Tuberculosis is getting an additional allocation from the Global Fund to Fight AIDS, Tuberculosis and Malaria, but the head of the Stop TB Partnership says the amount is still “disproportionately less” than the funding for HIV and malaria.
“With more than 4 million people with TB missing care in 2020, a financial gap of USD 6 billion for TB interventions, and being the hardest hit by the COVID-19 pandemic, it is impossible for me to understand why the TB response remains the ‘Cinderella’ of the Global Fund resource allocation for the foreseeable future,” Lucica Ditiu, executive director of the Stop TB Partnership, told Devex in an email.
Next to COVID-19, TB is currently the second infectious disease killer, and for every person not diagnosed and treated for TB, 15 others will become infected with the disease yearly, she added.
Under the Global Fund’s board’s latest decision, funding allocation for the three diseases will remain at 50% for HIV, 32% for malaria, and 18% for TB for resources up to $12 billion. But additional resources above $12 billion will be allocated differently — 45% for HIV, 30% for malaria, and 25% for TB. This shows a funding allocation increase for TB, although still lower than the allocation for the two other diseases.
In an emailed response, Harley Feldbaum, head of strategy and policy at Global Fund, told Devex the disease split allocation is “a difficult decision, but it’s an essential step that enables the Global Fund to allocate funds to the highest burden countries with the lowest economic capacity.”
“The decision the Board made responsibly protects HIV and malaria investments and funding to lower income countries, where there remain substantial unmet needs, while significantly increasing the proportion of funding directed to meet important TB needs with a successful Replenishment,” he said.
Ditiu was part of the discussions on the disease split, as a non-voting member of the Global Fund Strategy Committee. She said that “together with WHO,” they provided “a significant amount of data and evidence” to support a change in the allocation for TB. But she lamented in the end the decision “was more of a political nature.”
Aidspan, an independent watchdog of the Global Fund, said the new funding split — which sees a slight reduction in funding for HIV and malaria — “may not significantly reduce TB deaths” and suggests that “a better solution might be to dedicate funds to reducing TB deaths in the top 10 or so countries that contribute the most to TB mortality.”
Global Fund allocation to countries is made every three years, and the funding available is dependent on the resources raised during its replenishment cycle. The Global Fund’s seventh replenishment, to be hosted by the United States, is taking place next year. The fund has a detailed allocation process, but predominantly it is based on a country’s disease burden and economic capacity. The organization provides 77% of all international financing for TB.