Every three years, the Global Fund to Fight AIDS, Tuberculosis and Malaria must solicit its donors. This reenactment conference opened in Lyon this Wednesday 9 October. Objective: mobilize $ 14 billion.
It is a mechanism that dates back to 2002, and has since been praised for its results. The Global Fund to Fight AIDS, Tuberculosis and Malaria can indeed boast of having had a significant impact against these epidemics. Nineteen million HIV-positive people are on anti-retroviral treatment, more than 5 million TB patients are on treatment, and more than 131 million nets have been distributed in countries where the Fund operates. Overall, according to the organization, in these states, the number of deaths caused by these diseases has dropped by 40%, so 32 million lives have been saved.
" The Global Fund has a proven track record, " says Awa Marie Coll Seck, Minister of State of Senegal. " For malaria, the funds distributed by the Fund account for 64% of the total expenditure, and there has been progress in all the countries concerned: more impregnated mosquito nets, access to medicines has been facilitated, access to drugs has increased. quick tests too ... The Global Fund is an effective tool. We must give him the means. "
But despite these good results, the road to eradication of these three epidemics remains long; every year more than three million people die. Medical tools exist, however, whether prevention or treatment. But in the opinion of all, the most important of these tools is not available enough: the money is missing.
"There is no neutral position: we win or lose"
At the last Replenishment Conference in 2017-2019, pledges totaled more than $ 12.2 billion, but currently only two-thirds have actually been disbursed by governments. and private donor agencies. Also, at this 6th Replenishment Conference, Peter Sands, the Director General of the Fund, last January asked donors to be more generous and increase their contribution by 15%, with the aim of achieving $ 14 billion raised in Lyon for the period 2020-2022.
On the ground, progress is indeed constant, but less and less marked. Thus, in the case of HIV-AIDS, for example, it is almost certain that the milestones in terms of screening and treatment set for 2020 will not be achieved. Some observers fear even a rebound of the epidemic if funding ever does not increase. " We are not on track, " said Peter Sands at the opening of the conference on Wednesday. " We have the choice: either we accelerate the movement, or we go back. There is no neutral position: we win or we lose .
The amount requested is therefore important, but in the eyes of associations and NGOs, as it may be, it may not be sufficient to achieve the UN Sustainable Development Goal 3, namely the end of these epidemics in 2030.
"14 billion is the minimum"
" 14 billion is the minimum. We accepted this, stating that this is the minimum, " explains Hakima Himmich, president of Coalition plus, which brings together the various international associations fighting against AIDS. " It's important to understand that every dollar less means untreated people, canceled prevention programs. Every dollar less is life that may not be saved. "
NGOs are also worried that this $ 14 billion target will not even be met. On the eve of the announcement of the results of this fundraising, only $ 10.3 billion has so far been pledged - just under three quarters of the total expected.
However, there are still some States and private partners who have not yet announced their contribution, first and foremost France. Second largest donor, the host country of this conference is expected at the turn. In 2016, it was the only G7 country not to have increased its contribution, which amounted to just over one billion euros. However, in deciding to host this conference, Emmanuel Macron raises a lot of expectations, while global health issues have not been central to his action since his election in 2017.
" The commitment of France is huge. It is the second largest contributor to the global fund , " says Stéphanie Seydoux, French ambassador for global health. " It has contributed 4.6 billion euros since its creation, and it will remain engaged in this fight ." This place of second historical contributor behind the United States, France has already indicated that she intended to keep it. This suggests that his contribution will increase. Will that be enough to reach 14 billion? " France should increase its contribution by 25%. This would create leverage for other countries to follow. This is the only way to fulfill the set goal , " Hakima Himmich hopes.
The highly anticipated French contribution
What will be the French contribution? It is Emmanuel Macron who will announce it this Thursday morning. But already, it is understood that this figure of 14 billion is not erected in totem. " There will be a clear acceleration of effort, it is undeniable, " anticipates Stephanie Seydoux. " We are still in the final hours of the mobilization, and it is impossible to make a precise prediction but there will be more resources for the Global Fund, and this is the goal of this conference. "
Far from being a technical issue, this issue of the endowment of the Global Fund is crucial in terms of public health. Since its establishment 17 years ago, it has significantly changed the practices of development aid, and is regularly taken as an example. State grants are based on a multilateral approach in which civil society and health authorities are involved. It also conditions its payments for the sustainability of the programs set up on the ground, with controls carried out independently.
The Global Fund also tries to act as a catalyst to the extent possible: " every dollar spent by the Fund pays for 19 " , says Peter Sands. As proof of this commitment, the objectives of the Fund for the next three years are clear. "Making local health systems stronger" is at the top of the list, as is saving 16 million lives, and halving mortality from HIV / AIDS, TB, and malaria. An ambitious program, for which you need money.