TB advocates respond to Global Fund proposal for “historical disease allocation” model

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As board members of the Global Fund to Fight AIDS, Tuberculosis and Malaria prepare to meet Thursday and Friday in Geneva, advocates for tuberculosis detection, treatment and prevention have signed a response to a proposal they say will foster a divisive “disease against disease” approach to funding, and seriously undermine efforts to roll out cost-effective diagnostic and treatment approaches.

Their letter, circulated on World Health Organization/Stop TB Partnership letterhead, is in response to a Global Fund document listing “Options For A New Funding Model,” which gives a glimpse of how resources would be divided among responses to the three diseases.

In a section titled “Areas of Broad Agreement” states: “To begin, the division would be based on the historical levels of investment in each disease in the Global Fund’s portfolio.” The document goes on to say that the division would be an “interim approach” only, and that a more demand-based model would subsequently be developed.

But, the 67 signers of the response to the proposal say, that would allocate just 16 percent of Global Fund money to fight tuberculosis, making an appropriate response to the disease with new screening, diagnostic and treatment efforts impossible.

The “historical” 16 percent figure comes from Global Fund figures prior to 2010, the response says, before more effective strategies became available.

The limitations of that funding model also would incapacitate efforts to maintain basic levels of tuberculosis care, scale up HIV/TB interventions, extend early case detection to those in greatest need, and make better use of community based responses, the response says.

The response points to two other models, that it says would lead to better outcomes: determining funding by mortality caused by disease, or by disability adjusted years of life lost to disease (DALYs).

The response calls for an increase of the allocation for tuberculosis efforts to at least 20 percent, and the creation of an additional fund for equipment and medicine to address multi-drug resistant tuberculosis.

 Signers of the response to the proposal include those representing international organizations that include the World Health Organization, The international Union Against Tuberculosis and Lung Disease, Treatment Action Group, RESULTS, and tuberculosis control agencies in countries across Africa and Asia.

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