By Deborah Derrick
President, Friends of the Global Fight Against AIDS, Tuberculosis and Malaria
With the holidays behind us, returning to our day-to-day lives may almost seem anticlimactic. For those of us working in global health, however, New Year’s festivities started early and the excitement is likely to continue well into 2014. On December 3, the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that it had mobilized an unprecedented commitment of $12 billion from donors. The conference at which this announcement was made — the launch of the Global Fund’s Fourth Voluntary Replenishment — provided not only a time to celebrate, but also an opportunity to anticipate more progress saving lives in the months ahead.
The Global Fund is the world’s largest public health financier, supporting programs that save 100,000 lives per month. Created in 2002 to help provide resources to win the battle against the three diseases, which were collectively killing 6 million people annually, the Global Fund now provides:
• More than 20 percent of global funding for HIV/AIDS
• More than 50 percent of international financing for malaria
• The overwhelming majority of international funding for tuberculosis
At the Global Fund’s replenishment conference in December, donors from around the world made financial commitments that will span the next three years, from 2014-2016. The $12 billion raised was the largest amount ever committed to fight the three diseases. It marked a 30 percent increase over the $9.2 billion secured during the Global Fund’s last replenishment in 2010 and was a result of the generosity of 25 donor countries, as well as corporations and foundations, high-net-worth individuals and faith-based organizations. In addition, many implementing countries — those receiving grants from the Global Fund — pledged to increase their own resources, adding further fuel to the fight.
Dr. Mark Dybul, Executive Director of the Global Fund, characterized the meeting as not only a replenishment of financial resources but also a replenishment of hope, saying, “The 21st Century ideals that led to the founding of the Global Fund are now stronger than ever: partnership, shared responsibility and mutual accountability.”
The hope Dr. Dybul referred to is evidenced by the remarkable progress made in the past 20 years. In that time, tuberculosis deaths have decreased by more than 40 percent. In the past decade alone, HIV incidence is down by 33 percent and cases of malaria have dropped by 26 percent. Today, the end of these diseases is truly within sight.
Here in the United States, we were thrilled at the level of commitment to Replenishment. Of course, the U.S. government has been the largest contributor to the Global Fund since it was established. The announcement by President Obama that the U.S. will commit $1 for every $2 matched by other donors worldwide — up to $5 billion — was further illustration of this leadership. It also marks a potential $1 billion increase from the Administration’s previous pledge to the Global Fund for the 2010-2013 timeframe.
Notwithstanding this very successful pledging moment, the replenishment conference marked only the beginning of a rolling, three-year campaign to raise funds. The Global Fund will continue to work with donors and partners in its efforts to defeat AIDS, tuberculosis and malaria. Nafsiah Mboi, Chair of the Board of the Global Fund, who led the pledging session, put it this way: “We’ve had a terrific beginning. Now let’s go to work.”
In the years ahead, the Global Fund will deepen its work with donor governments; encourage increased private sector and high-net-worth individual investments, as well as domestic co-financing; and work to ensure treatment, prevention and care continue to reach those most in need. But this current moment is certainly one to celebrate — the beginning of a New Year in which our collective resolution is to control these three diseases once and for all. And, with replenishment efforts already well underway and increasing levels of support for the Global Fund worldwide, this is one resolution that we can hope to keep.
In loving memory of our friend and human rights warrior Andrew Paul Hunter
~ 22.1.1968 – 26.12. 2013 ~
We are still so deeply saddened by the loss of our friend and colleague Andrew Hunter who died suddenly in Bangkok on Boxing Day. Andrew had devoted his entire adult life to social justice for maligned and marginalised communities particularly that of sex workers, people living with HIV and people who use drugs. His passing has not just left a hole in our hearts but has also left a giant hole in the sex worker rights movement. We will miss his leadership and seemingly unstoppable energy in advancing the rights of sex workers and other marginalised communities that he represented so admirably and selflessly. Known by some as the gentle mentor, Andrew was the current President of the Global Network of Sex Work Projects (NSWP), founding co-ordinator of the Scarlet Alliance and a founding member of the Asia Pacific Network of Sex Workers (APNSW).
In honour of our friend Andrew and for those who cannot be in Bangkok at his formal memorial service on Saturday 18th January, we will be holding a small intimate service in Melbourne on the day to mourn his passing but above all, to celebrate his life, his loves and his passion for righting wrongs and consider a permanent memorial to honour Andrew’s contribution to sex worker rights.
