Global Fund Replenishment “window of opportunity” to beat AIDS, tuberculosis and malaria: Half open or half shut?

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MDheadshot“You have brief windows in history,” Global Fund Executive Director Ambassador Mark Dybul said Wednesday. He was referring to a now familiar argument he has made to support a request, that when he puts it this way, sounds modest: “Fifteen billion dollars to control three horrible pandemics.”

The window Dybul is talking about is the chance to turn the three pandemics of AIDS, tuberculosis and malaria from major worldwide public health threats, as he puts it “in wonky-epidemiological terms, into low level endemics.”

“We have the science today, and actually we have the economic power to control them,” he adds. But if those are not put to use now, he continues, all three diseases will outstrip the resources to control them. He cites Uganda where numbers of new cases notably descended more than a decade ago, and now are once again on the rise. That pattern has been repeated around the world with all three diseases, he adds.

LucyCheshireBy the time Dybul repeated his argument: “This window of opportunity isn’t going to stay open long,” at Wednesday’s Georgetown University conference: The Global Fund 2014-2016: Sustaining the Fight Against AIDS Tuberculosis and Malaria, the big numbers were in. With the world’s donor countries, as well as some of the countries where the donations are being put to use, having pledged an unprecedented $12 billion over the next three years to fight the three diseases, the conference ends $3 billion short of its targeted amount. Perhaps the biggest question remaining on Global Fund’s Fourth Replenishment Conference in Washington, DC, is how long the window will stay open.

In one of the morning’s panel discussions, Lucy Chesire, Executive Director of TB ACTION Group in Kenya, and Global Fund board member cited a heartening aspect of the latest and largest replenishment: “We’re seeing a number of implementing countries becoming donors to the Global Fund.” Chesire, who has lived with HIV for more than 20 years, cited the first-time pledge of $2 million from her own country, Kenya, which she also described as “one of the success stories of the Global Fund.” By then she also had noted in her Huffington Post blog, “it is only a start.”


At the same event, Global Initiatives Canadian International Development Agency director  David Stevenson said of efforts to roll out antiretroviral medicine for HIV, tuberculosis screening and treatment, malaria prevention measures and medicine: “When we reach 55 percent of the people in need, that means we’re not reaching 45 percent. That is a huge and urgent challenge.”

Dr. Jeffrey Sachs

Dr. Jeffrey Sachs

In the meantime, a statement from Doctors Without Borders/Médecins Sans Frontières put it more bluntly, saying that “The global effort to fight HIV, TB and malaria took a big hit today,” thanks to donor countries’ failure to hit the target of $15 billion. And economist Jeffrey Sachs, who had correctly predicted “the money is not in the bag,” noted in his Huffington Post blog, that “The world as a whole didn’t come up with a measly $5 billion a year for the Global Fund to Fight AIDS, TB, and Malaria. $5 billion was a bare minimum needed to maintain momentum in the fight against these diseases.” The world, he concludes, “has told the poor and dying to drop dead,” before noting, “nobody has to tell the poor anything. Their deaths are silent and unremarked.” His list of potential sources for an extra $1 billion a year (5 percent of Christmas bonuses on Wall street is on the list) is another reason to read his piece.

Still, Dybul has said it’s not over. More donations will come in. But the question remains: can they prop open the window of opportunity Dybul speaks of? And is propping it open good enough?

“It is ours for the grasping,” Dybul said Wednesday, “or ours for the losing.”

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