Opinion: The world must invest in the fight against HIV, TB, malaria

Since its founding in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria has become a vital part of the global health architecture. It has disbursed more than $38 billion and saved millions of lives from the world’s top three infectious killers.

I have personal experience of the transformative power of the Global Fund. While I was health minister of Ethiopia, the Global Fund’s grants not only financed our life-saving programs against HIV, TB, and malaria, they also supported the rapid establishment of the country’s national primary care system.

Later, I had the honor of serving as the Global Fund’s chair to guide its investments in many countries.

Globally, the world has made incredible progress against HIV, TB, and malaria. But the job is not done. Nearly 1,000 adolescent girls and young women are infected with HIV every day. A child dies every two minutes from malaria. TB is now the world’s leading killer among infectious diseases.

Which is why we still need a strong and well-funded Global Fund.

In the Sustainable Development Goals, world leaders made an ambitious commitment to end the epidemics of AIDS, tuberculosis, and malaria by 2030. But if current trends persist, we will miss those targets. Progress against malaria has stalled, while the decline in HIV and TB cases and deaths is not moving fast enough.

To reinvigorate progress toward the SDG targets, the Global Fund will require at least $14 billion over the next three years when it holds its 6th replenishment conference in Lyon, France, in October.

In New Delhi this week, health leaders from around the world will gather to discuss the Global Fund’s investment case and its estimates of the impact that could be achieved if it meets its replenishment targets.

With the replenishment of the Global Fund, more than 120 affected countries will receive a critical injection of international financing for health, allowing them to scale up health programs and fight back against drug resistance and other threats.

Crucially, the Global Fund plans to invest about $4 billion of its new funds in health systems strengthening, including building capacity for diagnostics, surveillance, and supply chains. These systems-focused investments are critical for building the long-term infrastructure to support countries on their journey toward universal health coverage.

But the Global Fund is more than just a source of foreign aid. It has also provided an effective mechanism to pool resources from donors and has helped to catalyze domestic funding. The Global Fund estimates that over the next three years, its grants will spur about $46 billion of domestic financing to fight disease and strengthen health systems.

The World Health Organization is proud to have played a role in founding and, in the early days, hosting the Global Fund. These days, we are next-door neighbors in Geneva and our partnership remains just as strong.

Over the years, the Global Fund has relied on WHO’s technical guidance and analysis when developing and implementing strategies and has leveraged WHO’s country presence and relationships with ministries of health.

Conversely, WHO has relied on the Global Fund to attract and disburse much-needed funding for health, catalyze multisectoral responses, and support countries in implementing WHO’s recommendations, such as our new guidelines on treating drug-resistant tuberculosis.

Our ongoing joint initiatives include the “Find. Treat. All. #EndTB” initiative, which aims to provide 40 million people with TB access to care by 2022, and the “High burden to high impact” initiative, which is designed to reinvigorate action against malaria in the countries with the highest malaria burden, including India.

Over the years, the global health landscape has become increasingly crowded and complex. While this is positive in the sense that it reflects increasing investment in health, it has also led to some fragmentation and duplication of efforts.

We are now working to address that and solidify our partnership through a landmark plan to achieve the health-related SDGs. The “Global Action Plan for Healthy Lives and Well-being for All” — currently being drafted by 12 organizations working on global health — will allow all of us to work together more effectively and efficiently to deliver better results and better value for money.

Despite the progress we have made against HIV, tuberculosis, and malaria, these three diseases remain a cause of enormous and preventable suffering and death. Apart from the lives they claim, they exact a heavy toll on health systems, sapping productivity and eroding economic growth.

In New Delhi this week, the question is not whether the world can afford to invest in the Global Fund — it’s whether the world can afford not to.