The history of global health and development didn’t have “the most attractive origins,” Global Fund Director Dr. Mark Dybul reminded an audience at Georgetown University in Washington, DC this morning. With roots in colonial exploitation, evolving into enlightened self-interest, continuing into cold-war inspired efforts to make friends and influence governments, the work of making things better in other people’s countries was a paternalistic business, with neither great expectations or much in the way of good intentions, and little interest in lasting results, he went on to recount.
With entirely related discussions over the next few hours covering lofty ideals of partnerships, fairness, rights and hard realities of politics and economics, the event, “The Global Fund 2014-2016: Sustaining the Fight Against AIDS, Tuberculosis, & Malaria,” at which Dybul was keynote speaker this morning was essentially about how all of that has changed in the years since the world began to band together to defeat the three pandemics.
“You could really say it’s about the human spirit,” Dybul said.
But it is also about a new funding model, which speakers who followed said offers opportunities for countries to plan their responses. At the same time, they noted that countries that are now considered middle-income are home to the poorest people in the world, as well as the highest burdens of disease. It is about “shared accountability,” that means that donors have to produce expected funding on time, as much as it means that recipients must funds use effectively, Canadian International Development Agency Global Initiatives Director David Stevenson noted.
But essentially, one panel of luminaries highlighted, it is about putting science into action.
“We have a very solid scientific basis for implementing what we’re doing,” National Institute of Allergy and Infectious Diseases Director Anthony Fauci, said. “It’s not wishful thinking.”
The need for economic sustainability has necessitated that shift to an evidence-based approach, agreed former U.S. Global AIDS Coordinator Ambassador Eric Goosby, who took charge of the President’s Emergency Plan For AIDS Relief in the wake of worldwide fiscal crises.
Using modelling to predict the results of scientifically predicated efforts — from medical circumcision to lower rates of HIV infections, to treating tuberculosis appropriately — field data can track the effectiveness of those efforts, Centers for Disease Prevention and Control Director Thomas Frieden said.
But, noting that budgeting for global health is categorized as “discretionary,” Fauci cited yet another change that needs to come to global health before its transformation is complete.
“It’s not discretionary,” he said. “It’s virtually mandatory. It’s what we need to do.”