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In brief
GFO Issue 327

In brief


David Garmaise

Article Type:

Article Number: 8

ABSTRACT We describe, In brief, a new debt swap donation from Spain; the latest PEPFAR results; sales in 2017 by Apple’s (RED) products; the World Malaria Report 2017; delays in the $9.5 billion USAID global health supply chain project; and an expansion of the Global Gag Rule.

Donation from Spain in new debt swap

As part of the Global Fund’s Debt2Health initiative, Spain has agreed to cancel outstanding debts of € 36.0 million owed by Cameroon, the Democratic Republic of Congo (DRC) and Ethiopia in exchange for investments by the three countries in domestic health programs supported by the Global Fund amounting to € 15.5 million.

According to a news release issued by the Global Fund, Cameroon will invest € 9.3 in HIV programs; the DRC will invest $3.4 million in malaria programs; and Ethiopia will invest € 3.2 million euros to strengthen its health system.

Under Debt2Health, creditors may agree to write off a portion of the debt owed to them, on the condition that beneficiary countries invest an agreed-upon amount in local programs approved by the Global Fund. To date, debts swapped under Debt2Health agreements by Australia, Germany and Spain total close to € 200 million.

Spain has invested more than $700 million in the Global Fund since it was created.

World Malaria Report 2017: Investment in the fight against malaria less than half of what is needed

The World Health Organization (WHO) estimates that in 2016, $2.7 billion was invested in malaria control and elimination by governments of malaria endemic countries and international partners. The WHO said that this is less than half of what is needed to reach the first milestone of the Global Technical Strategy for Malaria 2016-2030, which is a reduction of at least 40% in malaria case incidence and mortality rates compared to 2015 levels.

This information was contained in the World Malaria Report 2017 . More than half of the 2016 resources were channeled through the Global Fund.

According to the report, more countries are moving towards elimination: In 2016, 44 countries reported fewer than 10,000 malaria cases, up from 37 countries in 2010.

Latest PEPFAR results announced

Since 2015, two-thirds of the 63 high-HIV-burden districts in 10 African countries implementing PEPFAR’s DREAMS program have achieved a decline of more than 25% in new diagnoses among adolescent girls and young women (AGYW) aged 15-24; in 14 districts, the decline was greater than 40%.

DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) is an $385 million public-private partnership whose goal is to reduce HIV infection among AGYW in priority areas in 10 sub-Saharan Africa countries that accounted for nearly half of the new HIV infections that occurred among AGYW globally in 2014.



Other results to 30 September 2017 announced by PEPFAR include:

  • 15.2 million voluntary medical male circumcisions performed;
  • antiretroviral treatment supported for 13.3 million people; and
  • HIV testing supported for 85.5 million people.

Sales of Apple products in 2017 generate more than $30 million for the Global Fund

John Simon

In 2017, Apple’s sales of PRODUCT(RED) goods – including special editions of the iPhone 7 and 7 Plus – produced revenues of more than $30 million for the Global Fund, Apple announced on 30 November. Apple described 2017 as “a record year” for (RED).

“Connecting through our products and services helps make it easy for our customers to join us in the effort to create the first AIDS-free generation,” said Lisa Jackson, Apple’s vice president of Environment, Policy and Social Initiatives.

Apple said that to date (RED) has raised over $500 million for the Global Fund.

As a special promotion for World AIDS Day, more than 400 Apple stores featured a red Apple logo for the week. For every Apple Pay transaction made at a retail location, online or in-app, Apple said it would make a $1 donation to the Global Fund. In addition, Apple said, gaming developer King also rolled out limited-edition bundles across its popular titles — Candy Crush Saga, Candy Crush Jelly Saga and Candy Crush Soda Saga — with all proceeds from those in-app purchases going to the Global Fund.

USAID global health supply chain contract plagued by delays

The contractor managing a $9.5 billion USAID global health supply chain contract in numerous developing countries, Chemonics International, has limited time to prove it can overcome a long list of problems, according to Devex, an online media platform for the development community.

Internal documents obtained by Devex and interviews with USAID officials and current and former employees describe a massive logistical operation thrown into disarray by problems with planning, communication, information systems and management.

The contract is the largest ever issued by USAID. The supply chain system forms the backbone of multiple U.S. government efforts (including PEPFAR) to combat the world’s deadliest diseases. For patients in need of malaria drugs or antiretroviral HIV treatments, Devex said, the difference between a functioning and a faltering medical supply chain in their country can be the difference between life and death.

Facing a December performance deadline and scrutiny from a growing list of U.S. lawmakers and watchdog groups, project leaders are pointing to a range of actions they have taken in recent months to improve delivery times and cut down on chronic delays. Devex first revealed that the supply chain project was encountering problems in August, when reports showed that performance metrics hit all-time lows in early 2017. Only 7% of shipments delivered during the first three months of the year arrived “on time and in full.”

Under Trump, Global Gag Rule significantly expanded

In January 2017, President Trump reinstated the Mexico City Policy, known as the “Global Gag Rule,” the U.S. policy that withholds funding from any international NGO that provides services for, information about, or references for abortion, even where it is legal, and even with its own private funds. But, according to a 1 December article in the Huffington Post, the Trump administration not only reinstated the Global Gag Rule, it expanded it – by 15 times. Now, it applies to all U.S. global health assistance – a total of about $9 billion.

For the first time, the newspaper said, funding for maternal and child health, nutrition, malaria, tuberculosis, infectious and tropical diseases and more is held hostage, and providers are forced to choose between offering comprehensive health care or receiving critical U.S. funding. Roughly two-thirds of the funding affected by the expanded Global Gag Rule is for HIV programs around the world delivered under PEPFAR, it said.

An analysis by the Kaiser Family Foundation in the U.S. revealed that had the expanded policy been in effect in the FY 2013 – FY 2015 period, at least 1,275 foreign NGOs – 639 as prime recipients of U.S. global health assistance and 658 as sub-recipients – would have been affected. In addition to foreign NGOs, at least 391 U.S. NGOs that received U.S. global health assistance during this period (as prime recipients) would have been required to ensure that their foreign NGO sub-recipients were in compliance.

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