On January 28, ten years ago, the Global Fund was created in response to the devastating effects of AIDS, tuberculosis and malaria. In its ten years of existence, the Global Fund’s grants have brought treatment and prevention to millions of people. The world has moved from what was then a mood of despair to what now is genuine hope that, together, we can beat these pandemics.
HIV transmission rates are falling in nearly every region, including the worst-affected countries. Where treatment is available, the death rate is also falling. The prevalence of all TB cases is falling, along with mortality rates among HIV-negative TB cases. We are now approaching universal access to insecticide-treated nets in Africa to prevent malaria.
The Global Fund is providing nearly a quarter of all international funding to fight AIDS, two-thirds of the funding against malaria and more than four-fifths of all funding to fight TB. The Global Fund has played a central role in this turnaround.
Despite the important progress made, the world now faces some hard decisions: as more and more rich or emerging-economy countries focus on weathering the global economic slowdown, will they sacrifice the global health targets that are now within reach? Will we have to give up the hope of ensuring that no child is born with HIV? Or that no one will need to die from malaria? Or that we eventually can ensure that all who need it will have access to AIDS drugs or effective TB drugs?
Spending on global health has declined over the past two years, after nearly ten years of dramatic growth. The Global Fund had to announce late last year that - while it will disburse US$ 10 billion between 2011 and 2013 - it will not be able to expand its funding further, because some countries have already signaled that they will not be able to contribute as much as before - while others are trying but may also need to reduce their funding in the future.
Several government leaders are still fully committed to continuing the progress and sticking to continued large investments in global health - despite hardship at home. But they cannot be expected to compensate for other countries. And then there are the new, emerging powers; it is increasingly in their interest to play a more central role also in the global work for common goals and common gain. Will that mean they will take on a larger share of the costs to achieve such gains?
The Global Fund is changing to meet the new challenges of its second decade. Its focus is shifting from an emergency response to sustainable and efficient channel for funding to fight AIDS, TB and malaria. This means important changes in structure, functioning and management. In November 2010, the Global Fund’s Board approved a transformation plan and has now appointed Gabriel Jaramillo, an experienced manager of complex change processes, as its General Manager to oversee the implementation of this plan. In parallel, our Executive Director of the past five years, Michel Kazatchkine, has decided to step down. (See also Le Monde blog).
Change brings uncertainty, but it also brings hope, as it can be seen as an opportunity to improve and to save more lives every day.
This week the Global Fund celebrates its 10th anniversary in Davos, Switzerland at the annual World Economic Forum meeting. During the international meeting the Global Fund and the Bill & Melinda Gates Foundation will be making an important announcement. We are also launching an exciting video that you cannot miss. Watch this space tomorrow for more news.
We have never been so close to achieving dramatic health goals.
Together we can do great things.