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How today’s Global Fund replenishment decides who will be saved in the face of the HIV, TB and malaria pandemics

On Wednesday, 21 September, the 7th Global Fund Replenishment Conference takes place in New York.

At the conference, countries are expected to pledge to replenish the Global Fund.

Together with the technical agencies, the Global Fund calculated that a minimum of $18 billion (nearly R320 billion) is needed for three years (2024-2026), implying a 30% increase in pledges. Reaching this target will determine to a greater extent what can be done in the fight against HIV, TB, and malaria.

It will also determine how far be possible it will be to mitigate and catch up from the losses caused by the Covid-19 crisis.

The Global Fund rightly underlines there has been enormous progress over the last 20 years. However, there are still significant gaps and that have grown over the last few years, says Doctors Without Borders.

The Stop TB Partnership’s Global Drug Facility (GDF) announced last week that there could be significant supply delays of the critical GeneXpert TB tests due to production constraints by Cepheid, the US-based corporation that produces the test.

The delays are caused by Covid supply chain challenges and an increasing demand for GeneXpert TB tests.

“We insist on the urgent need for acceleration of efforts to cover these gaps and recover lost gains.”

The organisation says that patients are paying the brunt of the current funding shortfall.

“MSF teams are observing the consequences today: a lower coverage and a slower pace in rolling out prevention and treatment. Countries are pressured to de-prioritise essential interventions, make compromises on the quality of care, and delay important innovation. To better deal with future crises, such as epidemic outbreaks, violence or economic shocks, increased investment is needed for contingency plans, buffer stocks and community approaches.”

Donor countries should act on their discourse to mitigate and curb pandemics and must urgently re-engage in the fight against HIV, TB, and malaria.

The first opportunity to do so is to increase their pledges during the upcoming replenishment conference to the Global Fund. The Global Fund asks for a minimum of $18 billion for three years, but countries must realise that the estimation for domestic funding is likely too optimistic and much more than $18 billion is needed to bridge current and future gaps.” – Dr Esther Cass, Senior HIV/TB Advisor, Southern Africa Medical Unit MSF

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