Today, I am very pleased that Michel Kazatchkine, Executive Director of the Global Fund, has accepted the IAS’ invitation to post a guest blog regarding the first Global Fund Replenishment meeting taking place at The Hague, 25 – 26 March. In addition to his leadership at the helm of the Global Fund, we have been privileged to have Michel’s wisdom and advice as one of the European members of the IAS Governing Council for many years, where he has made an enormous contribution in shaping the strategic direction of the IAS.

Time to Redouble Our Efforts

By Michel Kazatchkine, Executive Director, the Global Fund to Fight AIDS, Tuberculosis
and Malaria

2010 will be decisive. The world will review progress on the Millennium Development Goals at a summit at the United Nations in September. But 2010 is also the year of the Third Voluntary Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The outcome will determine where the world will be with respect to the three pandemics and the health-related Millennium Development Goals in 2015. It will determine whether we will win the fight – or whether we will waver in our commitment and let the progress falter, allowing AIDS, tuberculosis and malaria to gain force again. 

Prof. Michel Kazatchkine - Executive Director of the Global Fund © International AIDS Society / Simon Deiner / SDR Photo

The first meeting of the Global Fund’s replenishment, which takes place this week in the Netherlands, will bring together a broad range of stakeholders, including donor governments, as well as private sector donors and beneficiaries. It is aimed at securing funds for the 2011 – 2013 grant period, and represents an important step in a process that will lead up to a final ‘pledging’ meeting in New York in early October, 2010.

The meeting this week is taking place nearly 10 years after Kofi Annan issued a “call to action” for a vastly accelerated response to AIDS, tuberculosis and malaria. At the time, the world recognized that it was failing to respond to the three diseases in developing countries, causing an unprecedented public health and human rights crisis. It is taking place eight years after the Global Fund was created and five years after G8 leaders met in Gleneagles to pledge to provide HIV prevention, treatment and care to everyone who needs it.

Because of what we have delivered, and because of how we have delivered it, I am confident that we will be allowed to continue to scale up programs and interventions, at least at the same pace as in recent years.

Programmes financed by the Global Fund are estimated to have saved the lives of almost five million people in the last six years alone. Every day, 3,600 lives are being saved. If countries can continue scaling up their efforts at the pace set in recent years, we could come close to, reach or even exceed the health-related Millennium Development Goals. By 2015, millions more HIV infections may be prevented and lives otherwise lost to AIDS saved, and we may virtually eliminate transmission of HIV from mother to child.

As of the end of 2009, the Global Fund had approved grants totaling US$19.2 billion in over 140 countries. Every dollar we receive goes straight to programs in country – we have no country offices, and our operating expenses are almost entirely covered by interest earned on our contributions. With government budgets under strain and the world’s poor facing increased economic hardship, the Fund’s continuous efforts to further improve value for money, increase efficiency and channel resources to where they achieve the best results are more crucial than ever. 

It has been a privilege to serve both as Executive Director of the Global Fund and as an IAS Governing Council member for the past several years, participating in discussion and debate with scientific, political and community leaders that have helped shape the global response to AIDS. Research and programmatic evidence from IAS conferences have informed the content and delivery of HIV prevention, care and treatment programs for more than 20 years.

With the launch of its advocacy campaign, Universal Access Now, the IAS is adding an important voice to replenishment discussions. The IAS briefing paper Will We End the HIV Epidemic?, released on 18 March, synthesizes current scientific evidence into a powerful argument that should resonate with political leaders and policymakers worldwide: there is no doubt that antiretroviral therapy (ART) saves lives and rebuilds communities.

Some have recently argued that the Global Fund and other donors are investing too much on treatment, to the detriment of prevention. They are wrong, for many reasons. First, at the Global Fund, we support programs that pursue an integrated and balanced approach covering prevention and treatment. An analysis of our spending shows that 30 percent of the amount allocated to HIV was spent on prevention and 27 percent on treatment. Second, there are also strong public health arguments for investing in treatment. We cannot successfully prevent the further spread of HIV unless we scale up both, prevention and treatment. We know that people are less likely to come forward for HIV testing if they cannot access treatment if they test positive. And now we have evidence that ART can play a key role in decreasing HIV transmission.

At the end of December 2009, programs financed by the Global Fund were providing ART to 2.5 million people – 500,000 more than one year earlier. We fund ART for 50 percent of the people who currently access this lifesaving treatment in Africa.  Scale up will continue: by the end of 2011, programs supported by the Global Fund will provide ART to 3.5 million people, averting over half a million AIDS deaths in 2011 alone.

We should celebrate these results, but first and foremost we should resolve to do much more. We need to reach the other half – the over 50 percent of people in urgent need of ART who still are unable to access life-saving treatments.

We have shown that it can be done. The moral imperative for treatment that Justice Edwin Cameron so eloquently laid out in his plenary address at the International AIDS Conference in Durban in 2000 may be even stronger today. Simply put, it would be shameful if we did not continue to scale up rapidly and denied access to the other half. And I am committed to working with the IAS and our other friends and allies towards a world that will see the end of the AIDS, TB and malaria epidemics, confident that the knowledge and resources are in our hands.