Since the Global Fund began, it has been working with countries and partners to support health system strengthening as a way to maximize impact of its core investments in HIV, TB and malaria. The Ebola outbreak is highlighting the critical role of this work.
By their nature, investments in health systems strengthening, known as HSS, are cross-cutting and aimed at bolstering national systems to benefit multiple disease program outcomes. With better health systems, the current Ebola outbreak in West Africa could have been easier to control and contained in rural areas.
The countries affected by Ebola experience acute shortage of qualified health workers. In Liberia, for instance, there are fewer than one health worker per 1,000 people, far below the minimum threshold recommended by WHO. A lack of routine data collection, ineffective logistics and supply chain, and insufficient healthcare infrastructure are common. With the Ebola outbreak, things only get worse, with health professionals failing to report to work.
The long-term solution for preventing, detecting and responding to disease outbreak is to strengthen health systems. The Global Fund has been reinvigorating its focus on HSS work this year, encouraging all grant applicants to include a significant HSS component in any application. Such investments are key in helping maximize the impact of disease-related interventions, increasing value for money, and in contributing to sustainability of health programs. Through country dialogue, partners are identifying many gaps and weaknesses in health systems, before investing strategically under the same platform. Investments can be most effective when needs are assessed well, as part of a country’s national health strategy and disease-specific plans, said George Shakarishvili, Senior Advisor for HSS at the Global Fund. The new funding model allows flexibility in reprogramming funds to invest in areas of emerging concerns in HSS.
Guinea, the country where the first case of the current Ebola outbreak was recorded, is seeking funds to invest in strengthening its information and procurement systems. To increase the benefits of our HSS investments under the new funding model, the Global Fund’s country team will seek the opportunity to work with Guinea’s Ministry of Health and partners to create a coordination platform for HSS investments in the country. Lyne Soucy, Fund Portfolio Manager for Guinea, said it will allow strategic investments in health systems for better responses to all diseases, including Ebola. “A stronger health system is part of the solution to win the fight against Ebola and all the other diseases in countries like Guinea,” Soucy said. “We are keen on working with all partners to support stronger health systems as a real way to respond to HIV, tuberculosis and malaria and many other health concerns.”
Global Fund News Flash: Issue 49
The Ebola outbreak in West Africa is causing concern all over the world. Unlike previous outbreaks of the disease, limited to villages and rural settings, this outbreak is spreading to more populous urban areas. It has captured global attention by killing more than 50 percent of those who get infected, and swiftly. More than 2,000 deaths have been reported so far, and those numbers are likely to grow. Beyond the need for an emergency response, the Ebola outbreak is also drawing attention to the longer-term need for health systems strengthening. The Global Fund is not a key organization in WHO’s Ebola Response Roadmap but we are closely monitoring the outbreak and engaging with our partners in affected countries.
Programs that are supported by the Global Fund in Guinea, Liberia and Sierra Leone have been put under strain by the outbreak. Fear of infection from the Ebola virus, which can spread to anyone coming into physical contact with the blood or bodily fluids of infected people, is holding back some patients from seeking care for other diseases at hospitals and health clinics. Many health professionals are themselves afraid to report for work, with more than 240 healthcare workers infected, reducing the already low capacity of health systems and forcing some clinics to close. Strict travel restrictions are also preventing Global Fund country teams from visiting West Africa, where monitoring and oversight of grants has been affected and preparations for the new funding model delayed.
Liberia’s Health Ministry and Sierra Leone’s country coordinating mechanism have informed the Global Fund that they will be formally asking for flexibility and possible reprogramming of Global Fund grants to help them respond to the Ebola epidemic. The Global Fund will respond swiftly to such requests and will seek to provide support to countries affected by Ebola within the mandate of the organization. It will try to support continuity of essential HIV, TB and malaria services and retention of people on treatment. It will share public health information and also provide services, following WHO guidelines, which educate partners and protect them from contracting the Ebola virus.
The Global Fund’s actions will follow the lead from each affected country, from WHO, and from other organizations with expertise in Ebola. In affected countries, there are several areas where the Global Fund may be able to contribute to the response: providing protective gear for staff in programs supported by the Global Fund; training of staff on how to protect themselves from Ebola; assigning available people or equipment in HIV, TB or malaria programs to temporarily assist in controlling the Ebola virus; providing special travel allowances to enable Global Fund beneficiaries to be reached. Extraordinary outbreaks call for extraordinary measures. We can all benefit by focusing on necessary tasks, under the guidance of leading agencies and experts.
GENEVA – The Global Fund to Fight AIDS, Tuberculosis and Malaria warmly welcomed a decision by the German parliament to increase Germany’s contribution to €245 million for 2014 in the budget for this year, reaffirming a strong commitment to global health.
