Death by Disease, Blamed on the Recession

"It is deeply worrisome that inadvertently, the millions of people fighting with deadly diseases are in danger of paying the price for the global financial crisis." -- Michel Kazatchkine, executive director, The Global Fund[1]

In 2010, 1.8 million people died from AIDS, 1.4 million from tuberculosis and 655,000 from malaria. The malaria deaths are mostly of African children, although there is a current debate about the total number, which could be actually 1.2 million according to a study in the Lancet that says the smaller figure, an estimate of the World Health Organization, is incorrect.[2][3][4][5]

One organization that is combating these three killers is the Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private partnership (PPP) and international financing institution (IFI) that was founded in 2002 to "dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need." With USD 22.4 billion of approved funding, the Global Fund is the world's primary financier of projects that combat the three epidemics. According to their website, the fund has given 3.3 million people with AIDS antiretroviral treatment, detected and treated 8.6 million new cases of tuberculosis and distributed 230 million insecticide-treated nets to protect families from malaria.[6]

DONORS WITHDRAW AMIDST FINANCIAL CRISIS

But the financial crisis has hampered the fund's ability to issue new grants. In 2010, its fundraising goal was USD 20 billion, but it was only able to raise USD 11.5 billion, which was still below the mininum USD 13 billion required to maintain its current programs. Then, in November 2011, the board of directors announced a change in strategy that was the result of "substantial budget challenges in some donor countries, compounded by low interest rates [that] have significantly affected the resources available for new grant funding." Under the new directive, which covers 2012 through 2016, the fund will not issue new grants until 2014 and "will only be able to finance essential services for on-going programs that come to their conclusion before 2014 by making savings in the existing grant portfolio." Essentially, the fund's 11th round of funding has been scrapped.[7]

Last month at the World Economic Forum in Davos, Switzerland, Bill Gates announced a USD 750 million contribution from the Gates Foundation to the Global Fund. But while welcome news, the donation will not affect the board's decision to cancel the current financing round, as they knew about it when the strategic change was made.[8]

Even as the board has "urgently requested donors to consider measures to increase and accelerate funding, and implementing country governments, especially those from middle-income countries, to increase funding for the three diseases and related health investments," board chair Simon Bland tried to soften the blow. He said that with the new funding model, which "focuses on investing strategically in countries, populations and interventions with high potential for impact and strong value for money," the fund will shift "from an institution that has successfully provided emergency funding to allow countries to cope with the runaway pandemics, to become a sustainable, efficient funder of the global efforts to control them."[9]

A TURNING POINT?

The Global Fund is not alone. The international fight against disease in general has taken a hit because of the financial crisis. According to a report by the Sydney-based non-profit disease research group Policy Cures, global public funding to fight neglected diseases -- which include malaria, TB, HIV, pneumonia, sleeping sickness and helminth infections -- dropped by USD 136 million in 2010 due to cutbacks from governments and philanthropic organizations.[10]

"This is a turning point where we decide whether our response to the global financial crisis is going to include letting neglected disease R&D be wiped out or not," says Policy Cures executive director Mary Moran. "Because you can't cut product-development funding midstream and expect that everything will just start up again when you're ready. She notes that this is "the first time since World War II where we've suddenly had this revitalization, saying that patients in the developing world deserve, need and must have better medicines. It would really turn back the clock to see that commitment disappear down the hole of the financial crisis."[11]

THE GLOBAL RECESSION IS NOT AN EXCUSE

In an opinion piece last week in The New York Times, Paul Farmer, chairman of the department of global health and social medicine at Harvard Medical School and a cofounder of Partners in Health, which has received support from the Global Fund in Haiti, Lesotho and Russia, said that "a recession is a lousy excuse to starve one of the best (and only) instruments we have for helping people who live on a few dollars a day. Most marginalized populations around the globe have always faced economic contraction; 'financial crisis' has been ongoing for them since the day they were born."[12]

"Simply put, if we allow the fund to fail, many people will die, and we will forfeit the chance at the 'AIDS-free generation' that U.S. Secretary of State Hillary Clinton called for in November," Farmer said. "This is no time to step back."[13]

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NOTES

[1] The Global Fund. "The Global Fund Adopts New Strategy to Save 10 Million Lives by 2016." November 23, 2011. Accessed February 7, 2012.
[2] Avert.org. Global HIV and AIDS estimates, 2009 and 2010. Accessed February 7, 2012.
[3] Centers for Disease Control. Tuberculosis - Data and Statistics. Accessed February 7, 2012.
[4] World Health Organization. Malaria Fact sheet N°94. December 2011. Accessed February 7, 2012.
[5] McNeil, Donald G., Jr. "Malaria: Specialists Duel Over Death Toll in 2011: Was It 655,000 People or Twice as Many?" New York Times. February 6, 2012. Accessed February 7, 2012.
[6] The Global Fund. About. Accessed February 7, 2012.
[7] The Global Fund. "The Global Fund Adopts New Strategy to Save 10 Million Lives by 2016." November 23, 2011. Accessed February 7, 2012.
[8]
Friends of the Global Fight Against AIDS, Tuberculosis and Malaria. "The Global Fund to Fight AIDS, Tuberculosis and Malaria Celebrates 10th Anniversary of Lifesaving Work." PR Newswire. January 26, 2012. Accessed February 7, 2012.
[9] Ibid., 1.
[10] Policy Cures. Global Funding of Innovation for Neglected Diseases: G-FINDER. December 8, 2011. Accessed February 7, 2012.
[11] Wadman, Meredith. "Financial crisis hits developing world disease research." Nature. December 7, 2011. Accessed February 7, 2012.
[12] Farmer, Paul. "Why the Global Fund Matters." The New York Times. February 1, 2012. Accessed February 7, 2012.
[13] Ibid.

image: An Anopheles stephensi mosquito is obtaining a blood meal from a human host through its pointed proboscis. Note the droplet of blood being expelled from the abdomen after having engorged itself on its host's blood. This mosquito is a known malarial vector with a distribution that ranges from Egypt all the way to China. Source: CDC (credit: Centers for Disease Control and Prevention, Wikimedia Commons)