Global Fund turns 10, but where’s the party?

Originally published on Global Post

partyLast week, amidst all the furor over pink ribbons and the Komen Foundation, another, quieter story unfolded.  Without much fanfare, the Global Fund to Fight AIDS, Tuberculosis and Malaria turned 10.

Over its first decade, the Global Fund has saved millions of lives — getting 3.3 million people with HIV into lifesaving treatment,  detecting and treating nearly 9 million cases of infectious tuberculosis, and distributing nearly a quarter of a billion insecticide-treated bednets to protect families from malaria. In light of these achievements, and of the enormous remaining need, there wasn’t as much celebration as you might have expected for this historic birthday.  The past year has been a rough one for the Global Fund —a shortfall in donor pledges, the cancellation of its next round of funding (Round 11), and changes in leadership have left many asking what will become of the Fund and the millions of people whose lives it saves.

As long-time advocates for reproductive and maternal health, we often find ourselves on the periphery of debates about funding for HIV, tuberculosis, and malaria programs. But AIDS, TB, and malaria are leading killers of women — 60 percent of all Africans living with HIV are women.

Reproductive and maternal health advocates should be rooting for, and working toward, a Global Fund that is vital, viable, and well-funded. Just like us, the Global Fund has always upheld the idea that their work contributes to achievement of all of the health-related Millennium Development Goals (MDGs). You can’t achieve MDG 6 (combat HIV/AIDS, malaria and other diseases) if you don’t also achieve MDG 5 (improve maternal health and achieve universal access to reproductive health), and MDG 4 (reduce child mortality) as well. The Global Fund’s endorsement of this linkage isn’t just empty rhetoric.  The Fund has always accepted and considered proposals that include reproductive, maternal, and child health interventions, when countries could demonstrate that they would have an impact on AIDS, tuberculosis, and malaria.

Remarkably, and distressingly, the Global Fund is one of the few donors that will fund reproductive, maternal, newborn, and child health and HIV out of the same pot of money. Countries don’t need to piece together separate HIV funds, reproductive health funds, and maternal health funds in order to finance an effective, integrated women’s health program.  The Global Fund doesn’t impose bureaucratic  restrictions over  what services can or can’t be co-located in the same clinic, or about what health worker can provide which service and when.   And, perhaps most importantly, the Global Fund recognizes, on paper and in practice, that its money has much more impact when it’s spent on treating a person and not just a disease.

Of course, the Global Fund could do better. Its new five-year strategy recognizes integration as a very cost-effective way to deliver better health outcomes, but recent funding setbacks have held up progress on this initiative. And it has yet to fulfill its potential in funding contraceptives, providing safe labor and delivery supplies, and training health care workers to carry out integrated programs.

In 2012, the Global Fund will develop an implementation plan for its maternal, newborn, and child health integration strategy.  Reproductive and maternal health advocates should be working now to ensure that this commitment to integration becomes a reality. But we should also join together with advocates focused on AIDS, tuberculosis, and malaria in demanding that donors fulfill (and increase) their commitments to the Global Fund.

The Fund has the will and the potential to make great progress — it just lacks the means.  Replenishing its coffers with funds sufficient to get the job done would make a fine belated birthday gift, and give so many women the gift of better health.

One Response to “Global Fund turns 10, but where’s the party?”

  1. Steven Earl Salmony

    If scientists will choose to speak truth to the powerful, perhaps they will encourage other stonewalling leaders to do the right thing. At the moment many too many elders are remaining electively mute and appear unwilling to confront ‘the powers that be’ with the best science available regarding either the ‘placement’ of the human species within the order of living things on Earth or the most adequate understandings of the way the world we inhabit actually works. Such willful refusals by so many knowledgeable elders to assume their individual responsiblities to science and fulfill their well-established, collective duties to humanity are indefensible. Before it is too late for human action to change the perilous, human-induced course of unfolding and fulminating ecological events in our planetary home, perhaps enough people will speak out loudly and clearly in ‘one voice’ about what they believe to be real (according to the knowledge and the ‘lights’ they possess) regarding clear and imminent dangers to future human well being and environmental health that are visible on our watch. By so doing a global, internet-driven transformation of consciousness could literally spring up, as if out of nowhere, among human beings with feet of clay. Because the finite and frangible ‘reality’ of the natural world we inhabit has got to become more evident to people everywhere, day by day, and because the biological and physical limitations of the natural world will become obvious to people everywhere during the timeframe when humanity will face ‘peak everything’, humankind could sooner rather than later reach a point in space-time when a critical mass of people see and agree that ‘the endless growth’ paradigm that is so powerful and prominent in the human world in our time is, in fact, the telltale mark of insanity. Then the human (not the natural) world will have to change, the seemingly unassailable force of self-proclaimed masters of the universe, their global political/economic endless growth regime and mass media notwithstanding. Human overpopulation, overproduction and overconsumption activities would be reasonably, sensibly and humanely regulated worldwide. Human beings with feet of clay would not even be able to think in good faith of ourselves as Homo sapiens, much less behave as if there were no limits to growth on a planet with the size, composition and ecology of Earth. Such circumstances would compel all of us at least to try and change behavior that can be seen readily as distinctly human and patently unsustainable lunacy. With regard to the construction of the ‘economic colossus’ we call a global political economy, the outrageous per capita overconsumption of limited resources and skyrocketing increase of absolute global human population numbers, change toward sustainable lifestyles and right-sized corporate enterprises would begin to occur ubiquitously. After all, there have got to be limits to the insanity of constructing any unsustainable human world by a species calling itself Homo sapiens sapiens. Somehow, somewhere, at some moment the leading elders in the human community must agree to limit something, some human activity. Any activity at all will work well. By so doing we change the endless growth paradigm and choose a new path, ‘a road less traveled by’, to the future. Until at least one human activity is meaningfully restrained, if not altogether halted from growing (at least momentarily), the unsustainable game of Ponzi we are recklessly and relentlessly playing will eventually lead to global destruction and degradation of a colossal, incalculable sort, I suppose.

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