At the launch of the Global Fund’s Fourth Replenishment last December, Germany had already announced a pledge of €200 million for this year as part of a total commitment of €600 million for the 2014-2016 period. By signing a Multi-Year Contribution Agreement that same month, Germany was able to provide the Global Fund with a predictable flow of resources to fight the three diseases.
With the 2014 budget now taking effect after its passage by parliament and signed into law by Federal President Joachim Gauck, the additional sum of €45 million can be added to the overall German contribution, representing an increase of more than 20 percent for 2014.
On top of that, the German contribution unlocks about US$30 million in additional contribution from the United States, which devised its pledge in a way that partially matches additional contributions by other donors.
“We are deeply thankful for the unwavering support the German people have shown in the fight against these deadly diseases from the very early days,” said Mark Dybul, Executive Director of the Global Fund. “The continuous commitment of our German partners will allow us to save millions of lives and reach the most vulnerable and marginalized populations.”
Donor pledges at the launch of the Global Fund’s Fourth Replenishment in Washington D.C. on 3 December 2013 totalled US$12.0 billion for 2014-16. The German contribution, combined with the matching funds, lifts that total to over US$12.28 billion, the largest amount ever committed to fight against AIDS, tuberculosis and malaria.
Since the creation of the Global Fund in 2002, Germany has contributed more than US$2 billion to the Global Fund, and is one of the leading donors.
More recently, Germany has been a strong supporter of the Global Fund’s refocused efforts on financial and risk management. Together with the other G7 leaders on 5 June 2014, Germany also reaffirmed its commitment to an AIDS free generation and to the Global Fund to reduce the burden of these three major infectious diseases on eligible countries and regions.
Friends Organizations Welcome Increased Commitment to the Global Fund from Germany for 2014
Washington, D.C., July 31, 2014 – The German parliament has voted to increase Germany’s contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria by more than 20 percent to reach EUR 245 million (approximately US $334 million) for 2014, reaffirming the country’s continued commitment to global health. As international advocates for the Global Fund, Friends of the Fund in Europe and Friends of the Global Fight in the United States commend this demonstration of support.
”We are grateful for this expression of support for the Global Fund, and applaud Germany’s strengthened contribution for 2014,” said Heidemarie Wieczorek-Zeul, Board Vice-Chair in charge of Germany for Friends of the Global Fund Europe and former Germany Minister for Economic Cooperation and Development. “Expanding commitment as Germany prepares to host the 2015 G-7 Summit is needed. We are hopeful that the country will increase its investment in the Global Fund even further prior to the end of the fourth replenishment.”
Germany’s increased contribution unlocks approximately $30 million in additional funding from the United States, following President Obama’s pledge at the Global Fund’s Fourth Voluntary Replenishment Conference in December 2013 to commit $1 for every $2 provided by other donors worldwide through 2016, up to $5 billion.
“We’re pleased to see momentum continuing to build around the Global Fund’s resource mobilization,” said Deb Derrick, President of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria. “Defeating these three diseases is truly a collective effort. Today’s announcement is an important signal from Germany and an illustration of global partners joining together to achieve this goal.”
At the December launch of the Global Fund’s current replenishment cycle in Washington, D.C., donors pledged $12 billion for 2014-16. The German contribution — combined with additional commitments made since the pledging conference, including public funding from Switzerland and Russia, private sector pledges from Bank of America, SAP and South Africa’s Patrice Motsepe, and matching U.S. funds — helped to increase the total to more than $12.28 billion, the largest amount ever raised in the fight against AIDS, tuberculosis and malaria.
“In a time of constrained economies the world over, this is a recognition of the tremendous work of the Global Fund and its ability to help turn the tide against AIDS, tuberculosis and malaria,” said Laurent Vigier, President of Friends of the Global Fund Europe.
Senator SINGH (Tasmania) (22:27): I rise this evening on behalf of the three million men, women and children who are killed each year by AIDS, tuberculosis and malaria. I do so by supporting very strongly the determination of RESULTS International, particularly its Tasmanian volunteers with whom I have been engaging very closely on this and other issues related to their organisation’s efforts to end poverty. I want to highlight that next week Australia will host the International AIDS Conference in Melbourne between 20 and 25 July. That will be an ideal opportunity for the government to seriously consider providing an additional $125 million to replenish the Global Fund—much needed international development assistance to the Global Fund to fight AIDS, tuberculosis and malaria.
An extra incentive for Australia to provide additional resources to the Global Fund is that Australia is a voice on the board of the Global Fund for continued investment in the Asia-Pacific region. From 2004 to 2013, Australia contributed $400 million to the Global Fund and in this period the Global Fund invested $4 billion in the Asia-Pacific, emphasising the Global Fund’s importance for our region. Pledges to the Global Fund at the pledging conference in December 2013 and contributions that several donors have announced since December have provided the Global Fund with a total of US$12.2 billion for the 2014 to 2016 period. However, these pledges represent a shortfall of US$2.8 billion over three years from the US$15 billion the Global Fund had been seeking to meet its demand.
