Jeffery Sachs, PhD – the director of the Earth Institute at Columbia University and special advisor to Secretary-General of the United Nations, Ban Ki-moon – called on the membership of the American Society of Tropical Medicine and Hygiene to take urgent action Sunday evening. Sachs gave the opening plenary address during the organization’s 60th Annual Meeting in Philadelphia.
“What happened a couple of weeks ago was the biggest set back to the Millennium Development Goals since I started advising Ban Ki Moon,” Sachs said, referring to the Global Fund to Fight AIDS, Tuberculosis and Malaria announcement a couple of weeks ago that it will be unable to grant any new funding proposals until 2014 due to financial constraints brought on mostly by a lack of follow through by countries on their financial commitments to the Fund.
The U.S. Congress was undertaking last-minute budget talks over the weekend as it determined funding for the rest of fiscal year 2012. One of the programs that hangs in the balance is the U.S. contribution to the Fund and the President’s Emergency Plan for AIDS Relief (PEPFAR).
“I remind you that what the U.S. pledged between 2011 and 2013 for the Global Fund was $4 billion over three years,” Sachs said. “We spend $1.9 billion a day on the military. So what we’re talking about is two days of military spending over three years to fund a pledge at the Global Fund which is at risk of not being funded.”
Sachs urged the audience of about 2,000 to contact Admiral Tim Zeimer, U.S. Global AIDS Ambassador Eric Goosby, Chair of the Global Fund Simon Bland and World Health Organization Director-General Margaret Chan, and make the case for these lifesaving global health interventions. “It has to come back to the president and to the Congress that it’s unacceptable for America to stand by and put the Global Fund into a situation of abeyance at this critical moment,” Sachs said, acknowledging that the current funding climate, including unfulfilled pledges by some European countries, makes it all the more imperative that the U.S. follow through on its pledge to the Fund. “We need to let them know that what has happened in the last ten years is the finest demonstration of the marriage of science, politics and ethics and that we are all motivated to move forward in that effort,” he said.
Using the scale up of Malaria response funding and interventions over the past decade as an example, Sachs discussed how the Millennium Development Goals have spurred an onslaught against infectious diseases globally.
Experts approximate that there are about a million deaths per year attributable to malaria, Sachs said, 90 percent of which occur in sub-Saharan Africa (SSA), where the temperature, humidity and vector species make an unrivaled force in infection.
Sachs started his macroeconomic work in SSA in the mid-1990s, and found malaria a consideration in all economic work on the continent. “Everyone there either was sick with malaria or had children at home with malaria,” he said.
“When you added up the world effort in malaria [control] at the end of 90’s it totaled $80 million – almost no control at all,” he said, adding that in Africa it was just a shadow of an attempt. “Africa was deemed a place too hard [to make a difference] – even during the global eradication effort,” he said. But in the spring of 2000 Nigeria’s president asked Sachs to work with him for the first summit on malaria, putting goals of curing malaria on the agenda.
It was a point of take-off with many precursors, Sachs said: the meager tools that had been applied to the problem, like use of the antimalarial chloroquine, were no longer effective; new research showed that insecticide-treated bed nets could make a big difference in the epidemic; and malaria was receiving new political attention.
Despite all of this, it was the money that made the real difference. “It took mobilizing money to make it possible to start scaling up this effort – even in 2004, three years into the Global Fund, spending on malaria was $200 million worldwide from donor agencies,” and the Global Fund was the sole donor agency. “$200 million… that’s 60 cents per American per year… it’s about 40 minutes of pentagon spending… We went from basically nothing at the beginning of the decade to about $1.8 billion in funding at the end of 2010… that’s good news,” he said.
He then noted that marked progress was seen in the number of child deaths prevented annually by malaria intervention scale up from 201 – 2010, including roughly 294,000 child deaths prevented in 2010 alone. The World Health Organization estimated that Africa saw more than a 30 percent decrease in malaria deaths in 2009 due to the scale up of malaria programs.
Still, the cost of a comprehensive scale up of malaria control efforts is approximately $3 to $4 billion per year in Africa. With the economic climate we’re now seeing and the threat to Global Fund funding, Sachs said we’re at risk of losing the progress that we’ve made