Peter Sands breaks down the 'huge amount at stake' for HIV progress

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WASHINGTON — Fresh off a $14 billion replenishment in October, Peter Sands, executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria, thought 2020 would be the year to get the world back on track in reducing the rate of HIV infections. The funds raised were enough for the organization to increase allocations to countries by over 23%, which Sands hoped would accelerate the end of the epidemic.

“And then, of course, COVID comes,” Sands said, speaking Friday during a Devex event as the 23rd International AIDS Conference concluded. “We face the really sobering prospect that if we don’t mount an effective response, we could find ourselves losing maybe a decade’s worth of gains in terms of the reduction of death, the reduction of infections. So, there’s a huge amount at stake.”

COVID-19 | A conversation with Peter Sands

Watch the full interview with the executive director of The Global Fund on YouTube.

The pandemic's potential to cause a massive backslide in the fight against HIV took center stage at the virtual AIDS conference, which drew 20,000 people from 175 countries hoping to refocus efforts on the 40-year-old epidemic to ensure recent gains are not lost.

“COVID has changed the world of global health — and there’s no, sort of, getting away from that — and will continue to be a massive force changing the way we think about these things for several years to come,” Sands said.

Sands said COVID-19 lockdowns have had a drastic impact on both treatment and prevention of HIV. The pandemic has disrupted global supply chains, while local mobility restrictions have affected distribution of antiretroviral drugs and other medicines.

Although organizations have tried to get creative with delivery methods, like using courier services, prevention and behavior-change activities have also been affected, he said. Some countries have used the pandemic as an excuse to accentuate the stigma associated with HIV-related care, he said, preventing access to needed services.

“If we don’t mount an effective response, we could find ourselves losing maybe a decade’s worth of gains.”

— Peter Sands, executive director, The Global Fund

As lockdowns begin to lift while the coronavirus continues to spread, Sands said he is concerned about COVID-19’s impact on health personnel providing critical HIV-related care. Even high-income countries have struggled to provide health workers with appropriate personal protective equipment, and a more acute lack of supplies could be devastating in low-income countries also fighting HIV outbreaks, he said.

“I don’t just mean salaried doctors and nurses. I mean the people within the communities who are providing services, providing outreach, because there aren’t that many of them,” Sands said. “There’s very little backup to them, and if they fall sick or have to isolate, then the services will begin to fall apart pretty quickly.”

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The Global Fund has allowed recipient countries some flexibility in how they spend their money intended for HIV, tuberculosis, and malaria care during the pandemic, Sands said. The fund created a $1 billion COVID-19 Response Mechanism, which included some leftover money from the international financing organization’s last funding cycle. But it cannot afford to spend much more outside the scope of its target diseases, Sands said.

“We can’t divert that [$14 billion] to COVID because we will start 2021 further back than we intended to be. Right? That is the harsh reality: COVID will have knocked us back a bit. And so, if we have any ambition to continue the fight on HIV, TB, and malaria and get to where we want to, we’ve got to commit that $14 billion to HIV, TB, and malaria,” Sands said, adding that COVID-19 will not be “solved within existing development assistance envelopes.”

Sands acknowledged that The Global Fund, which was created to fight the spread of infectious diseases, already has the infrastructure in place that would be useful for any organization that was looking to do the same for COVID-19.

He said it was too soon to know how having HIV, tuberculosis, or malaria could impact someone’s chances of contracting or surviving COVID-19. This is an important consideration as the world waits for the successful development and deployment of a coronavirus vaccine.

“There’s going to be a lot of people who aren’t going to be protected by a vaccine still in the second half of 2021,” Sands said. “The economic impact of all of this and the broader pressures on the health system — they’re going to kind of reverberate through ‘21.”

“There's only so much a health system can do,” he added.

Watch the full video here.

About the author

  • Teresa Welsh

    Teresa Welsh has reported from more than 10 countries and is currently based in Washington, D.C. Her coverage focuses on Latin America; U.S. foreign assistance policy; fragile states; food systems and nutrition; and refugees and migration. Prior to joining Devex, Teresa worked at McClatchy's Washington Bureau and covered foreign affairs for U.S. News and World Report. She was a reporter in Colombia, where she previously lived teaching English. Teresa earned bachelor of arts degrees in journalism and Latin American studies from the University of Wisconsin.