‘Difficult times’ in global fight against AIDS, TB and malaria

Mark Dybul.jpg

The organisation that finances the prevention and treatment of the AIDS virus and other global killers is urging top donors to provide an additional $15 billion (€11.5 billion) to fight infectious diseases over the next three years or risk reversing a decade of advances in care.

Mark Dybul, who heads the Global Fund to Fight AIDS, Tuberculosis and Malaria, said on Monday (8 April) that double-digit declines in mortality from the three disease could be jeopardised if donors fail to top up the fund.

But he acknowledged that threatened cuts to international development budgets make his sales pitch harder.

“We understand that these are difficult times,” Dybul told a news conference in Brussels. “Unfortunately, infectious diseases don’t pay much attention to budget cycles.”

Dybul became executive director of the Global Fund in January after a series of thefts and management problems shook the credibility of the Geneva-based financing organisation. He was in Brussels for two days of discussions on funding needs for 2014-2016 that is a precursor to a donor conference later in the year.

A report released on Monday by the Global Fund said it needed $87 billion, or €67 billion, through 2016 to finance programmes in 151 nations. Of that, $58 billion is targeted for AIDS/HIV, $15 billion for tuberculosis and $14 billion for malaria.

Existing donors, governments in beneficiary nations and private donors are expected to provide some $72 billion, the report said.

The additional $15 billion in “replenishment” funding is designed to avoid gaps in treatment and prevention from different budget cycles in donor countries and is similar to financing schemes used by other international funding agencies.

The Global Fund estimates that $87 billion would treat 17 million TB patients, provide antiretroviral therapy to 18 million people being treated for the AIDS virus, and prevent 196,000 malaria deaths.

Controversies hit Global Fund

Spending for treatment and prevention suffered a setback when the Global Fund temporarily suspended project financing in 2011 amid internal management squabbles and allegations of theft in a few recipient countries.

The problems led to an overhaul of how the organisation hands out money and the appointment of Dybul, a physician who is co-director of the Global Health Law Programme at Georgetown University in Washington.

The Global Fund has also come under recent fire for supporting a treatment scheme to replace ineffective malaria drugs, such as chloroquine. The Affordable Medicines Facility for Malaria was launched as a pilot programme in developing countries to provide better drug treatments more quickly through private-sector sources.

Critics such as the anti-poverty campaign group Oxfam argued in a report that the $356-million (€274-million) programme was misguided and exposed patients to wrong diagnosis and fraud.

Asked by EURACTIV whether past concerns about the Global Fund’s performance could deter donors, Dybul said donor support and commitments showed they had confidence in the Global Fund.

The European Commission, he said, was hosting the two-day conference in Brussels and last year committed to providing additional funding. Both Washington and London have promised more financing for 2013.

“It’s pretty clear that the fund is on a great forward trajectory and on the right track,” Dybul said.

The Global Fund already estimates that money from its biggest contributors – which include the European Commission, EU member states, the United States and Japan – will decline slightly from 2012 to 2013.

The organisation’s data show that contributions from private foundations and companies are also shifting downwards.

In December, the World Health Organization (WHO) warned that funding for prevention and control of malaria – kills an estimated 655,000 people every year and sickens millions more – has levelled off after rapid expansion between 2004 and 2009.

In a statement accompanying the release of its annual World Malaria Report, the UN health body said “these developments are signs of a slowdown that could threaten to reverse the remarkable recent gains in the fight against one of the world’s leading infectious killers.”

The AIDS virus, tuberculosis and malaria are infectious diseases that together kill millions of people every year but are readily preventable.

Established in 2002, the Global Fund claims its efforts have helped reduce deaths and ailments through prevention and treatment. From 2005-2011, the number of AIDS-related deaths fell 24%; mortality rate for malaria fell 26% between 2000 and 2010; and the TB mortality rate fell 41% in the two decades ending in 2011.

Mark Dybul, who heads the Global Fund, said better treatments and technologies that provide more rapid diagnosis can lead to further improvements in prevention and care.

  • 9-10 April: Global Fund preliminary donor's conference in Brussels

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