GFATM the Global Fund to Fight AIDS TB and Malaria

As the Global Fund to fight AIDS, Tuberculosis and Malaria—one of the main donors for the HIV response in the last 20 years in Eastern Europe and Central Asia (EECA)—is moving away from funding the HIV response in EECA, the region is looking for ways to invest their available domestic resources in a much more cost-effective way.

“There are purely epidemiologic and economic arguments behind this transition,” said Dumitru Laticevschi, Regional Manager Eastern Europe and Central Asia Team, The Global Fund. “The economies here are considerably better for the same level of disease burden than the average in the world, that’s why it is expected that the region increasingly takes care of the epidemic by itself.”

The key challenge for the Global Fund, UNAIDS and other partners is to strengthen national responses and “to squeeze the problem to a size that is manageable for the governments to take over,” added Mr Laticevschi.

A series of HIV allocative efficiency studies conducted in 2014 in the region with support from the World Bank, UNAIDS Secretariat and some cosponsors, the Global Fund, USAID/PEPFAR and other partners, recommended countries to prioritize investment in the most cost-effective interventions to maximize health outcomes, including updating HIV testing and treatment protocols, reducing treatment costs, and optimizing service delivery. The studies were based on the Optima HIV mathematical modelling approach which has been applied in over 60 countries globally to help support HIV-related investment choices.

Recently, a new wave of the allocative studies was concluded in 11 countries of the region (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, Tajikistan, Ukraine, and Uzbekistan). Individual reports with a set of recommendations for each country, as well as a regional report with aggregated results from the eleven-country analysis are available here.

“We provided the technical support for these analyses,” said Sherrie Kelly, Team Lead HIV, TB, and Malaria Applications, Burnet Institute who supported the 2014 and 2019 studies in EECA. “We have the models in place and work with the national teams. The countries are the owners of the projects, data, and results. We are just the mathematical modelers.”

The modeling is informed by demographic, epidemiological, behavioural and other data, as well as expenditure estimates provided by national teams and available in the literature. The epidemic model is overlaid with a programmatic costing component and a resource optimization algorithm. Results are intensively discussed and validated by national teams and key stakeholders from respective countries. The UNAIDS Secretariat facilitated the entire process to ensure the capacity of national partners to facilitate optimized health spending was strengthened.

“We hope that the recommendations from the study will help our national partners to adjust National Strategic Plans and to focus on the most efficient, cost-saving interventions with maximum health outcomes and will not only save money, but will save people’s lives,” said Alexander Goliusov, UNAIDS Regional Director in EECA a.i..

The Global Fund to Fight AIDS, Tuberculosis and Malaria has raised US$ 14 billion for the three diseases for a three-year period (2020–2022)

GENEVA, 11 October 2019—UNAIDS is hugely encouraged by the firm commitment that donors have shown to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). At its Sixth Replenishment Conference, held in Lyon, France, on 9 and 10 October 2019, the Global Fund raised US$ 14.02 billion, the highest amount ever for the partnership, which is working to end the three diseases.

“I truly commend all countries and partners that have stepped up to the mark and committed to investing in the Global Fund to Fight AIDS, Tuberculosis and Malaria,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “These investments are a critical lifeline for millions of people around the world. Going forward, putting people at the centre will be critical for making the money work most effectively.”

UNAIDS congratulates the President of France, Emanuel Macron, for his personal engagement and his call on countries to increase their pledges to honour the proposed 15% increase above the last replenishment. Most donors matched or surpassed the 15% increase and many new donors attended and pledged for the first time.

UNAIDS will continue to work closely with the Global Fund providing strategic information, technical expertise and capacity-building to countries in sourcing and implementing Global Fund grants. UNAIDS advocates for a people-centred, human rights-based approach to ending AIDS and fully supports the active engagement of civil society and community-based organizations in reaching the most marginalized people and people being left behind. In 2018, there were 37.9 million people living with HIV, 15 million of whom are still in urgent need of access to life-saving antiretroviral therapy.

The pledges to the Global Fund will boost the response to HIV. UNAIDS will continue to advocate for increased investment to meet the full resource needs of the AIDS response to end AIDS by 2030 as part of the Sustainable Development Goals.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 27 June 2019—UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) have signed a strategic framework for cooperation and collaboration to strengthen and accelerate support to countries’ efforts to end AIDS. The framework outlines the existing, wide-ranging scope of collaboration between the two organizations, and highlights specific areas for enhanced cooperation to help focus efforts and resources where they are needed most.

