In a joint statement, the communities and civil society delegations to the Global Fund Board commended the pledges from donor governments, implementing countries, the private sector, and civil society partners for the Fund’s Fifth Replenishment. At the same time, they said, all involved must not only deliver on these commitments, “but also stay focused on the crucial work ahead to mobilize additional resources to address the needs of the most vulnerable and key populations no matter where they live.”
As reported in GFO #296, US$12.9 billion was pledged up to and at the Replenishment Conference in Montreal, Canada on 16-17 September, very close to the Fund’s US$13 billion goal.
The delegations said that this figure is only the minimum of what is needed. “The Global Fund’s Investment Case states that $13 billion is just 80% of its full need. Without further investment, it will certainly mean communities disrupted, lives lost, and preventable new infections,” they added. The full text of the statement can be found here.
This reaction – applauding the success of the replenishment drive but saying that more money needs to be invested – was quite common. For example, on 17 September Mike Podmore, Director of STOPAIDS, a U.K. NGO, said that “despite very challenging economic and political contexts, the world has seized this critical moment to demonstrate their unwavering commitment to the fight to end AIDS, TB and malaria.”
“This replenishment will help keep us on the right trajectory to reach the targets of ending AIDS, TB, and Malaria by 2030,” Podmore added. “But it is only just enough to do so. $13bn is 80% of what the Global Fund needed to be fully funded and so this can only be the beginning of an ongoing fundraising effort for the Global Fund and for the broader global responses to the three diseases. If we don’t continue to increase investment, then the epidemics will rebound to hit us twice as hard.”
What follows is a sampling of the reaction from other organizations that underscored the need for more to be done.
“The Global Fund has reason to celebrate an increase in donor contributions,” said Mit Philips, a health policy advisor at Médecins Sans Frontières. “However,” he added:
“The success of the Replenishment conference should be balanced by the reality of who is at risk of being left behind. The truth of the matter is that the Global Fund lowered its ambitions and set the funding target at what it would be able to raise from donor countries, rather than what it requires to bridge the yawning gap in needs and to meet the challenges ahead in fighting the three killer diseases. The lower funding target is also aligned with the limitations the Global Fund has placed on how much funds some countries can receive and for which interventions.
“Celebration of the replenishment results will ring hollow if it means prematurely cutting support to middle-income countries that are grappling with growing epidemics or other countries with large unmet needs. We call for the Global Fund to have an honest reckoning of the impact of its policies and to put an immediate freeze on any further rationing of funding. The Global Fund must continue to raise and mobilise additional resources as a priority.”
In a blog published in the Huffington Post on 30 September, Chris Collins, president of Friends of the Global Fight, a U.S. organization, said that the global effort is currently underfinanced. “The Montreal meeting needs to be a launching pad for global health financing sufficient to make these epidemics history,” he said.
In a joint statement, Women4GlobalFund, the International Community of Women Living with HIV, and the Communities delegation on the Global Fund Board said, “With a fully funded Global Fund we hope to see interventions in countries go beyond the traditional biomedical approaches…. The Global Fund’s Strategy … takes a strong stand on strengthening the response to HIV, TB and malaria by supporting programs that address gender inequalities and gender-related risks and removing gender related barriers that prevent people from accessing health services.”
W4GF advocate Talent Madziva said that the replenishment demonstrates that the development community is taking ending AIDS seriously. “These resources need to be prioritised correctly! Whilst we celebrate this replenishment we need to implement the right programmes and respond in accountable ways that places women and key population at the centre of responses – ensuring we are part of shaping and monitoring programmes and services) to achieve the right results.”
Some organizations were critical of individual countries’ pledges. “I am disappointed by the French position,” said Laurent Vigier, chair of Friends of the Global Fund Europe. (The contribution from France remained flat at €1.08 billion.) “Since the creation of the Global Fund, France has always taken more than its share to show its determination and express its solidarity with the poorest, affected by these three epidemics. By making the decision not to increase its contribution for the next triennium 2017-2019, it is its exemplary and constant determination in helping the poorest which is undermined. An increase of France’s pledge, even a symbolic one, especially in the harsh context that we are dealing with nowadays, would have had an amazing impact on the international community and would have given everyone even more hope that a better world is possible,” Vigier said. (The full statement is on file with the author.)
On 15 September, Astrid Berner-Rodoreda, a spokesperson for Action Against AIDS Germany, said that her country’s pledge of € 800 million, a 33% increase over the € 600 million pledged for the last replenishment, may not be sustainable. “Based on preliminary information,” she said, “debt-to-health swaps as well as Germany’s technical support for the Global Fund were for the first time calculated into Germany’s contribution. The actual increase of the core contribution therefore only amounts to a meagre € 25 million euros annually.” (The full statement is on file with the author.)
See additional reactions in our article on the replenishment outcomes in GFO #296.