Tag Archives: Global Fund

Historic Replenishment of the Global Fund to Fight AIDS, TB and Malaria Only a Starting Point

The ACTION partnership thanks world leaders for the unprecedented commitments they have made to scale up the global fight against AIDS, tuberculosis, and malaria.

Today, world leaders gathered in Washington D.C. to commit a total of US $12 billion over the next three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the largest amount ever committed to fighting the three diseases. These pledges represent a 30% increase from pledges secured in the previous Global Fund Replenishment.

“This is an unprecedented starting point,” said Kolleen Bouchane, ACTION Director. “But it’s just that — a starting point. If we accept the challenge of U.S. President Obama to not leave U.S. ‘money on the table’, an additional $3 billion needs to be mobilized.” The U.S. pledged to contribute $1 to the Global Fund for every $2 contributed by other donors – up to $5 billion over the next three years.

A fully-funded Global Fund will allow the scale-up of lifesaving programs, including tuberculosis (TB) treatment. The Global Fund provides nearly 90 percent of international donor financing for TB, and its programs have put 11 million people on TB treatment. The World Health Organization recently called the Global Fund “essential” to fighting TB and beating back the spread of drug-resistant TB.

Highlights from the Global Fund’s replenishment among ACTION partners include:

  • The U.S. Administration will commit up to US $5 billion over the next three years – a potential $1 billion increase from the Administration’s previous pledge.
  • The United Kingdom made a historic commitment of up to £1 billion, more than doubling its commitment from the previous three years.
  • Canada affirmed its leadership in the fight against the diseases by increasing its pledge to CAN $650 million, an increase of 20 percent.
  • Japan committed US $800 million.
  • France committed €1.08 billion, maintaining its pledge level but only thanks to innovative financing mechanisms like the air tax levy and the financial transaction tax.
  • The European Union pledge of €370 million represents an increase of 12 percent over their previous pledge – although this is still less than ambitious given the EU is collectively the second biggest development donor in the world.
  • Australia pledged AUD $200 million.

A key highlight of this replenishment was pledges by recipients of Global Fund investments. India pledged US $16.5 million and Kenya made a first-time contribution of US $2 million.

“We thank world leaders for these tremendous commitments,” said Allan Ragi, Executive Director of the Kenya AIDS NGOs Consortium (KANCO), an ACTION partner. “Citizens in countries that benefit from Global Fund investments will continue to work with our governments to ensure commitments reach the people who need them most and continue to save lives.

Recording of June conference call now available

We are pleased to announce that a recording of our June conference call is now available for download.

The call represents the launch of our June action which focuses of building public pressure on the UK government to secure an announcement of money for the Global Fund to Fight AIDS, TB and Malaria.

The Fund is the single largest provide of funding for the three disease in the world and is approaching replenishment in the second half of 2013.

Our guest speaker on the call was Laurindo Garcia, an ambassador with the Here I Am Campaign and a passionate HIV/AIDS activist. Here I Am is a campaign which uses the personal stories of people directly affected by the work of the Global Fund.

Click here to listen again or read more about our action here.

Undernutrition and Malaria: A Vicious Circle

Malaria and malnutrition are closely related, as malaria usually affect families that are both poor and malnourished.  The months of the ‘hunger gap’, when malnutrition is at its peak, often coincides with the rainy season, when mosquitoes breed and the number of malaria cases shoots up. The diseases combine in a vicious circle: malnourished children have weak immune systems, so their bodies are less able to fight diseases such as malaria, while children sick with malaria are more likely to become dangerously malnourished.

Credit: These O Duke

Credit: These O Duke

Evidence shows that investing in nutrition is tremendous value for money in the fight against child mortality.  The example of malaria prevention shows that integrating nutrition programs into other development initiatives delivers even greater benefits.

The most underweight children have the highest risk of dying from malaria but if children are deficient in essential micronutrients, such as zinc, Vitamin A, iron and folate, they face dying from malaria even if they are not underweight. Large numbers of children less than five years old suffer and die from malaria due to lack of protein energy, zinc, vitamin A and other micronutrients.