“The long-standing partnership between UNAIDS and the Global Fund has been instrumental in helping countries to halt and reverse their HIV epidemics,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “The new framework builds on this successful partnership and will deliver maximum impact for people on the ground, enhance country ownership and sustainability, and Fast-Track progress towards ending AIDS.”

Under the new framework, UNAIDS and the Global Fund will advocate for a more robust response to HIV, support each other’s activities and processes, and continue to provide strategic information, technical support and capacity building to countries. The two organizations will advocate for increased global and domestic funding, work to improve data collection and systems and ensure data is used strategically for decision making and implementation.

“Partnership is in the Global Fund’s DNA, and we will continue to work closely with UNAIDS to step up the fight against HIV and save millions of lives,” said Peter Sands, Executive Director of the Global Fund.

The framework highlights critical areas for enhanced collaboration which include HIV prevention and treatment access, community-led service delivery, gender, rights and community engagement and a special focus on accelerating progress in West and Central Africa. To measure progress towards the enhanced areas for collaboration a results matrix will be established.

UNAIDS will continue to analyse gaps in the response to HIV, support the development of national strategic plans and investment cases and address human rights and gender-related barriers to equitable access to health services. UNAIDS will also ensure that civil society are fully engaged in the response to HIV, particularly communities and key populations most affected by HIV.

The Global Fund will continue to attract, leverage and invest additional resources to end HIV. The Global Fund currently raises and invests nearly US$ 4 billion a year for the responses to HIV, tuberculosis and malaria, to support programmes run by local experts and leaders in countries and communities most in need.

UNAIDS urges donors to fully fund the Global Fund to Fight AIDS, Tuberculosis and Malaria at its sixth replenishment conference taking place in France in October 2019. This will enable countries, civil society and partners to implement an evidence-informed, people-centred and human-rights based response to HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) presented its Sixth Replenishment Investment Case to donors and partners at a meeting held in New Delhi, India, on 8 February. The Investment Case calls for US$ 14 billion to be invested over three years to help save 16 million lives through programmes for HIV, tuberculosis and malaria.

The Global Fund estimates that investing today will cut the mortality rate for the three diseases in half and build stronger health systems by 2023. Full funding would enable the Global Fund to continue playing a critical role in the response to HIV, tuberculosis and malaria, accelerating progress towards universal health coverage and achieving the Sustainable Development Goals.

“Only with a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria can we reach the global targets set for HIV, tuberculosis and malaria,” said Tim Martineau, Deputy Executive Director of UNAIDS, Programme, ai. “UNAIDS is committed to continuing to work with the Global Fund to ensure that it meets its financial targets so that countries can end AIDS as a global health threat and save more lives.”

The Global Fund’s Sixth Replenishment target of US$ 14 billion represents an increase of US$ 1.8 billion, or 15%, more than the US$ 12.2 billion raised during the Fifth Replenishment period.

UNAIDS will continue to strengthen its long-established partnership with the Global Fund to maximize the impact of the investments, accelerate inclusive people-centred responses and end AIDS as public health threat by 2030.

UNAIDS estimates that US$ 26.2 billion will be required for the AIDS response in 2020. In 2017, US$ 21.3 billion was available for the AIDS response in low- and middle-income countries, a shortfall of US$ 5 billion. UNAIDS urges both donors and funding from domestic sources to be scaled up to fill the gaps and end the HIV, tuberculosis and malaria epidemics by 2030 as part of Sustainable Development Goal 3.

Together, UNAIDS and the Global Fund have ensured that millions of people living with HIV have access to treatment and that the people most affected by the epidemic have the health and support services they need.

GENEVA, 14 November 2017—UNAIDS welcomes the appointment of Peter Sands as the new Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

“The Global Fund is a critical partner for UNAIDS,” said Michel Sidibé, Executive Director of UNAIDS. “Mr Sands has the experience, leadership and vision needed to do the job and I very much look forward to working with him to improve the lives of millions of people around the world.”

UNAIDS has worked closely with the Global Fund since its inception in 2002. UNAIDS leverages its relationships and partnerships to assist countries in securing Global Fund resources, implementing grant programmes and overcoming bottlenecks. The Global Fund, in collaboration with other donors and governments, secures the resources to implement effective responses to HIV, tuberculosis and malaria.

Together, UNAIDS and the Global Fund have ensured that millions of people living with HIV have access to treatment and that people most affected by the epidemic have the health and support services they need.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The Executive Director of UNAIDS, Michel Sidibé, has spoken out about the need for continued leadership in global health from the United States of America to end the AIDS epidemic. During a speech at the Foundation for AIDS Research (amfAR) Capitol Hill Conference, Mr Sidibé said, “What scares me is the move to a conspiracy of complacency. People think that AIDS is done, that we can move on. Now is not the time to lose our momentum.”

