The Global Fund was founded in 2002 with the aim of mobilising resources to fight AIDS, Tuberculosis and Malaria in countries that cannot independently afford treatment. It has disbursed US$30 billion since July 2016, and has 20 million lives as a result. Are there realistically sufficient resources to solve these issues, and what needs to be done to put the resources we have to use here?
The projection is that by the end of 2019, there will be 36 million people alive because of the investment of the Global Fund partnership. We’ve seen that the mortality rates from these three diseases globally have gone down by 30 percent since the fund was created. The question is what we can achieve for the next couple of years ahead. For now, the world is now pretty much on track to achieve the SDGs. The projections show us these goals can be achieve if the whole partnership works together. The next few years will be critical. You can’t delay investment in the face of epidemics.
Around 40 percent of Global Fund investments are used to build resilient and sustainable systems for health. Could you explain in more detail what this means in terms of exactly how much is being mobilised to achieve this, and whether this includes or excludes digital infrastructure?
If you want to put people on treatment, you need health infrastructure; health professionals and you need an effective procurement and supply chain management system. From the beginning, without changing our focus, we started to invest in the health systems in developing countries. We are actually investing a lot in countries to improve data management, which is critical. We know exactly where we need to invest to achieve the highest impact. We’ve found that in many countries data sources and management are poor. We have a huge opportunity now, especially with cell phone technology that wasn’t available just a couple of years ago. We just established a new online platform, called Wambo, for countries to procure drugs and commodities. This saves hundreds of millions of dollars and makes transactions more effective and more transparent. This is new way of doing business.
What, in your view, is the optimal approach to keeping a sharp eye on project costs without compromising their execution or range of impact?
It was always one of our mandates from the start to be a lean organisation. That is why the fund is not an implementing agency and has no offices in its target countries. That was deliberately to keep administrative costs as low as possible. Instead we are working with partners in those countries, signing contacts for funding with them in exchange for targets to which we hold them accountable. We keep a very sharp eye on the project costs, but also on results achieved. This is results-based funding. Our disbursements depend on verified progress at country level.
The Global Fund’s results summary of 2016 mentions that 60 percent of it’s the total investments is directed towards women and girls. What programmes or projects has it invested in to remove gender-related obstacles from effective healthcare, and what crucially needs to happen to remove these completely in the long term?
This is a key point, particularly for overcoming HIV AIDS. We’ve made tremendous progress, and we’re achieving more than 70 percent coverage rates with AIDS treatments in many African countries. However, we’re not always reaching the most vulnerable populations, and the most critical populations here are young women and girls. HIV still disproportionately affects them. They get infected at a much younger and age and at a much higher rate compared to young men of the same age. Not only do we believe in women and girls as key to development, but also from looking into our data, we can see that without investing in them, we will not achieve the goal of ending AIDs. We are now designing specific programmes in the 13 most impacted countries in Africa to ensure women and girls get treatment, but also tested, and especially encouraged to come forward. Decreasing gender-based violence and keeping girls in school longer is also important to empowering women.
Finally, what is the Global Fund doing to ensure it reaches communities in the more remote rural areas of developing countries?
We call this the Last Mile Challenge. This is means that, even in difficult counties like the Democratic Republic of Congo, the system works up to a certain point, but the real challenge is reaching remote villages and conflict zones. Here, we’re partnering with the private sector, because there’s no other sector that knows better how to provide commodities in remote areas. We pioneered this with Coca Cola in 2008 in Tanzania. They’re probably the best example of this. Now we’re rolling it out in a range of other countries. They teach governments and other partners how to do procurement effectively. We’re partnering with other private sector companies meanwhile that know everything about the logistics of reaching remotes areas and how to optimise supply chain management. This could be one of the big remaining challenges of development finance, but I think with these partners we can address the issue effectively.