The Global Fund to Fight AIDS, Tuberculosis and Malaria made an appeal in August for an additional $5 billion to continue supporting countries in its response to the coronavirus. But after more than five months, only $259 million — or about 5% of that ask — has been filled to date.
Part of the challenge is that the global health financing framework is not built to address a crisis with the magnitude of COVID-19, according to Francoise Vanni, director of external relations and communications at the Global Fund. The $5 billion ask is on top of usual commitments or investment plans made by countries for global health, including for the Global Fund, which also needs to make sure that donors honor their commitments to the fund’s core programs from its sixth replenishment in 2019.
“It's like if we were after the Second World War, wondering whether the budgets made before the war would be sufficient to rebuild Europe — of course not. So there's something of that nature that we need to push the boundaries. And it's always difficult to challenge and to push the boundaries,” Vanni told Devex.
“If we don't borrow on the future now, the future is going to go away.”— Francoise Vanni, director of external relations and communications, Global Fund
The current global focus on COVID-19 vaccines adds to the challenge. The Global Fund is not involved in vaccine procurement. Vanni said it’s been challenging for the Global Fund and partners to stress the continued importance of other COVID-19 tools such as diagnostics, personal protective equipment, and therapeutics.
She said even as vaccines become more widely available, governments need to keep testing for COVID-19, health workers still need to be equipped with the right protective gear, and hospitals still need oxygen and other equipment.
“It’s obviously a more complex narrative than, ‘Let's all have vaccines, and you know, the world would be fine,’” Vanni added.
The $5 billion is part of the $38 billion requirement by the Access to COVID-19 Tools Accelerator, for which the Global Fund is a co-lead of the diagnostics pillar, together with the Foundation for Innovative New Diagnostics, as well as the health systems connector pillar with the World Bank and the World Health Organization.
That requirement is expected to change again soon, as ACT Accelerator partners review current needs, Vanni said. And the amount is likely to increase as current needs and deployment efforts — particularly for COVID-19 vaccines — increase.
The additional money is to help countries continue their response to COVID-19, provide protection to health workers, reinforce health systems, and mitigate the impact on HIV, TB, and malaria.
But efforts to finance the ACT Accelerator also need to cover the other elements of the response, not just vaccines. Otherwise, more health workers will be at risk of contracting the disease and dying due to a shortage of protective equipment, and test-and-trace strategies won’t work due to a lack of diagnostics, Vanni said.
This is likely to have a snowball effect on the fight against HIV, tuberculosis, and malaria. A qualitative survey done by the Global Fund in June previously showed COVID-19 was causing widespread disruptions to HIV, TB, and malaria service delivery in countries.
“We are really looking at the facts on the ground and know that without further investment in adaptation for HIV, TB, and malaria programs and in fighting COVID-19, indeed, more people will die, and we’ll go backwards in the fight [against these diseases],” Vanni said.
“Whether you think of it from a humanitarian and human life perspective or whether you look at it from an economic perspective, the result is the same: It's much better to invest now, rather than losing 20 years of investment and having to start all over again with the COVID-19 complication on top,” she added.
Vanni said the Global Fund and partners are coordinating to ensure donors understand that “everything fits together.” They are also focusing on key political platforms, such as the G-20 group of leading economies, and on the richest countries. While low-income nations also have their own obligations, the reality is that these economies have been hit hard by the pandemic.
“And therefore, you know, large economies and traditional donors need to understand that they have a special responsibility in the context where we are,” Vanni said.
“We need to borrow on the future, because if we don't borrow on the future now, the future is going to go away,” she added.