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.”
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.”
The leader of The Global Fund spoke with Devex's Raj Kumar about what happens when the virus is eradicated from high-income countries only. Watch the full conversation with Last Mile Health's Raj Panjabi, Roots Africa's Beatrice Savadye, and Devex 's Jenny Lei Ravelo.
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.