Today is the 10th anniversary of the founding of the Global Fund for HIV, TB and Malaria. This was an initiative promoted by then UN General Secretary Kofi Annan to put significant funding into fighting the three biggest communicable diseases afflicting the developing world.
Sadly, it is a tenth anniversary with quite a shadow cast over it. The Global Fund had received pledges and projected contributions of $11.7 billion in 2010 for the time period 2011-13, but subsequently several donors (mainly from the EU, and in particular the Eurozone) have reneged on their pledges or delayed in coughing up the promised cash as they wrestle with their own economic crises. The Fund is still disbursing some $10 billion of previously approved grants between 2011 and 2013, but no new grants will be made until 2014 unless some or all the previously promised funding arrives. This means that in the Democratic Republic of the Congo, for instance, 28,000 people with HIV who were meant to start life-saving treatment by 2014 may now be unable to.
The irony of this is that the British Government had found the Global Fund to be one of the most effective, transparent and accountable mechanisms for funding effective treatment and prevention that was saving lives on a major scale. So much so it had agreed to double its funding last year (although the UK has also drastically cut back its bilateral funding for HIV & AIDS at the same time) In fact, the Global Fund is being widely recognised as one of the most effective mechanisms for delivering the Millennium Development Goals (certainly with respect to the fourth goal, which was to reduce the spread of these three diseases, and to see the number of infected and dying decrease significantly by 2015).
Now, the MDGs and the Global Fund are not without their critics. Other illnesses afflict the poor significantly, particularly non-communicable disease such as diabetes and cancer, as well as less fatal but no less debilitating parasitical diseases. And by focussing so much money and energy into a few illnesses, wider health issues were in danger of being neglected. We have not been above agreeing with these reservations in this blog. However, there can be no major doubt that the funding crisis facing the Global Fund will mean millions will not get onto treatment programmes, and that this will inevitably cost lives.
Other recent research has shown that in all areas, funding for health-related development is in decline, despite clear evidence that it works. The problem is that so many donor nations are in severe economic decline, and that other issues such as climate change, food and water security and sustainable economic development have become more fashionable. In this instance at least it is the fickleness of donors and the public of wealthy nations that looks set to wreck progress on the health of the poor rather than feckless developing countries frittering away aid. The Coalition Government here in the UK, much to its credit, has been one of the few to buck this trend, but even it is facing an increasingly hostile climate of public and press opinion, and increasingly within the governing Tory party, that says we should not be giving money in aid when we have economic woes of our own.
But the evidence is there to see. Maternal and infant mortality is reducing – the rates of HIV infection and AIDS related deaths are going down dramatically. Almost all because of initiatives like the Global Fund. We may need to rethink how we fund and support the development of health systems in the developing world in the long term, but we cannot just sit back now and watch a decade of progress collapse. It is a mark of our humanity what we do with our resources when time gets tough. If we forget our neighbour in need when times get tough, what does that say of us?