With fewer than 100 days left before the Global Fund's Replenishment Conference on October 10, we are off track from our global goal to end the epidemics of AIDS, tuberculosis (TB) and malaria. A resurgence of these epidemics will cost lives, undermine development, and threaten global health security.
The Global Fund to Fight AIDS, Tuberculosis and Malaria, together with the President's Emergency Plan for AIDS Relief (PEPFAR), the President’s Malaria Initiative (PMI) and their partners, including our three organizations, have saved millions of lives:
- An estimated 21.7 million (19.1-22.6 million) people living with HIV were able to access antiretroviral therapy (ART) by the end of 2017; five and a half times more people than a decade ago. High-level political leadership, matched with country-level ownership, innovation, investments, and community-led activities have driven this remarkable result.
- The Global Fund's Strategic Initiative, implemented by the Stop TB Partnership and the World Health Organization (WHO), aims to identify the 1.5 million people not yet receiving TB care in the 13 countries that currently account for more than three-quarters of the gap in TB diagnosis and treatment worldwide.
- This year, two billion mosquito nets will be distributed in Africa alone to protect against malaria. Globally, malaria deaths have been cut by more than half compared with the highest points of the malaria crisis in the early 2000s, saving 7 million lives.
Maintaining the current level of world investment without increase will simply not be enough to meet the internationally agreed targets of the 2030 United Nations Sustainable Development Goals.
Today, HIV is the leading global cause of early death among women aged 15 to 49. Although approximately 37 million people worldwide are living with HIV, a quarter remain undiagnosed. We have not yet tipped the AIDS epidemic into a decisive decline – we are currently at the highest number of people living with AIDS globally, 1.8 million people become newly infected every year, and nearly 1 million people died of AIDS-related illnesses in 2017 alone. HIV prevention and treatment services still do not reach the most vulnerable communities and the people who need them most.
TB is now the world’s most lethal infectious disease, with over 10 million people falling sick each year, and is responsible for an estimated 1.6 million deaths annually. At the first-ever United Nations ‘High Level Meeting on TB’ in September 2018, Heads of State committed to reaching 40 million people with TB treatment by 2022 – but right now 4 million people with TB are missed each year. This highlights the urgent need to strengthen health systems and the need for new ways to diagnose and treat TB.
In 2017, an estimated 219 million cases of malaria occurred worldwide, killing 435,000 people, most of them children under the age of five. Malaria is an entirely preventable and treatable disease and yet it takes the life of a child every two minutes. The latest WHO World Malaria Report confirms that, after a decade of unprecedented progress against malaria, the declining trend in cases has levelled off.
In order to get back on track to end these epidemics, we need to examine current progress and challenges and recognise critical resource needs. Developing and donor countries must all invest more to fight the three diseases and to build resilient and sustainable health systems that work for all. We are also in critical need of new funders at every level: governments, countries impacted by these diseases, private foundations, and companies. One place to start is an ambitious Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria in October 2019. With the bulk of international investments for AIDS, TB, and malaria channeled through the Global Fund, this 6th Replenishment pledging conference is a critical opportunity to end the epidemics.
The Global Fund’s Replenishment ask is at least $14 billion, an increase of at least 15% from the 5th Replenishment. Advocates have highlighted the need for even more of an increase to meet the critical need and the Sustainable Development Goals. The Global Fund Advocates Network (GFAN), in its Get Back on Track report, makes the case for why at least $18 billion is needed. Critically, sustaining current funding levels without an increase will actually see us move backwards in the fight to end the epidemics and will put the world’s most vulnerable people at greater risk.
In the last decade, we have seen tremendous success through partnerships and community-led responses. But now we must bring increased energy and commitment to the populations that are hardest to reach. Partnering with people who are often denied basic human rights and access to healthcare, addressing inequality, and targeting those who live in poverty, young people, and other vulnerable populations is what we need to get back on track.
Without a fully funded Global Fund, empowered communities, and increased overall access to healthcare, we will miss the opportunity to be the generation that ends these three epidemics and other deadly diseases. There has never been a better time to increase investment in the Global Fund and the life-saving work it supports.
Few investments have had the impact that the Global Fund has in saving lives, preventing infections and creating strong and resilient health systems. We encourage global partners, governments, and the private sector to step up the fight and increase their commitments to the Global Fund. The world has the chance to make 2019 the year where we stepped up and committed a global end to AIDS, tuberculosis, and malaria.
Dr. Abdourahmane Diallo, is Chief Executive Officer of the RBM Partnership to End Malaria.
Dr. Lucica Ditiu, is Executive Director of the STOP TB partnership.
Gunilla Carlsson, is Executive Director (a.i) if UNAIDS.