An ambitious strategy to eliminate AIDS, TB and malaria

Prime Minister Justin Trudeau made a major commitment toward ending AIDS, tuberculosis and malaria as epidemics when he recently announced that Canada will host donors at a replenishment conference for the Global Fund in Montréal on 16 September 2016.

Major support from Canada and other partners will empower implementation of an ambitious new strategy by the Global Fund to accelerate the end of these preventable diseases by 2030.

When we set out in 2014 as co-chairs of the Global Fund’s Strategy Committee to oversee the formulation and writing of that new strategy, we hoped to be widely inclusive to take full advantage of the rich diversity of the Global Fund Board. It includes multilateral representation from donor and implementing governments, and also activist representatives from communities affected by the three diseases, civil society, technical partners, the private sector and private foundations.

We were inspired by the diversity, yet we knew we had to reach out even further to gain insight and wisdom from diverse groups of people who have played their part in reversing the spread of the three diseases, which seemed unstoppable just a little over a decade ago.

Global outreach consultations brought together more than 1500 people from 128 countries to contribute insights and experience. This was no easy task. But looking back, we are glad we did it. These voices came armed with epidemiological intelligence, with years of experience in implementation and with first-hand experience of having been affected by the diseases.

We met with people who convened at partnership forums held in Addis Ababa representing sub-Saharan Africa, in Bangkok representing Asia, in Buenos Aires representing Latin America, the Caribbean, Eastern Europe and Russian civil society, and in Istanbul representing North Africa and Middle East. Input was also received through online consultations, and solicited written and in-person submissions.

With diverse views and interests around the table, we sometimes faced negotiation stalemate. In those times we sought and got inspiration and answers by returning to our focus on shared values of compassion and inclusiveness. Those values led us through and through. Our task was to guide deliberations towards a concise practical vision for a world free of the burden of AIDS, tuberculosis and malaria with better health for all. We consider the result – a strategy entitled Investing to End Epidemics – an improved roadmap for accelerating the end of these diseases.

MAXIMISING IMPACT 

The strategy identifies critical pathways to achieving that goal: maximizing the impact the Global Fund partnership can achieve against HIV, tuberculosis and malaria; building resilient and sustainable systems for health; and promoting and protecting human rights and gender equality. With ending the three epidemics by 2030 as an agreed goal, sustainability of Global Fund support is essential, so the strategy considers resilient and sustainable systems for health as the foundation for success.

This approach builds on achievements made in a number of implementing countries. For example, in Rwanda, Global Fund resources have been managed by performance-based and accountable leadership practices coupled with innovative partnerships.  This has increased the capacity of district health centers and extended community outreach services to every corner of the country.

Contributors to the strategy recognized the great impact the Global Fund partnership has achieved, saving more than 17 million lives since its founding in 2000. But collective success can mask inequalities among and within countries, as well as among different groups of people. Too many people still die in a world that has the knowledge and the capacity to prevent and treat diseases.

To achieve greater progress, the partnership must be more innovative in investing in a diverse landscape. So, with the strategy, we have emphasized the benefit of putting communities and countries first, introducing a more predictable, simplified and differentiated grant allocation model, allowing unique approaches in the response to the diseases.

AMBITIOUS ROADMAP

At the international level, global health partners have delivered an ambitious roadmap to end HIV, tuberculosis and malaria as epidemics. The strategy provides for a pathway to align the work of the Global Fund with UNAIDS’ Fast Track Strategy, the End TB Strategy and the Global Technical Strategy for Malaria. In a broader sense, it provides for a way to align the Global Fund partnership’s work to the global goals adopted by all member states of the United Nations in September 2015 as the Sustainable Development Goals.

Human rights are pivotal to end the epidemics, so the Strategy calls on the Global Fund partnership to be a leader in fighting stigma and discrimination. This requires bold leadership at global, country and community levels.

Recognizing that women and girls are often the most affected by diseases, the Global Fund will vigorously support programs and initiatives that not only provide women and girls with access to health but go far and beyond to reshape women’s health, education, safety, and social and economic well-being.  

The approach will also shine a spotlight on and invest in the needs of transgender people. A catalytic fund of US$800 million has been introduced to provide for targeted support in regions or countries and communities that are otherwise not getting essential focused assistance.

The strategy’s aspirations will come to naught if there are not enough resources to implement it. But with a successful cycle of fundraising in the Global Fund’s 5th replenishment, and with effective and efficient implementation, the Global Fund partnership estimates it will save 8 million lives in the 2017 through 2019 period. 

We believe that having a map and the means to get to a destination is crucial, but more important is being able to put the roadmap and the resources to good use. Just as we reached out to diverse groups for inputs into the strategy, we will need them to deliver on its implementation. We started with a people-driven process of producing the strategy and we must now act together as a stronger partnership until we end the diseases for good.

Anita Asiimwe is former vice chair of the Global Fund Strategy Committee appointed from the government of Rwanda as Global Fund board member representing East and Southern Africa. David Stevenson is former chair of the Global Fund Strategy Committee appointed as board member representing Canada and Switzerland.