30 Jan 2019
CSOs want India to double its health spending

The preparatory meeting for the Global Fund’s Sixth Replenishment, which is scheduled for 7–8 February 2019 in New Delhi, is the first such meeting to be held in an implementing country.

Preparatory meetings have been organized for each of the last few replenishment campaigns. The purpose of these meetings is to provide donors and partners with an opportunity to discuss the Investment Case and the impact that the Global Fund expects to achieve if its replenishment target is attained.

CSOs from India and the Asia-Pacific region have been busy planning for the New Delhi meeting. The Global Fund Advocates Network Asia-Pacific (GFAN AP) and the India Working Group (IWG) for the Sixth Preparatory Meeting held a Communities and Civil Society Planning Meeting on 16–17 January 2019 in New Delhi.

The meeting aimed to support joint strategizing and to create synergies among representatives of CSOs and communities in India, regionally and globally –– to advocate for a fully funded Global Fund leading up to the Sixth Replenishment Pledging Conference which will be held in October 2019 in Lyon, France.

Are African countries ready for the Global Fund’s Sixth Replenishment’s push toward greater domestic financing to end HIV, TB and malaria?

See separate commentary in this issue by Ida Hakizinka.

The Preparatory Meeting is also providing an opportunity for the Indian CSOs to shine a spotlight on the response to the HIV, TB and malaria epidemics in India as well as on efforts to build resilient and sustainable systems for health. In particular, the CSOs are advocating for universal health coverage and increased domestic financing for the three diseases.

The 17 January 2019 news release from CSOs stated that “the global community is looking at the Indian government to further demonstrate leadership and commitment towards a fully funded Global Fund” by rallying other donors –– including donor countries, the private sector, private foundations and high net worth individuals –– to promote increased pledges to the Sixth Replenishment.”

The CSOs are calling on the Government of India to increase its pledge for the Sixth Replenishment from $20 million (for the Fifth Replenishment) to at least $40 million. The CSOs said that this increased pledge should be announced early to demonstrate, in the words of Daxa Patel, President of National Coalition of People Living with HIV in India, “momentum and leadership for the Sixth Replenishment” and  “India’s commitment and solidarity towards global health.”

India’s National Strategic Plan for HIV has a budget of $4.7 billion for the period 2017–2022; there have been substantive increases in domestic budgets for the country’s TB program; and India’s National Strategic Plan for Malaria calls for $1.5 billion to be spent for the period 2017–2022.

“Despite these investments and commitments, India is still not on track,” the CSOs said. “Public spending on health is still around 1.2% of GDP, which is significantly lower than peers of similar income levels. With such low priority accorded to health by the government, the Indian population has one of the lowest levels of financial risk protection for health in the region with the majority paying out-of-pocket for healthcare.”

Sonal Mehta, Chief Executive of the India HIV/AIDS Alliance, stated that the Government of India should immediately increase health expenditures as a percentage of GDP from the current 1.2% to 2.5%. (The government has a goal to reach 2.5% by 2025.) Ms Mehta also called on Indian states to increase their health spending to over 8% of their total budgets and to fully fund the response to HIV, TB and malaria.

Editor’s Note: In addition to the preparatory meeting in New Delhi on 7–8 February, another important meeting –– the African Leadership Meeting on Investing in Health –– takes place on 9 February in Addis Ababa, Ethiopia. The topic of domestic resources for health will be high on the agenda. See separate commentary in this issue by Ida Hakizinka.

See also a separate article in this issue on the Investment Case for the Global Fund’s Sixth Replenishment.

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