The importance of Global Fund replenishment: GFAN lays out “the Cost of Inaction” in new report

The Global Fund to Fight AIDS, TB, and Malaria is the world’s largest public health financing mechanism, mobilizing approximately US $4 billion per year. An estimated 4.3% of the US $4.5 billion in the Global Fund’s malaria portfolio is allocated to eliminating countries and regions. The Global Fund has been the biggest financial supporter of malaria since its inception in 2002.

As part of its Fifth Replenishment campaign to fund its investments over the coming three years, the Global Fund is currently securing voluntary pledges from donor governments to raise a minimum of US $13 billion that will accelerate the end of the world’s three deadliest infectious diseases. Donor contributions to the Global Fund will complement expected increases in domestic financing in countries where the Global Fund invests.

Ahead of the Global Fund replenishment conference in Montreal on September 16, the Global Fund Advocates Network (GFAN) released a new report entitled Investing in the Global Fund: The Cost of Inaction, which lays out the opportunity for impact against the three diseases if the Global Fund is successful in reaching its replenishment target, and examines the costs if governments do not commit the estimated resource levels required. Estimates show that a $13 billion contribution will save up to 8 million lives and avert some 300 million new infections across the three diseases, leading to upwards of US $290 billion in economic gains over the coming decades.

The stakes are high. While robust Global Fund financing can lead to the positive outcomes listed above, insufficient investments will undermine the unprecedented investment and great health gains made since the inception of the Global Fund. The report makes the case that failure to fully fund the Global Fund could lead to unnecessary increases in infections and deaths, further spread of drug resistance to front-line treatments, and rapidly escalating economic costs. Those who will suffer the most from insufficient investments will be vulnerable populations.

As of September 2015, the Global Fund has invested more than US $7 billion towards the global malaria control effort, largely by scaling up access to key commodities, such as long-lasting insecticidal nets (548 million distributed to date), indoor residual spraying, rapid diagnostic tests, and artemisinin-based combination therapy. The report classifies the return on investment in malaria as “phenomenal.” Complacency, waning political commitment, or decreasing budgets could lead to deadly malaria resurgences whose toll is described in the report as “catastrophic.” This is particularly true in malaria eliminating countries that have achieved progress but remain vulnerable to the risk of resurgence if tailored interventions and strong surveillance programs are not sustained.

Some donor governments—such as Japan, Italy, and Canada—have pledged increased commitments to the Global Fund, while others—like France—have matched previous contribution levels. Several countries, including the US, the UK, and Australia, have not yet announced specific funding amounts for the replenishment.