Results International have advocated strongly that an additional contribution of $125 million to the Global Fund, by the Australian government, which would take Australia’s total contribution over three years to $325 million, is much needed. The impact of an additional contribution by Australia to the Global Fund could be multiplied up to 10 times in the Asia-Pacific region. Under Labor, Australia’s contribution to official development assistance grew with every budget. In 2006-07 the Australian government invested $2.9 billion and by 2013-14 that amount had almost doubled to $5.7 billion. The Global Fund is working to eventually eradicate deaths from AIDS, tuberculosis and malaria. Therefore, an increased investment in the period 2014 to 2016 is crucial to accelerate progress in reducing the death toll from these diseases.
Part of the Howard government’s pledge to the Millennium Development Goals was its commitment to a time line for Australia to contribute 0.5 per cent of its gross national income to overseas aid. Labor honoured that commitment. However, two days before the September election, the then Abbott opposition announced it would dishonour that commitment. The following examples show the impact of the scale-up in detection and treatment of AIDS, TB and Malaria by the Global Fund and other donors: between 2002 and 2012, the number of people on antiretroviral therapy, ART, to treat HIV and AIDS had increased from 200,000 to almost 10 million; the number of deaths from TB has declined by 40 per cent since 2000, due to advances in both detection and treatment of TB; since 2000, the proportion of African households which have an insecticide treated bed net to protect them from mosquitoes carrying malaria has increased from three per cent to 53 per cent and the number of deaths from malaria has fallen by 33 per cent.
In the Asia-Pacific region, the Global Fund has supported the following outcomes: 38 million people treated and counselled for HIV and AIDS; 5.1 million people tested and treated for tuberculosis; 29 million insecticide treated bed nets distributed to combat malaria; and 7.4 million health and community workers trained. Nevertheless, the three diseases continue to have a significant impact in the Asia-Pacific region, as the most recent figures from 2009 demonstrate. The 35 countries in the Global Fund’s Asia region were home to five million people living with HIV; the Asia region accounted for 8.5 million cases of TB, 60 per cent of the estimated global total; the region also includes half of the 22 high-TB-burden countries; there were 131 million suspected malaria cases in the 35 countries of the Asia region, more than half of the global total.
The Abbott government’s $7.6 billion cut in foreign aid will not provide 1.5 billion lifesaving malaria treatments. It cannot deliver antiretroviral treatments for 10 million people with HIV and AIDS. HIV and AIDS is still a disease with no cure and remains a global epidemic, often forgotten in the western world. As Australians, we must work towards an international dialogue on the prevention of HIVAIDS. That is why this international AIDS conference, which is being held in Melbourne next week, is so important.
The International AIDS Conference is a fantastic opportunity for Australia to develop prevention policies and engage with experts in policy and science. That is exactly what we need to do as members of parliament as well. I take the opportunity to thank Senator Dean Smith, who I recently joined in becoming co-chair of the parliamentary group for HIV and AIDS, for his knowledge and input into issues around HIV and AIDS to do with the upcoming conference, which we both hope to attend.
It is particularly important that we update Australia’s HIV policy within our aid program to include TB-HIV integration as recommended by the World Health Organisation. This is because TB is the leading killer of people living with HIV, causing one in five HIV-related deaths. TB is the most common presenting illness among people living with HIV, including those who are taking antiretroviral treatment. At least one-third of the 34 million people living with HIV are infected with latent TB. As the host of the International AIDS Conference 2014 and in the light of the international community’s consideration of setting goals looking to end the death toll from AIDS, TB and Malaria, Australia has an opportunity to display strong leadership by announcing a supplementary pledge to the Global Fund.
Achieving these goals will undoubtedly require an increased investment now, to make prevention and treatment available to all people who need it, and to improve the present screening methods and medication, especially for TB. The government has the chance at this international AIDS conference to earn back some of its global respect that it has lost—of course, the respect that it has lost not only in this policy area but also in other policy areas, such as climate change that we were debating earlier in this place. The government has this opportunity to earn back that respect by making a clear commitment to the international community that it recognises a great need, and it wants to help. I am pleased that Australia is hosting this international AIDS conference in Melbourne next week. It will be an opportunity for Australia to highlight its efforts towards HIV and AIDS. It will also be an opportunity for us to make a pledge that we can do more and should do more, as we did under Labor and as has not, unfortunately, been honoured under this government. This is an opportunity for them to reverse that. Let us hope they do this at this HIV-AIDS international conference in Melbourne.
Global Health News
Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.