015. If we continue to scale up we should be able to reach or surpass some of the health-related Millennium Development Goals (MDGs), such as containing the spread of multidrug-resistant TB (MDR-TB), and virtually eliminating mother-to-child transmission by 2015," Kazatchkine told IRIN/PlusNews.

In Africa, 94 percent of ARV patients access treatment due to outside sources, Sidibe said 
UNAIDS executive director Michel Sidibe agreed. "Without a fully-funded Global Fund, our shared dreams of universal access to HIV prevention, treatment, care and support could become our worst nightmare, putting the lives of millions currently on treatment in jeopardy."

The October replenishment meeting comes at a time when donors like the United States and the UK Department for International Development (DFID) have backed away from increasing their HIV funding commitments. The US President's Emergency Plan for AIDS Relief (PEPFAR) contributes one-third of all Global Fund monies.

A new 126-page report, "The Global Fund 2010: Innovation and Impact", released this week, details progress made by Fund-suported programmes, including increased access to antiretrovirals (ARVs), improved TB cure rates, and reduced levels of AIDS-related mortality and new HIV infections.

According to the report, 2.5 million people have received ARV treatment since 2002 through the Fund, which provides half of all ARVs dispensed in developing countries; the Fund also accounts for two-thirds of TB funding worldwide.

In sub-Saharan Africa, the organization is the single largest multilateral funding mechanism in the health sector, and its support has meant that countries like Namibia, Rwanda and Zambia are likely to reach their MDG targets for universal ARV access.

The Fund recently awarded South Africa about US$43 million as part of its Round 9 of grants. South African Health Minister Dr Aaron Motsoaledi said the country relied heavily on partners like the Global Fund to provide treatment to the 920,000 people enrolled in the country's public-sector ARV programme.

Within eight months of ARV introduction, adult mortality had decreased by 10 percent in Malawi
Funding the Fund

Kazatchkine said he hoped donors would renew or increase their commitments, come October, and that developed nations would realize that the economic downturn plaguing their domestic constituencies had often been felt much harder in countries with a high disease burden and export-driven economies.

Sisonke Msimang, executive director of the Open Society Initiative for Southern Africa, told guests at the report launch that international donors needed to bear in mind that funding HIV also meant funding broader goals, such as strong civil societies, improved health systems, and better health outcomes.

The report noted that the introduction of HIV services in Rwanda was followed by an increase in the uptake of primary health care services.

Sidibe said highlighting the wider benefits of funding could be the way to secure donor money for HIV in future. "The Global Fund has helped us to change completely the architecture of aid - it has changed completely the governance system of aid; it has created an alternative service delivery approach that has expanded government's capacity to deliver."

"We need to leverage resources to push broad health objectives, and this means integrating, bringing in the links between reproductive health, maternal and child health," he told IRIN/PlusNews. "We need to take HIV/AIDS out of isolation."

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Theme (s): Aid Policy, HIV/AIDS (PlusNews),

[This report does not necessarily reflect the views of the United Nations]

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