Discussion with Peter Sands on The Global Fund and the Private Sector’s Contributions to Fighting HIV, TB and Malaria During COVID-19

Ian MatthewsNews

Discussion with Peter Sands on The Global Fund and the Private Sector’s Contributions to Fighting HIV, TB and Malaria During COVID-19

Peter Sands is the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. A former Chief Executive Officer of Standard Chartered PLC, one of the world’s leading international banks, he has been a research fellow at Harvard University since 2015, dividing his time between the Mossavar-Rahmani Center for Business and Government at Harvard Kennedy School and the Harvard Global Health Institute, working on a range of research projects in financial markets and regulation, fintech and global health.

Mr. Sands participated in a discussion with Dr. Tadesse Gebremedhin, Minister of Health of Ethiopia, moderated by Sherwin Charles, CEO and co-founder of Goodbye Malaria, during a GBCHealth hosted webinar, Reimagining Commitment to Fighting HIV, TB and Malaria During COVID-19: Focus on the Private Sector, on July 16, 2020. During the discussion, Mr. Sands shared his perspective on the Global Fund’s response to COVID-19, strategies to mitigate potential rollback on progress made against the three diseases, and what is needed to ensure optimal and most effective private sector engagement for elimination of the three diseases in the era of COVID-19. This Q&A is adapted from his comments during the discussion.

What is the effect of COVID-19 on HIV, TB and malaria, and why was the Global Fund well-positioned to take action so quickly?  

We have an incredible amount at stake right now, not just in terms of the lives that could be lost to COVID-19 itself, but also the lives that could be lost because of the knock-on impact on other diseases. It is not just HIV, TB and malaria, it’s also maternal health, immunization and so much more. Analyses from groups like UNAIDS, WHO, Stop TB and others estimate that we could see another half a million deaths from HIV/AIDS, another half a million deaths from TB, and malaria deaths could double in the next year due to the pandemic. On TB and HIV, we could lose a decade worth of gains, and for malaria we could slip back to the death rate at the millennium, two decades ago.  

That is not an outcome that any of us are going to let happen. I am determined and confident we can avoid that. The question is, how much can we mitigate the negative impact? 

The Global Fund moved very rapidly right at the beginning of March, providing countries with grant flexibility and creating the COVID-19 Response Mechanism (C19RM). We are providing about a billion dollars to help countries fight COVID-19, to mitigate its impacts on lifesaving HIV, TB and malaria programs, and to prevent fragile health systems from being overwhelmed. We have also been seeking additional resources so that we can channel additional funding into our response.

Countries can use C19RM funds to adapt their existing HIV, TB and malaria programs given that these programs cannot be implemented in quite the same way during lockdowns. They can be applied to introduce urgent fixes to health systems, such as supporting labs that are under huge pressure, and to protect health workers, as well as to address some fundamental issues around COVID-19, such as diagnostics.

The Global Fund was created to fight the three world’s deadliest diseases: AIDS, TB and malaria. We have the infrastructure, relationships, and expertise working with governments, communities and the private sector to leverage our capabilities to combat COVID-19. People underestimate how much the COVID-19 response in many countries is leveraging the infrastructure that has been put in place to fight other diseases. 

While we have moved fast and we are working hard to support countries, we should acknowledge that a lot more needs to be done. We are only at the early stages of the pandemic in much of Africa, and we need to act accordingly. It will require more resources, determined action and leadership, and a huge amount of collaboration. 

How important is the private sector’s role in responding to COVID-19? And how do we ensure that the Global Fund maximizes its partnership with the private sector in the COVID-19 fight?

The Global Fund was founded as one of the first global public-private partnerships, and we have seen our private sector partners respond very quickly and constructively to the challenge of COVID-19. Whether it is helping to adapt existing HIV, TB and malaria programs, helping to address some of the logistical challenges, such as medical product distribution, or  providing online communication tools to civil society groups and Country Coordinating Mechanisms to enable them to shift rapidly to an online model, the private sector has been an active partner. 

However, we will need more corporate engagement, and it needs to be sustainable. We need the innovative capabilities of the private sector and new tools to prevent, diagnose and treat the disease. 

There are shortages of personal protective equipment (PPE) and other medical supplies all over the world, and it does not make sense to be shipping these items all over the world. This is a great opportunity to start manufacturing PPE locally, but it needs to be of good quality. There are a lot of issues around logistics and supply chains where the private sector also plays a vital role. 

Further, the world has shifted to a digital operating mode incredibly quickly. For example, TB consultations are now happening online; but many of the people involved have not been trained accordingly and don’t have the technology or the experience to carry these consultations out properly. The private sector is the best place to source that kind of expertise. 

The private sector has underestimated what is at risk with infectious diseases. If there was ever a lesson as to what is at stake – the disruption to business and the economy – COVID-19 is that lesson. I hope that when we make it through this pandemic, we remember that there is a very powerful link between the health of the population and its ability to generate wealth. 

Business has a lot at stake in making societies healthier. My message to companies already engaged in health issues is that you must convert the rest of the business community, because the business community as a whole does not engage in health as much as it should. I think COVID-19 could transform the relationship between the business community and health to a much broader engagement than we have achieved thus far.

The economic impact of the COVID-19 pandemic has been sudden and noticeable, while malaria, HIV and TB have been decimating our economies for decades, in a way that is not so immediate. How can we make the economic impact of the three diseases more evident?

It is the classic situation where the thing you lose suddenly is very visible, but the thing you have never had, or that has been eroded slowly, is less noticeable. A very good example is that there are many beautiful countries that could have great tourism businesses, which would create a lot of employment and wealth for host countries, but because they have high burdens of malaria, it is extremely difficult to build a tourism industry. When you do the math on that opportunity cost, it is a compelling business proposition to get rid of malaria. So we need to make that case clearer, because the burden we could take off the continent – not just by tackling COVID-19, but by getting rid of the other three diseases – would have enormous impact.

Ian MatthewsDiscussion with Peter Sands on The Global Fund and the Private Sector’s Contributions to Fighting HIV, TB and Malaria During COVID-19