Global Fund Panel Stresses Strengthening Health Systems, Community Engagement Vital To Delivering UHC

Stamping out HIV/AIDS, tuberculosis and malaria can play a major role in helping to achieve universal health coverage (UHC), said a high-level panel of leaders and supporters of the Global Fund to Fight AIDS, Tuberculosis and Malaria, convened yesterday in the lead-up to the World Health Assembly later this month.

Panelists highlighted the Global Fund’s contributions toward UHC in reducing the global burden of AIDS, tuberculosis and malaria, building capacity of national health systems, and fostering engagement with communities directly affected by these diseases; but they also acknowledged that UHC cannot be achieved without increased national investment in health.

Pictured from left to right: Erika Castellanos, Director of Programs at Global Action for Trans Equality; Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; H.E. Dr. Cleopa Kilonzo Mailu, Permanent Representative of the Republic of Kenya to the United Nations in Geneva; Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO; H.E. François Rivasseau, Permanent Representative of France to the United Nations in Geneva; Oxana Rucsineanu, Moldova National Association of tuberculosis patients; and Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The panel convened to discuss the Global Fund’s contributions to the global fight against HIV/AIDS, tuberculosis, and malaria, and to highlight the importance of replenishing their funding from the international community at a replenishment event in October later this year. The Global Fund has set its sights on a minimum fundraising target of US$14 billion to fund the next three-year cycle of aid, a target far larger than the US$12.9 billion pledged by donors in 2016.

The savings would far outweigh the costs according to Global Fund leaders and government officials. “What we will deliver is [halving] the annual death toll of the three diseases by 2023, building on the halving that is already happening,” said Peter Sands, Executive Director of the Global Fund. He stressed that fighting any diseases which strain health systems will ultimately “create capacity in [those] health systems” and open opportunities for further investment.

But the event at the Geneva Palais des Nations also highlighted the need to better link internal aid initiatives such as the Global Fund with greater national government investments in health, particularly in primary health care, where many governments still fall short.

Two panelists focused on the importance of government investment in local health issues. “Communities are masked in averages that do not reflect what they need,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO).

Dr Tedros cited the 2001 African Union (AU) Abuja Declarations and Frameworks for Action on Roll Back Malaria, in which each AU member state pledged to allocate at least 15 percent of their annual budget to health sector investment. In the eighteen years since, several AU members have increased health spending, but many are not meeting the mark set by the Abuja Declarations.

Kenya is among the African states which has worked alongside the Global Fund to make significant strides toward UHC. “Universal health coverage is not a choice, but an imperative,” said H.E. Dr Cleopa Kilonzo Mailu, Ambassador and Permanent Representative of the Republic of Kenya to the United Nations in Geneva. “We need to encourage countries to embrace UHC.”

“This is a great opportunity for the Global Fund to [encourage countries to allocate resources] and whatever comes from the outside is an additional benefit,” said Dr Tedros.

Funding is not the only area where the Global Fund can provide models for moving forward on more efficient health systems. HIV and tuberculosis advocates on the panel cited the Global Fund’s Country Coordinating Mechanisms as models to create community engagement by including people living with the targeted disease, which is necessary to reach marginalized groups with the least access to quality care.

“The Global Fund provides means that empowered communities and helped them make changes to improve their quality of life,” said Erika Castellanos, Director of Programs at Global Action for Trans Equality. She stressed the importance of targeting the Global Fund’s three major diseases as an issue of engagement with those often left behind, such as LGBT and poverty-stricken communities. “There is no single HIV grant that has not transcended HIV and helped in other health areas. Receiving adequate services should not be a privilege. It is a right.”

“If countries develop universal health coverage which focuses on the minority, it will work for the majority,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The panel concluded on three key messages: health as a human right; the necessity of government engagement with health investment; and the importance of donor contributions to the Global Fund’s replenishment.

“We do acknowledge the tremendous progress that has been made in countries dedicated to UHC,” said Dr Mailu. “This is what we want to pursue further. To do so we must encourage support of Global Fund replenishment.”

The Global Fund’s Sixth Replenishment Investment Case was launched on 20 January in Paris and was followed by a publicized preparatory meeting in New Delhi on 7 February. Next week, the Global Fund will hold a Board meeting at which its new Board Chair and Vice-Chair will take over and begin discussion of grant allocation for the next funding cycle.

The replenishment event, at which the Global Fund hopes to reach their minimum fundraising target of US$14 billion, will take place in Lyon on 9-10 October following a high-level United Nations General Assembly meeting on UHC in New York on 23 September. Each of these events marks an important stride by the Global Fund toward not only acquiring international aid funding, but also providing means through which countries can invest in their own health systems.

“Money on health is a very good investment, and most countries should be spending more,” said Sands.

Image Credits: WHO.

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