Senior United States officials, researchers, implementers, policy-makers and advocates were present at the event, which was held to review the substantial progress in the response and what is required to end the AIDS epidemic by 2030.

The conference, Making AIDS History: a Roadmap for Ending the Epidemic, was chaired by Susan Blumenthal, amfAR’s Senior Policy and Medical Advisor and former United States Assistant Surgeon General. Speakers acknowledged the strong bipartisan commitment and leadership of successive United States Administrations and the Congress, which have saved millions of lives and made it possible to begin envisaging a world without AIDS. It was noted that cuts to international assistance, multilateral organizations and United States global AIDS programmes would have irreversible and devastating consequences.

Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, presented data illustrating dramatic results, including progress towards reaching the 90–90–90 targets among adults in Malawi, Zambia and Zimbabwe and corresponding declines in new HIV infections.

“It is remarkable what we have achieved, bringing together governments and communities, with the support of UNAIDS and collaboration with the Global Fund to Fight AIDS Tuberculosis and Malaria,” said Ms Birx. “These essential partnerships make hard-earned United States taxpayer dollars go so much further and amplify our results.”

Mr Sidibé emphasized that partnership and global solidarity are paying off—in both economic terms and in the number of lives that have been saved. “The generosity and compassion of the American people has helped us move from despair to hope,” he said.

Kenneth Cole, Chief Executive Officer of Kenneth Cole Productions, Chairman of amfAR and International Goodwill Ambassador for UNAIDS, referred to commitments made by governments to Fast-Track the response to the epidemic and said that strong, continued United States leadership is essential to seizing the moment and dramatically scaling-up access to HIV treatment and prevention services. “We are at a tipping point and tipping points can go one of two ways—we have to end up on the right side. We have come too far to see 35 years of hard won progress grind to a halt,” said Mr Cole.

UNAIDS is leading global efforts to end the AIDS epidemic and is working with countries, donors, civil society and partners to increase action and Fast-Track the response to HIV over the next four years to end AIDS as a public health threat by 2030. 

Victoria is a nurse who provides opioid substitution therapy (OST) to 50 people a day. The OST programme in Belarus started in 2007 as a pilot project with a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Today, the programme has grown to 19 sites across the country providing OST to nearly 900 people; however, that is less than 5% of people who use opiates in the country.

Thirty-seven per cent of all people accessing OST in Belarus are living with HIV. Victoria says that OST helps people living with HIV who used to inject drugs to keep taking their antiretroviral therapy. People who are HIV-negative also rely on the programme to avoid HIV infection through injecting drug use.

The OST programme in Belarus is available to adults dependent on opioids. It includes the provision of methadone, regular medical check-ups, psychological support and the services of social workers. Eugene Halubitski has been the head of the OST programme at a clinic in Minsk since 2010. He provides medical and psychological support to many clients, including Sergey.

Sergey first enrolled in the OST programme in 2009. Since then he has found a job, got married and became a father. A 2014 study found that every US$ 1 invested into OST saves around US$ 6 from the consequences of drug dependence, such as crime, unemployment, the provision of antiretroviral therapy and AIDS-related deaths.

People who adhere to OST programmes come every day to a clinic to take a dose of methadone, which helps to alleviate their dependence on opioids.

The World Health Organization recommends increasing OST coverage to 40% of people who inject drugs in order to lower the number of new HIV infections.

The financing of harm reduction in Belarus is steadily transitioning from the Global Fund to Fight AIDS, Tuberculosis and Malaria to domestic resources. OST is almost completely funded by the state.

Thirteen years ago, Alexander took part in a rehabilitation programme. Today, he is a psychologist and helps others to recover from drug dependence through peer counselling, meditation and psychotherapy. His experience shows that a life free from drugs is possible.

During a visit to Belarus, UNAIDS Executive Director Michel Sidibé‏ met with the staff and clients of an OST centre in Minsk, where he congratulated the work of the centre’s staff.

He said, “I can say with confidence that this is one of the best opioid substitution therapy programmes I have visited. It provides comprehensive and holistic serves which are people centred.”

Clients shared personal testimonies with Mr Sidibé. “They believe in their future now. The opioid substitution therapy programme respects people’s dignity and restores social capital,” he said.

He added that, “We see that the harm reduction programme in Belarus works and needs to be scaled up.”

The evidence of the effectiveness of harm reduction is the basis for a comprehensive package of interventions for preventing the spread of HIV and reducing other harms associated with drug use.

Photo credits: UNAIDS/Alexandr Konotop