Africa needs to take urgent action to deal with the funding crisis of the Global Fund.

by chenodeu1 on 2012-02-22 14:59:14

"We urgently need donors to replenish the Global Fund and national governments to strengthen their HIV/AIDS response, or we face failing the most vulnerable in our societies and betraying families who have come to depend on these life-saving programs. In this report, we highlight that without an emergency plan and support for affected countries, we are facing a collective responsibility to people affected by HIV around the world." In the report, the Coalition also states that the Global Fund must have a more effective financial early warning system to ensure that when donation commitments are not met, they can raise alarms. "We will never again be in the position where life-saving programs are canceled or delayed without an emergency plan and support for affected countries."

The report, titled "Don't Stop Now: The Impact of Underfunding on the Global Fund's Response to HIV, Tuberculosis, and Malaria," is available on the coalition's website. This report is based on data from impact studies conducted in five countries where the coalition operates: Bangladesh, Bolivia, Sudan, Zambia, and Zimbabwe.

The coalition also stated that national governments must invest more in their own HIV responses; and bilateral donors must immediately take steps to fill the gaps in critical HIV services created by the Global Fund funding crisis. In November 2011, the Global Fund canceled Round 11 and said no new grants would be available until 2014. According to the coalition's report, this news came like a punch just as major scientific breakthroughs and signs of real progress began to generate the most widespread optimism in the history of the AIDS epidemic. "Now," the report says, "all hopes that the HIV response would enter a new phase are effectively put on hold until at least 2014, and progress made in many areas may actually be reversed. The impact on individuals and communities will be devastating."

As a result of the Global Fund's funding crisis, the scale of the global HIV response will be severely affected, and important existing services will be reduced or eliminated unless urgent measures are taken. This is the central idea of a well-written and purely argued report issued on January 24, 2012, by the International HIV/AIDS Alliance.

Alvaro Bermejo, Executive Director of the Alliance, stated in the report that bilateral donors are required to fill the service gaps. "For donors and other stakeholders to reduce HIV responses due to funding difficulties during economically tough times is short-sighted and counterproductive," the report says. "While trillions have been found by governments to bail out reckless financial sectors, donors have left the Global Fund underfunded to save millions of lives. The Global Fund is the best mechanism to make possible a world without AIDS, but it can only do so with sufficient investment."

The Global Fund, which has directly invested in 150 countries and regions, provides two-thirds of international funding for tuberculosis and malaria and one-fifth for HIV services. The report says that the Global Fund plays an essential role in linking health systems and social systems; the fund has been promoting human rights and empowering people living with HIV to strongly influence national coordination mechanisms. These principles and approaches are embodied in the "universal welcome" of the new Global Fund strategy for 2012-2016, which aims to save 10 million lives by 2016.

The International HIV/AIDS Alliance says that progress in many areas is at risk of being overturned. The alliance calls on donor countries to honor their existing commitments and increase their contributions to create a new fundraising opportunity, making about $2 billion available for the Global Fund in 2012. Specifically, the alliance says donors must accelerate the delivery of their contributions; donors who have not yet committed, especially G20 countries, should do so; donors should urgently replenish funds before the International AIDS Conference hosted in July 2012; and donors should consider measures such as financial transaction taxes proposed by several countries to increase funding sources.

The report describes the impact of the funding crisis on individual countries. For example, in Bolivia, prevention activities focusing on key populations, such as men who have sex with men and lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations, which are at the center of the country's HIV epidemic, will be disrupted. Additionally, the opportunity to expand outreach work to other populations currently not accessing formal healthcare facilities—such as prisoners, street youth, and indigenous peoples—will be lost. Finally, important research programs providing insights into the HIV epidemic will be canceled.

However, the report states that the cancellation of Round 11, combined with other measures taken by the Global Fund—such as strict rules for grant renewals—means the fund will not be able to support any new HIV, tuberculosis, or malaria services. Moreover, the report claims that programs such as HIV care and support, considered basic, will be interrupted because they are not seen as "essential" according to the rules of the Global Fund's Transitional Funding Mechanism (TFM). For the same reason, the report says, crucial advocacy and legal work combating stigma and discrimination, enabling people to access services, may also lose funding; and social efforts addressing many drivers of the epidemic—such as interventions focusing on protection, education, and gender equality—"will be left unfinished."