In New York, on Sept. 21, the U.S. government is set to host the seventh replenishment of the Global Fund to Fight AIDS/HIV, Tuberculosis and Malaria. The event is an important milestone in global health with significant impact for millions of people worldwide that are dependent on this funding.
As the COVID-19 pandemic — which disproportionately impacted women and girls in all countries — has shown, the need to secure an absolute minimum of $18 billion to fight existing pandemics of HIV/AIDS, TB, and malaria, with a specific emphasis on women and girls, is both immediate and necessary. A successful replenishment would transform the future of vulnerable populations across the globe.
The ongoing COVID-19 pandemic has been consistently harder for women and girls, pushing over 47 million into extreme poverty. Women have often served as the “shock absorbers” of societies, immaterial of gross national income, personal income, or education status. Research has demonstrated that shutdowns and restrictions early in the COVID-19 pandemic disrupted contraceptive services, abortion access, and other sexual and reproductive healthcare across the globe.
An intensification in domestic violence left women and girls with little or no access to support as ill-equipped, underfunded services scrambled to respond to latent gaps in services plagued by a lack of political will for reform.
As COVID-19 took its toll and funds were poured into R&D for vaccines, the concurrent pandemics of HIV/AIDS, TB, and malaria, all of which are preventable and treatable, continued to affect millions of women and girls worldwide.
“The world needs policies and strategies that amplify women’s voices, promote women’s leadership, and carve out space for girls.”
—The additional burdens experienced by women during pandemics continue to be disproportionate. Without exception, women and girls have borne the brunt of social and economic impact of these diseases, not least because women make up 70% of the health workforce and 90% of frontline staff who have direct contact with patients.
HIV/AIDS, TB, and malaria destroy lives, disrupt communities, and deprive future generations of opportunities to thrive. Women are the face of HIV/AIDS, have more exposure, less financial autonomy, and are at constant risk of gender-based sexual abuse, harassment, and violence. TB, the oldest of these known pandemics, remains one of the top five killers of women between the ages of 20-59. It was also estimated in 2020 that a child died from malaria every 75 seconds.
In 2020, the Global Fund and other global health organizations acknowledged that commitments to combat HIV/AIDs, TB, and malaria were already off track to meet the Sustainable Development Goals by 2030. That year, governments missed every global HIV target set.
In 2021, the situation worsened, and it became evident that for the first time in decades, progress had been reversed and infection rates were again on the rise for all three diseases.
In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections, while women and girls aged 15-24 were twice as likely to be living with HIV than young men, with six out of every seven new infections occurring in girls aged 15-19. Similarly, over 95% of all malaria cases are reported in sub-Saharan Africa, while deaths due to this completely treatable disease rose by 21% between 2019 and 2021.
Even with a successful replenishment of the Global Fund, the impact of the latest pandemic will still have negative and long-term effects on the health of millions of people. With two years of disrupted health services, reduced access to care for sick populations, imposed restrictions, limitations on movement, disrupted supply chains, health worker burnout, and increased financial barriers to health care, the world will have to work harder to get all three diseases back on track.
While the Global Fund has a strong commitment toward gender equality and women’s empowerment in its new strategy for 2022-2028, without international investment and increased domestic funding, women and girls will continue to be left behind.
Replenishment of the Global Fund is our shared opportunity for international engagement and sustained commitment to tackle these diseases, strengthen health systems, and prepare for future pandemics.
The world needs policies and strategies that amplify women’s voices, promote women’s leadership, and carve out space for girls. Meaningful participation by women in decisions and actions for both pandemic response and health is an essential step towards gender equality. It builds in the means through which women can protect themselves and their families from infection, address stigma, and gain greater access to much-needed health care services.
As first responders within their communities, women’s organizations need both a seat at the decision-making table and proper funding. Women need to be paid for work done. Health care work can no longer be seen as a selfless act of goodwill if gender equality is to be achieved. Sexual and reproductive health care services must be protected as priority services regardless of the peaks and troughs of pandemics.
Solutions require a collaborative, long-term commitment matched with clear gender-specific targets. As first responders and primary caregivers at home and in the community, women and girls need access to health services, a strong safety net, and a voice at the decision-making table.