An Opportunity to Link Arms, and Resources, on the Path to $15 Billion

Imagine the benefits that the end of these diseases would bring: more healthy mothers and children, an increased number of productive workers, greater global economic growth, and a safer, more stable world for all of us.
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We are all aware of the fighting in Syria, the riots in Turkey, and, of course, the economic crisis that continues to hold the globe in its grip.

I'd like to call attention, though, to one of the world's greatest success stories -- and an opportunity for us all to renew our commitment to uniting for the greater good. Over the past decade -- and with the U.S. government leading the way with investments in the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Malaria Initiative (PMI), and the Global Fund to Fight AIDS, Tuberculosis and Malaria -- the world has reduced HIV incidence by more than 20 percent, tuberculosis deaths by more than 40 percent and malaria deaths in Africa by 33 percent. Better still, between effective current interventions and new scientific knowledge, we are close to being able to contain the threats of AIDS, tuberculosis and malaria once and for all.

Imagine the benefits that the end of these diseases would bring: more healthy mothers and children, an increased number of productive workers, greater global economic growth, and a safer, more stable world for all of us.

The Global Fund -- the world's largest global health financier -- has worked with the U.S. government and other partners for the past 10 years to fight these the scourges of AIDS, tuberculosis and malaria. This year, the Global Fund seeks to replenish its resources by mobilizing pledges from donors to continue and expand this work, especially in regions with the greatest disease burden and fewest resources. Commitments pledged this year will impact the Global Fund's budget, and its ability to save lives, for years to come.

Four Pillars of Support

In its recently published Needs Assessment, the Global Fund estimates that $15 billion will be required over the next three years to maintain the programs it funds today; allow new programs to be added; and renew and scale up existing, effective programs.

This is an ambitious but achievable goal. It is also one that will require close collaboration among a variety of stakeholders. The Global Fund has identified four primary "pillars" of support to get to that $15 billion goal, noting that the fights against these diseases "cannot be the sole responsibility of external donors."

Current donor countries. The contributions of developed countries will continue to be critical. To date, more than 50 donor governments have pledged $28.8 billion to the Global Fund, representing the organization's largest source of income since its inception in 2002.

The private sector. In recent years, the Global Fund and its implementing partners have worked with companies to ensure better health for the communities in which they reside and work. Through these partnerships, companies have contributed both financially to the Global Fund and through innovative tools such as workplace prevention campaigns and investment in supplies, testing and treatment. The Anglo American Corporation, for example, which employs 100,000 people in South Africa, has created the world's largest workplace program for the prevention, counseling, voluntary testing and treatment of HIV.

The contributions of high-net-worth individuals are also expected to be critical to leveraging additional resources in the fight against the three diseases. The Global Fund recognizes that these donors have the unique opportunity to set an example of support for the rest of the world.

Domestic co-investment. Country ownership has always been a guiding principle of the Global Fund. From the way grants are devised to their implementation, the organization assists countries in taking a managerial and financial role in their health infrastructure. It is not surprising, then, that country co-investment is an important component of the Global Fund's response to the three diseases.

According to the Institute for Health Evaluation Metrics, domestic investment in global health was more than 18 times higher than all external aid to low- and middle-income countries combined in 2010 -- and there has been increased momentum in domestic funding since then. Given this, the Global Fund is ramping up its outreach around domestic financing for fighting AIDS, tuberculosis and malaria. As traditional donors contemplate their new pledges, they are encouraged by this steady move toward sustainability.

Emerging economies. The term "emerging" economy is actually a misnomer for upper-middle-income countries such as Brazil, Russia, India and China. They emerged some time ago in terms of their global economic power. The Global Fund anticipates that such countries will increasingly finance their own health investments for HIV/AIDS, tuberculosis and malaria and consider becoming broader donors to these causes. For example, Indonesia is currently developing an exit strategy from Global Fund financing.

The Tipping Point
"This moment in time makes all the difference in the world."
-Mark Dybul, Executive Director of the Global Fund

The world currently stands at a tipping point. We have made enormous scientific gains against HIV/AIDS, tuberculosis and malaria, and we have a huge opportunity to make even more progress. But this opportunity will slip away -- and the gains we've made will be put at significant risk -- unless we continue investing in proven interventions and leverage recent global health breakthroughs, including falling costs, growing scientific knowledge and improved implementation.

We have faced some difficult years as a planet, economically and politically. But the gains we have made against the three diseases should inspire hope, and we can make history if we keep up the fight. We can embrace a bold new global commitment to end these epidemics or risk losing the progress made to date. Working together, we can successfully follow that path to $15 billion.

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