Unlike many causes of death and disability, with appropriate nutritional support these deaths are entirely preventable. With the advances in nets and other simple malaria technologies there is massive potential to bring down child deaths through increased investment in these simple solutions.

Studies have demonstrated that malaria-control programs will have limited success if they do not also address undernutrition.[1]  Nutritional counseling and education of mothers followed by feeding programs have to specifically focus on improving the health of the malnourished. This, alongside malaria-control measures, could reduce deaths from malaria on a large scale if built into a long term programme.

Medicins San Frontiers (MSF) is one of the organisations in the field that is addressing both malnutrition and malaria as public health problems and integrating their prevention and treatment into the set of basic health measures aimed at all young children.  They are currently employing this approach in Niger[2]

The effort being made to treat malnutrition in Niger is tremendous, and this needs to be supported,” says José Antonio Bastos, president of MSF in Spain. “The problem in 2012 was that a massive plan for treating malnutrition was prepared and implemented, but it excluded other health needs, in particular malaria prevention and immunisations. It failed to take account of the fact that even if you provide children with appropriate nutrition, you can still lose them to malaria or a respiratory infection. There is a need for an integrated response, rather than for pushing one response to the exclusion of others.”

So measures to improve nutrition, if sustained over a number of years, increase the success of other development interventions.  In the UK there is an opportunity to promote this lesson on 8th June, when the Prime Minister is hosting a second ‘Hunger Summit’, co-hosted by the Childrens Investment Fund Foundation (CIFF).  The UK government can take the lead by giving a significant pledge, of £150 million per year, for the next five years. This has been calculated as the UKs ‘fair share’ of the funding gap, according to World Bank figures, and will encourage other donor countries and leverage major contributions from private foundations.

[1] “Malaria, Anemia, and Malnutrition in African Children—Defining Intervention Priorities” Erdhart, et. al. July 2006. http://jid.oxfordjournals.org/content/194/1/108.full.pdf

[2] http://www.doctorswithoutborders.org/press/release.cfm?id=6739&cat=press-release

World TB Day 2013: Media round-up

Following our blogpost yesterday you may well have been aware that yesterday was World TB Day. Leading media outlets in the UK certainly took note and here we provide a round-up of what some of them have been saying about the growing threat of TB both domestically and globally.

Friday saw some fantastic coverage in the Financial Times with a four-page health supplement entirely dedicated to TB. Articles covered topics ranging from the fight against HIV/TB co-infection, the problems surrounding TB in children and the need for funding for vaccine research.

The lead article states ‘Tuberculosis has failed to capture imaginations in the same way as HIV’ and, as a result, there has been a serious lack of financial commitments in fighting the second biggest infectious killer after AIDS. The article also highlights the vital role played by The Global Fund to Fight AIDS, TB and Malaria and the urgent need for renewed funding commitments from donors.

The BBC made note of the call from an international group of doctors and scientists for visionary leadership if we are to tackle TB effectively. Reporting on an article in The Lancet, the article highlights the growing problem of drug resistant TB strains largely as a consequence of complacent and neglectful governments worldwide.

It is so important that there is a complete shift in our thinking, particularly at a political level, about TB in order to ensure that we make significant strides in tackling TB and saving millions of lives. Along with this piece featured on the BBC, The Lancet has also published a Series of papers on TB to commemorate World TB Day 2013 that are well worth a read.

There was an informative piece in The Independent warning of the rise in the number of drug-resistant TB cases in the UK. The article notes that if the rise in TB continues at its current rate then by 2015 Britain will have more new cases each year than in the whole of the US. Somewhat encouraging is the fact that a government task force will be set up to tackle the problem. Dr Paul Cosford, director for health protection at Public Health England, has also said “TB will be a major priority for Public Health England”.

Finally, our friends at ACTION have also put together this great blog outlining a selection of stories and events leading up to World TB Day yesterday. To take a look at ‘the drumbeat to World TB Day’ just click here.

