At the end of 2019, the excitement was palpable around the possibilities resulting from the Global Fund’s largest-ever Replenishment, which resulted in over USD 14 billion raised for the organization and its fight against HIV, TB and malaria.
The start of 2020 saw a much different reality; as COVID-19 ravaged the globe, progress against the three diseases was rapidly threatened. As Global Fund Executive Director Peter Sands wrote, “the COVID-19 pandemic hit, and everything changed.”
The Global Fund’s 2020 Results Report reflects the unique circumstances imposed by COVID-19. On one hand, the report includes promising data regarding the progress the Fund has experienced in the previous year – data that mostly predates the emergence of the pandemic. In 2019:
- 6 million lives were saved – a 20% increase over the previous year.
- 20.1 million people received lifesaving antiretroviral therapy for HIV.
- 5.7 million people received lifesaving treatment for tuberculosis.
- 160 million mosquito nets were distributed to protect nearly 320 million people from malaria.
- The Global Fund disbursed USD 3.5 billion across 150 countries to fight HIV, TB and malaria and strengthen systems for health.
- A cumulative total of 38 million lives have been saved since 2002.
Despite these results, Sands warns that “we cannot escape the reality that the results for 2020 will look very different from the achievements of 2019 portrayed in this report.” Given the catastrophic knock-on effects of COVID-19 on the fight against the three diseases, Sands stresses the need to “act with urgency, massively increasing collaboration, resources and innovation.”
The Fund has found that 75% of the HIV, TB and malaria programs it supports have been moderately or severely impacted by COVID-19, and recent modelling studies show that deaths from HIV, TB and malaria could as much as double in the next year as a result of COVID-19.
The report discussed the Fund’s response, which focused on:
- Adapting HIV, TB and malaria programs to mitigate the impact of COVID-19 and safeguard progress;
- Protecting front-line health workers through the provision of personal protective equipment and training to front-line health staff, including community health workers;
- Reinforcing systems for health so they don’t collapse by supporting urgent enhancements, including to supply chains, laboratory networks and community-led response systems;
- Fighting COVID-19 by supporting control and containment interventions, including testing, tracing and the support of isolation, communications and treatment (as therapeutics become available).
The report also emphasized the role of resilient and sustainable systems for health (RSSH) as a foundation for global health security and a necessary preparation for future health threats, in addition to being key to the fight against the three diseases. “To end these epidemics and to confront new threats like COVID-19, we must continue to build more RSSH,” Sands wrote. “We must strengthen workforce capacities, support dynamic community responses, build more efficient and effective supply chains and data systems, and secure adequate and sustainable financing.”
Additionally, the report highlights some of the roles of the Global Fund’s private sector partnerships, noting that “private sector partners are… complementing the contributions of other development partners through funding and innovative solutions.” For example, the report emphasizes how new technologies, health innovations and greater efficiency from the private sector can play a “transformational role” in fighting infectious diseases, and that “rapid deployment of supply chain and information technology solutions” from the private sector “is critical to help low-income countries quickly strengthen their capacities to fight COVID-19.”
Throughout the report, the Fund emphasizes how the experience, partnerships and infrastructure built to fight the three diseases is a huge part of the fight against COVID-19. “The fight against HIV and AIDS – the most recent deadly pandemic before COVID-19 – demonstrates how a united world, led by strong communities, can work together to drive a disease into retreat,” says Sands. “The investments that the Global Fund has made in systems for health over the last 20 years are underpinning the response to COVID-19 in many low- and middle-income countries… but these need to be vastly expanded now.”
After detailing the impact of COVID-19 on the three diseases, and the critical role the Fund is playing in the COVID-19 response in the most vulnerable countries, the report mentions that the Fund “urgently needs and additional USD 5 billion over the next 12 months to continue to fight COVID-19, protect health workers and systems for health, and defend progress in the fights against HIV, TB and malaria. To date only a small fraction of this funding has been received, and it is estimated that [The Global Fund’s] emergency response fund will run out of money by the end of September 2020.”
Summarizing the juxtaposition between the recent gains and current challenges, Sands wrote, “This is an inflection point. We can surrender the gains we have made against HIV, TB and malaria, and allow our progress towards the SDGs to be sharply reversed. Or we can act with speed and scale, investing far greater resources than have yet been committed, to counter both the direct impact of COVID-19 and to mitigate the knock-on consequences for HIV, TB and malaria.”