If you can’t be at any of the the memorial services being held for Andrew, light a red candle in his honour, unfurl your red umbrella, raise your glasses and give thanks for the friendships and alliances he so lovingly encouraged. It is these memories and our friendships and alliances that will sustain us in our loss and bolster us as we continue to pursue Andrew’s dream where only rights will stop the wrongs.
Global Fund News Release
14 January 2014
GENEVA — UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria express deep concern that access to HIV services for lesbian, gay, bisexual and transgender (LGBT) people will be severely affected by a new law in Nigeria––further criminalizing LGBT people, organizations and activities, as well as people who support them.
The new law could prevent access to essential HIV services for LGBT people who may be at high risk of HIV infection, undermining the success of the Presidential Comprehensive Response Plan for HIV/AIDS which was launched by President Goodluck Jonathan less than a year ago.
The health, development and human rights implications of the new law are potentially far-reaching. Homosexuality is already criminalized in Nigeria. The new law further criminalizes LGBT people, organizations and activities. The law states: “A person who registers, operates or participates in gay clubs, societies and organisation, or directly or indirectly makes public show of same sex amorous relationship in Nigeria commits an offence and is liable to conviction to a term of 10 years imprisonment.”
The law also criminalizes any individuals or group of people who support “the registration, operation and sustenance of gay clubs, societies and organisations, processions or meetings in Nigeria.” The conviction is also 10 years imprisonment.
The provisions of the law could lead to increased homophobia, discrimination, denial of HIV services and violence based on real or perceived sexual orientation and gender identity. It could also be used against organizations working to provide HIV prevention and treatment services to LGBT people.
Nigeria has the second largest HIV epidemic globally––in 2012 there were an estimated 3.4 million people living with HIV in Nigeria. In 2010, national HIV prevalence in Nigeria was estimated at 4 percent among the general population and 17 percent among men who have sex with men.
In the 2011 United Nations Political Declaration on HIV/AIDS, all UN Member States committed to removing legal barriers and passing laws to protect populations vulnerable to HIV.
UNAIDS and the Global Fund call for an urgent review of the constitutionality of the law in light of the serious public health and human rights implications and urge Nigeria to put comprehensive measures in place to protect the ongoing delivery of HIV services to LGBT people in Nigeria without fear of arrest or other reprisals. UNAIDS and the Global Fund will continue to work with the Nigerian authorities and civil society organisations to ensure continued and safe access to HIV services for all people in Nigeria.
UNAIDS and the Global Fund urge all governments to protect the human rights of lesbian, gay, bisexual and transgender people, through repealing criminal laws against adult consensual same sex sexual conduct; implementing laws to protect them from violence and discrimination; promoting campaigns that address homophobia and transphobia; and ensuring that adequate health services are provided to address their needs.
Global Fund News Flash: Issue 35
Darshana Chakma peers through a microscope, a hot breeze from the rice paddies blowing through the open windows of her small clinic. A girl suffering from chills and a bad headache waits nervously with her family to find out if she has malaria. Darshana gets the results – negative – and the news is met with cries of joy from her family, before Darshana makes a record in a worn notebook. “It is only a fever, but make sure the children sleep under the mosquito nets,” Darshana tells the family. “Cover your arms when you go to the hills and if the fever continues, come to see me again in a week.”
Darshana is a community health worker in Rangamati, a remote district of Bangladesh. She is one of the unsung heroines behind a quiet revolution that is transforming countless villages and hamlets in this country. Despite being one of the poorest countries in the world, with relatively low healthcare spending, Bangladesh has made strides in a number of human development areas, including child and maternal mortality, women’s literacy and life expectancy. Bangladesh is turning into an example for the region.
The British medical journal, The Lancet, recently called Bangladesh’s success “one of the great mysteries of global health.” Health experts say the accomplishment is largely explained by its community-based approach to health – and in particular by the mass deployment of community health workers.
BRAC, Bangladesh’s oldest nongovernmental organization, and the Ministry of Health have trained tens of thousands of community health workers, who are playing a leading role in reducing the burden of malaria and TB and improving local health systems, with support from the Global Fund. The program is made up exclusively of women who are selected from their own villages. Acting as the eyes and ears of their communities, this army of nurses, lab technicians and volunteers provides basic health care and delivers prevention and treatment services village by village. “I know these communities very well,” says Darshana, 37, a lab technician for 16 years. “I see many cases of malaria and TB. They know me so they come to the clinic. I feel very proud of what I do because I am serving the community.”