World TB Day 2013: New funds desperately needed to tackle growing tuberculosis threat

For World TB Day, the World Health Organisation and the Global Fund to Fight AIDS, Tuberculosis and Malaria released a joint statement urgently stating the need for US$1.6 billion a year in international financing to prevent the spread of TB.

According to the joint statement, US$1.6 billion would fill a funding gap that would enable full treatment for 17 million TB and multi drug-resistant TB (MDR-TB) patients and save 6 million lives between 2014-2016.

The TB Europe Coalition (TBEC) has also issued a statement calling on the European Commission to increase public health funding to fight the resurgence of tuberculosis (TB) in Europe and eradicate its deadly strains.

According to TBEC, TB is Europe’s ticking time bomb. The World Health Organisation reported an estimated 76,000 cases of multi-drug resistant TB in the WHO European Region in 2011, accounting for a quarter of the global TB burden. Controlling and treating TB costs European Union member states €15 million every week and €750 million every year.

The numbers offered by both statements seem to speak for themselves, but they also don’t communicate the very real human impact of this disease on the residents of Europe.

RESULTS UK interviewed Oxana Rucisineanu, a former TB patient from Moldova on her personal experience with multi drug-resistant TB. Her story is compelling and should encourage us all to do what we can to ensure that TB receives the attention and funding it so desperately needs.

Before being diagnosed Oxana explains she was leading what most of us what refer to as a standard life. Between working and socializing Oxana began to suspect something was wrong when she began to lose weight and was persistently bothered by a pain in her chest. Unfortunately for Oxana it was confirmed she has TB – a diagnosis she described as being “one of the most painful things”.

Stigma remains a substantial issue for TB patients. In a story that is all too commonly heard, the “shame” that Oxana felt meant it took her months to accept her diagnosis and move on. In Moldova, as is the case in many social settings, Oxana explains that the perception of TB is one that makes it incredibly difficult to advocate for and be associated with. It is considered an illness of “the homeless, alcoholics, drug users and former prisoners”. As a result, “there are very few former patients who would like to stay involved in TB advocacy” instead choosing to “forget about this nightmare”.

To exacerbate the social stigma, more and more people are being diagnosed with MDR-TB. MDR-TB emerges as a result of improper treatment, something all too common given that many national governments either lack the resources or political will to tackle TB appropriately.

I am told that the physical consequences of taking MDR-TB drugs is virtually impossible to comprehend it is so bad. Indeed, when I ask Oxana about her experience with MDR-TB drugs she states that “the only thing I would like to say is that I would never wish that experience on my greatest enemy!”. Side effects include vomiting, diarrhea, dizziness, anxiety, depression and suicidal ideation — to name just a few.

Drug-resistance is an alarming problem. Not only are the drugs incredibly toxic for patients, but treatment also costs over a hundred times the amount compared to treatment of standard TB. Failure to act now would mean we face a future of unparalleled costs in tackling TB as well as millions more suffering through the stigma, debilitating side effects and the loss of many more lives. I ask Oxana if she would like any final words. She urges the world not to forget that TB is more than just a medical issue. It is also social and economic and we must ensure that in order to consolidate the results of successful treatment there must be ongoing support to guarantee ex-patients a decent, social and secure life.

You can watch Oxana explain the importance of the Global Fund to Fight AIDS, Tuberculosis, and Malaria in this video from the Here I Am Campaign

Countering HIV stigma and creating support in Ethiopia

The following post is brought to you by Steve Lewis, our Global Health Advocacy Manager. Following on from our delegation post, Steve describes our visit to one of Addis Ababa’s health centres:

In February I travelled to Ethiopia with RESULTS staff and five UK parliamentarians to see health programmes and assess the effectiveness of UK support for poverty reduction in the country. The trip was a fascinating mixture of meetings with the ‘highest’ and the ‘lowest’ in the chain of support for poverty-related health programmes.

