The Global Fund has effectively reached its target of “at least $14 billion” for its Sixth Replenishment, the largest amount ever raised for a multilateral health organization. Many donors, spurred by President Emmanuel Macron’s stirring appeal to end injustice and inequality, topped up their pledges with last-minute increases, and several new donors from all sectors came to the table.
Reaching the target, the Fund says, means helping to save 16 million lives, avert 234 million infections by 2023, and help put the world on track to meeting the health-related Sustainable Development Goals’ target of ending AIDS, tuberculosis and malaria as epidemics by 2030.
“The whole truth”
President Macron, who hosted the pledging event in Lyon, France, began his final announcement of the Replenishment total by saying, “We are going to tell you the whole truth.” He announced that after the final reckoning, the total amount raised had been $13.8 billion, and in light of this he had committed France to increase its pledge by $60 million, while Bill Gates (standing next to him on the stage) had committed to match this with another $60 million from the Bill & Melinda Gates Foundation, for a total of $13.92 billion. Then Macron said that he, Global Fund Executive Director Peter Sands, Bill Gates, and ONE and (RED) co-founder Bono would work on existing donors to achieve increases of at least another $100 million during the Replenishment period, bringing the total to $14.02 billion.
He said, “We promise to go further than that [$13.92 billion] by at least another $100 million. I can tell you that we will reach the $14 billion, as I know there are those that want to increase their contributions. So, we are there!”
This was resoundingly cheered in the Lyon conference hall where Macron made the final announcement at 14h50, talking off the cuff, with obvious excitement and striking enthusiasm, with a microphone in one hand and a small piece of note paper in the other. He was surrounded by activists and champions representing people living with the diseases, many of whom had made moving presentations during the morning’s events.
President Macron also stated which countries had increased their pledges since that morning (some of these were Ireland, New Zealand, Luxembourg, Emirates, Qatar, Saudi Arabia, Armenia, and Azerbaijan), which countries were new donors to the Global Fund as of this replenishment (including Democratic Republic of Congo, eSwatini, Cameroon, Burundi, Malta, Equatorial Guinea, Mali, Greece, and Ukraine), and said that African countries together had pledged twice as much as at the last Replenishment.
Global Fund Executive Director Peter Sands then spoke very briefly, saying, “It’s a fantastic result, Mr President, and a fantastic result that everybody in the room should be proud of. And tomorrow we focus on how we […] will maximise the results, and make the best use of these resources, and really transform this world. Thank you.”
Morning pledging session
Global Fund Chair Donald Kaberuka opened the morning session and introduced President Macron, emphasizing that it was time to “change gears” towards more country ownership, partnership and value for money.
President Macron then made a spirited, warm introduction to the actual pledging event, which culminated more than two days of pre-meetings and civil society activity advocating for the Replenishment. Before Macron began his speech, he introduced Amanda Dushime, an 18-year-old young woman from Burundi who is living with HIV, having been tested for the first time only at age 11, and who is on antiretroviral treatment.
Amanda delivered a short, poised call to action, claiming young people’s rights: “simply, the right to live, and to have hope for the future.” Her rallying cry – “Entendez-nous, impliquez-nous, accélérons le mouvement! ("hear us, involve us, step up the fight!") – for young people to have agency in their own development by participating in the decisions that affect them, was referred to repeatedly by President Macron in the speech that followed. Throughout the remainder of the event it was clear that Amanda’s presence had profoundly affected Macron, who hugged her repeatedly during the course of the event.
(See seperate article in this issue about the pledging session.)
President Macron’s bottom line: Investing to combat injustice
President Macron spoke for about 40 minutes, introducing the final pledging session with warmth, solemnity and enthusiasm in equal measure. He spoke of the shared goal – to be facilitated by a successful Replenishment, of reaching “at least $14 billion” – of eradicating HIV, tuberculosis and malaria from the face of the earth, which would in turn enable the attainment of the 2030 goals.
Macron also spoke with passion and sincerity of inequality between countries (with more than half of the world’s population not having access to the health-care they need, and women and girls affected disproportionately by HIV). This, in the end, was the bottom-line theme of his speech and of his appeal to all donors: “It’s not only a fight against controllable illness, but against inequality,” he said.
Reminding those gathered of the “incontestable” results the Global Fund has achieved, he said, “In 17 years we have done the unthinkable, but today the situation is critical,” referring to the threats of the resurgence of malaria, the rise of multi-drug-resistant TB, and the ongoing crisis of adolescent girls’ and young women’s susceptibility to HIV infection. Stating that he would be “very simple and very clear” with his audience, he said, “We do not have the right to step back,” he said. “but we do have the possibility of eradicating these diseases.”
Macron also described the need for collaborative work to strengthen health systems, and consolidate local efforts towards primary healthcare. “Where health systems are weak, the fight against the diseases is weaker,” he said, “which is why we – the rich countries – have to invest, alongside domestic governments, to enable primary health care systems.”
At the end of his speech, having described some his lobbying with other countries for the Replenishment, congratulated several African governments on their commitments to establishing primary health care, and thanked businesses, foundations, Bill Gates and Bono for their coming to the table with increased pledges, Macron said, “We did the accounting [so far] just before coming here [today] – we are not there yet [at the $14 billion].” Then, to the delight of the room (there was much laughter and cheering), “I will not let anyone leave this room, or Lyon, until the $14 billion is reached!”
Citing Amanda’s words earlier in the day, Macron said, “There are too many young people who are waiting for us. They don’t want ‘aid’, they want the right to choose the kind of life they want. They want a normal life, they want to be able to choose who they fall in love with, what work they will do – simply, to live. We owe it to them.”