Malaria is one of the major public health problems in Bangladesh. Out of the country’s 64 districts, 13 districts are highly-endemic areas. With its lush vegetation, wide rivers and poor roads, Rangamati poses particular challenges. But the district cut the number of overall malaria cases from 28,000 in 2008 to 8,000 in 2012, and has reduced the number of malaria deaths from 24 to 1 in the same period.
To reach some remote villages where electricity is rare, the women sometimes go on long solitary trips on foot, or even in canoes during the monsoon season, carrying their microscopes and mobile pharmacy. Rapid diagnostic kits mean that a simple pin prick can deliver a diagnosis on the spot, allowing patients to start taking artemisinin-based combination therapies, the latest-generation drugs for malaria. Dr. Moktadir Kabir, senior malaria program manager for BRAC, says Bangladesh’s nongovernmental organization sector owes much of its vibrancy to the empowerment of women. “Women are agents of change and development in Bangladesh. Women have played a central role in community building.”
The participation of women in civil society lies in the very birth of the country. When Bangladesh broke away from Pakistan in a bloody war in 1971, much of the country’s administration was wiped out, so nongovernmental organizations filled the gap. Partnerships between governments and non-governmental organizations flourished, and women stepped in, first distributing emergency war aid and then expanding to family planning and disease control.
While malaria threatens most of Bangladesh, the risk is greatest in the east and north-east, areas bordering India and Myanmar, such as Rangamati. Indigenous people and migrant workers who cross the porous borders are among the most vulnerable groups, and have become a special focus of the health workers.
Diana Chakma, a community health worker, says prevention services including teaching the correct use of insecticide-treated nets are vital to fighting the disease. After a ride by bus and then by rickshaw, Diana treks uphill to reach the village of Khamarpara, a cluster of 100 houses made of bamboo that lives off the harvest of rice, sesame, ginger and maize. Almost all the hill women work at plantations, making them and their children easy prey for the mosquitos that thrive in the alluvial valleys. A group of women and children gather in a circle and listen as Diana and a shasthya shebika, or health volunteer, start their presentation. To let everyone cool off from the heat, they hand out coconuts cut by machete and served with a straw to the apas, or sisters, as the community workers are referred to. “Sometimes I have to walk far, but I get a lot of love and respect in return,” Diana says. “There is nothing better than seeing the smile of a malaria patient who has been cured.”
FRIENDS OF THE GLOBAL FIGHT
Friends of the Global Fight works to end the worldwide burden of AIDS, tuberculosis and malaria. We educate, engage and mobilize U.S. decision makers to support the Global Fund, the world’s largest public health financier. For more information about Friends of the Global Fight, visit www.theglobalfight.org.
Washington, D.C., January 9, 2014 – Friends of the Global Fight Against AIDS, Tuberculosis and Malaria applauds today’s White House nomination of Dr. Deborah Birx as the next U.S. Global AIDS Coordinator — a position charged with leading the President’s Emergency Plan for AIDS Relief (PEPFAR) and overseeing the U.S. relationship with the Global Fund to Fight AIDS, Tuberculosis and Malaria, the world’s largest public health financier.
“Dr. Birx brings a wealth of scientific, leadership and implementation experience,” said Deborah Derrick, President of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, praising the nomination. “Friends looks forward to working with Dr. Birx and continuing strong Global Fund and PEPFAR collaboration under her stewardship.”
Launched with bipartisan support in 2003, PEPFAR is the largest single-country initiative in history to tackle one disease. The U.S. program and the Global Fund together provide the overwhelming majority of international AIDS relief. The two work hand-in-hand around the world, where, in collaboration with local partners, they have helped save millions of lives.
If confirmed, Dr. Birx will succeed Ambassador Eric Goosby, M.D., who served as U.S. Global AIDS Coordinator between 2009 and 2013 and Deborah von Zinkernagel, who has been serving in an interim capacity as Coordinator since October.
Dr. Birx has spent three decades combating HIV/AIDS with the Centers for Disease Control and Prevention (CDC) and Department of Defense. She is a trained clinician in immunology and a widely respected HIV/AIDS expert and currently serves as Director of the Division of Global HIV/AIDS in the CDC’s Center for Global Health.
“The world has now reached a critical moment in the fight against HIV/AIDS,” said Derrick. “I look forward to a speedy confirmation process for Dr. Birx and to continued joint efforts to contain and ultimately defeat this disease.”
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.