We met with DFID officials, the Ethiopia Minister of Health and officials at the Africa Union (AU). The meeting with the AU took place in their sleek new building constructed the Chinese government.  But while these meetings provided us facts and figures, it was hard to understand the impact of the work on the ground level.

We were able to see how this work affected communities during a site visit conducted by AMREF to local water and sanitation projects as well as to a local health centre in a poor and crowded urban area of Addis Ababa, the capital of Ethiopia. Queues of patients waited on benches in the open air, waiting to be seen by nurses and staff who work to diagnose and treat common illnesses such as tuberculosis, pneumonia and stunting (malnutrition). The health centre had no actual doctor on site – Ethiopia has an acute shortage of doctors and most other senior health personnel.

I found the most encouraging part of the visit to be a meeting with a support group of women with HIV/AIDS. On previous visits to Africa a few years ago, I had seen high levels of stigma against people living with HIV. No one wanted to admit it, and no one wanted to know. But in this health centre a crowded group of women in multi-coloured dresses sat around a table and waited patiently to tell us their stories.  They told us they meet every Wednesday morning, and their numbers are growing.

As children crawled around the floor, the women were not shy to tell us about their lives. The health centre has diagnosed them with HIV but now provides daily drugs to keep the impact at bay (anti-retrovirals or ARVs). Some years ago a woman would have had to take around a dozen pills a day, with severe side effects, but now they take just three pills.

“What about the side effects?” I asked.

A confident young woman told us she suffers no side effects and feels perfectly healthy. “These ARVs have kept me alive,” she said simply.

The ARVs are bought in bulk for Ethiopia by the Global Fund for AIDS, Tuberculosis and Malaria (GFATM). Our UK delegation were proud that the UK is one of the biggest donors to the Global Fund.

The other huge advance in medical technology has been vast improvements in ‘Prevention of Mother to Child infection’ (PMTCT). Only ten years ago most babies born to HIV positive women would have been born HIV-positive themselves and would have quickly died. Now, a simple regimen of check-ups and a daily pill at the crucial time means nearly all babies are born HIV-negative. They do not have HIV and have the chance to grow up healthy. This health centre provides 46 women with anti-retrovirals and 44 of them have given birth to healthy children. Two were born with HIV, of which one baby passed away. The HIV-positive child comes with his mother to this support group.

The women give each other emotional support to come to terms with living with HIV. But they hold their heads up and seem happy to talk to strangers about their lives. Our parliamentarians asked many inquiring questions but the women were not fazed.

-          “How many children do you have?”

-          “Two, and that’s enough…”

-          “Do you husbands come to the support group meeting?”

-          “No, and that’s the way we like it.”

-          “What hopes do you have for your daughter when she grows up?”

-           “I would like her to be a doctor.”

The visit provided an excellent example of how Ethiopia is dealing with tough health challenges and effectively demonstrated that UK aid money is being put to good use.

RESULTS UK leads delegation to Ethiopia

Last week, RESULTS led a cross-party parliamentary delegation to Ethiopia to explore how the country is dealing with key health issues affecting international development. The country continues to face enormous health challenges that include the spread of infectious disease and malnutrition. Yet, in light of this, Ethiopia is making impressive strides towards improving key health indicators and come up with innovative ways of responding to its health worker crisis.

RESULTS was joined by parliamentarians from all three major parties – Sir Tony Cunningham MP, Heather Wheeler MP, Kevin Barron MP, Baroness Hooper and Lord Hussain. The parliamentarians were able to attest that aid works – over the past ten Ethiopia has cut its infant mortality rate in half and it is on track to meet Millennium Development Goal 4 to reduce under-five mortality rates by two thirds. It has also created a model for dealing with its health worker crisis, which has successfully delivered TB care and treatment to the population.

The Global Fund to Fight AIDS, TB and Malaria

The delegation was able to visit one of only two hospitals in Addis Ababa that treats multidrug-resistant TB (MDR-TB). With support from the Global Fund, the most successful health financing mechanism to date, the hospital is providing MDR-TB treatment to patients from all over the country. MDR-TB is a form of TB that does not respond to the standard treatment using first-line drugs and is extremely difficult and expensive to treat. The Global Fund grant covered the cost for renovating the hospital’s MDR-TB ward and provides all second-line drugs needed to treat MDR-TB.

Innovative Reponse to the Health Worker Crisis

Ethiopia is one of 57 countries worldwide that faces severe shortages in their healthcare workforce and lacks doctors, nurses, midwives and other health workers needed to deliver healthcare to its population. In response to this crisis, Ethiopia has developed an innovative model called their Health Extension Programme (HEP).

The HEP shifts tasks to less specialised health workers called Health Extension Workers (HEWs) in order to deliver essential healthcare to communities that would otherwise not have access to such services. HEWs are women from the local community aged at least 18 years with 10 years of schooling who are provided with one year of healthcare training encompassing family planning, water and sanitation, and control of infectious diseases, including TB. Two HEWs are placed in each local health posts that provide primary care to their communities.

Health Extension Workers Delivering TB Care

The delegation was able to meet with HEWs in both Addis Ababa as well in more rural settings around Awassa in the south of the country. We were able to visit sites supported by TB REACH, a funding mechanism that finances projects to carry out TB diagnosis and treatment in areas with limited or no access to TB care.

The TB REACH grant currently allows HEWs to collect sputum samples from individuals with TB symptoms and provides local health centres with motor bikes to collect these samples and transport them to the lab for diagnosis. TB diagnosis has more than doubled since the project started, more people are being treated for TB and fewer people are dying or failing to complete their treatment.

Improving Child Survival Rates

Ethiopia’s HEWs have also been trained to treat the diseases that needlessly kill more than hundreds of thousands of children under five each year: malaria, diarrhoea, pneumonia, as well as malnutrition. Within the HEW programme’s first five years, malaria death rates in Ethiopia decreased by more than half and new HIV infections fell by 25 percent. In addition, mortality of children under five dropped by 28 percent, a lauded outcome.

The UK Government is a key donor supporting the Ethiopian Government to carry out health interventions that are working. The delegation heard time and again about how effectively and transparently the Ethiopian Government is using UK aid to reach the most vulnerable, making a real difference in the lives of some of poorest. The delegation validated that UK aid equals excellent value for money.

TB in TIME Magazine

TIME Cover, Credit: James Nachtwey

In a blogpost last week we discussed the increased media attention on tuberculosis in recent weeks. A study, reported on in The New York Times and Al Jazeera, highlighted that many developing countries are awash with falsified and substandard TB drugs. This was encouraging the spread of drug-resistant forms of TB (DR-TB), something that was also said to be the case in a Wall Street Journal article discussing India’s counter-productive TB strategy.

Following from these, this week TIME Magazine declares “Contagion: Why drug-resistant TB threatens us all”. Worryingly, the article points out that despite estimates “there will be over 2 million new cases of MDR TB from 2011 to 2015, yet today only 10% of new MDR cases get proper treatment”. Continue reading

‘The end of the global AIDS epidemic is within our reach’ – MPs debate HIV in developing countries

Just before the Christmas break, Pauline Latham MP (Mid Derbyshire, Conservative) secured a Westminster Hall Debate on HIV in developing countries. During a busy and well-attended debate, Ms Latham pointed out that ‘the end of the global AIDS epidemic is within our reach’ and echoed the slogan used by the Stop AIDS Campaign for World AIDS Day: ‘why stop now?’

Why stop now indeed, especially when we have the tools, the science and the knowledge to turn the tide on this epidemic. Pamela Nash MP, Chair of the All-Party Parliamentary Group (APPG) on HIV/AIDS, reiterated this point and stated “We just need to sustain the political will”.

Undoubtedly political will is vital, but there is another important element to sustain, and dare we say scale up, in response to HIV/AIDS – Tuberculosis (TB) co-infection.

TB is the leading cause of death among people living with HIV/AIDS in developing countries, accounting for one in four deaths, with 1.1 million people acquiring TB in 2011. 79% of patients live in sub-Saharan Africa, yet TB does not get the attention or focus warranted by the suffering and death it causes. Why is this the case?

As Nick Herbert MP, the Conservative member for Arundel and the South Downs and a founding member of the APPG on Global Tuberculosis explained whilst speaking in the debate:

“It is striking that the diagnostic ability and treatment for HIV are much further ahead than they are for TB, yet TB is a more easily and cheaply treatable disease. Why is that? It is straightforwardly because HIV is a disease that affected the west, and TB was a disease that the west believed had gone. Its attention was therefore not on it. The resources and money that were invested in necessarily trying to deal with the terrible and growing problem of HIV were not directed in the same way at TB. Therefore, the diagnosis of TB is not as quick as it should be, and the treatments go on for an extended period, with old-fashioned drugs that must be taken on a continuous basis; if they are not taken in that way, the problem of drug-resistant TB arises—and that is a killer and particularly difficult to deal with.”

Mr Herbert also highlighted that of the estimated 9 million people who get ill with TB every year, 3 million go without proper diagnosis or treatment. Put simply, we fail to reach far too many people—often in the poorest, most vulnerable communities—with quality TB care.

We need to accelerate our efforts to tackle TB, and it is clear that we need to think outside the box.  One way of doing this is through TB REACH, a WHO initiative that gives small grants of up to 1 million dollars to find and treat those who don’t have any access to TB diagnosis or treatment, Mr Herbert added.

He also stated that a longer term solution to tackling TB would be the creation of a new vaccine that could tackle both normal and drug-resistant strains of the disease. This would have implications not only for developing countries, but also for us here in the UK, where rates of TB infection continue to rise.

The importance and contribution of the Global Fund to Fight AIDS, Tuberculosis and Malaria to tackling both HIV and TB was widely recognised by members, as were the wider developmental benefits accrued from continued investment in fighting the three diseases.

Responding to the points raised, the Parliamentary Under-Secretary of State for International Development Lynne Featherstone MP acknowledged the two points raised by Mr Herbert in relation to the TB REACH programme and on vaccination, both of which she said she would consider further. The Minister also highlighted that DFID’s support for TB research includes £205 million to the Global Alliance for TB Drug Development, and £14 million to the Tropical Disease Research Programme.

Ms Featherstone concluded the session by stating: “It is heartening to see so many Members who genuinely hold HIV as a priority and will pursue the wonderful goal of zero infections”.

European Parliament holds hearing on Global Fund and drug resistant TB

Last week, the European Parliament’s Committee on Environment, Public Health and Food Safety (ENVI) held a hearing examining the funding problems in the European Region left after the Global Fund cancelled it’s last funding round and the impact this has had on the region and on rising rates of drug resistant TB. Steve Lewis, our new Global Health Advocacy Manager, attended the hearing and reported back for the TB Europe Coalition. We are re-blogging his post:

Last week I was at a discussion in Parliament in Brussels during which European MEPs discussed the disturbing rise in TB in Eastern Europe. One of the worst hit countries is Romania where Romanian MEP Claudiu Tănăsescu told me, “When I used to work as a GP in Romania we believed that TB had been virtually eliminated. But this is not the case.”

Information from various countries has been published recently in our report ‘Bridging the Gap – why the EU must address the funding crisis at the Global Fund to tackle HIV and TB epidemics in Eastern Europe and Central Asia’. The report includes case studies that demonstrate that without the resources to aggressively tackle these two diseases, the region risks undermining the progress made to date.

Since the Global Fund to Fight AIDS, TB and Malaria was forced to cancel its last funding round in 2011, many Eastern European and Central Asian countries have been left facing cuts to their programmes and without the means to scale up their responses. This is particularly worrying when it comes to multidrug resistant TB (MDR-TB) whose rates are rising across the region. Continue reading