May 9, 2023
Chris Collins, President & CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, submitted the following comments at the Pandemic Preparedness and Response HLM Multistakeholder Meeting and the UHC Multistakeholder Meeting in New York.
Pandemic Preparedness and Response Comments
The question for today’s hearing, and for the HLM itself, is: health security for whom? If we mean greater security for people globally, not just in rich countries, then we need to recognize:
First, the AIDS, tuberculosis and malaria pandemics are killing millions of people each year. We are officially off track in meeting global targets for these diseases – and that’s not health security. As part of pandemic preparedness the world must recommit to the SDG goal of ending these pandemics by 2030.
Second, the people and systems working every day to address AIDS, TB and malaria played an enormous role in helping communities tackle COVID-19. Over a third of Global Fund investments help countries build preparedness capacity. The Global Fund and other programs must be fully integrated in a holistic approach to pandemic preparedness.
Failure of the Pandemic Fund and the Global Fund thus far to find a way to make the Global Fund eligible for round one Pandemic Fund resources is a worrisome sign, signaling lack of a coordinated, integrated approach to PPR.
Third, pandemic preparedness is fundamentally about stronger health systems that are able to deliver on people’s needs today. The surest way to prepare for the next pandemic is to build investments in the health care workforce, community systems and other aspects of resilient health systems.
Fourth, the world has been chronically underinvesting in health and we have the results to show for it. We need to close the gap in the Global Fund’s 7th replenishment and make other new PPR investments.
We can’t trade current pandemics for future threats. We can’t abandon a critical, unfinished global health target for a shiny new one. We need to create an integrated approach to strengthening health services today in a way that makes all of us safer for the future, with implementing countries in the lead.
I urge the political declaration include: #1) a recommitment to ending the AIDS, TB and malaria epidemics, #2) a call for an approach to PPR that integrates current programs; #3) an emphasis on investment in health and community systems, and #4) a call for additional pledges to the Global Fund to meet its Replenishment 7 target along with other new investments. Thank you.
Over the last generation, investments in programs to fight AIDS, tuberculosis and malaria have driven a more than five-fold increase in official development assistance for health. In many settings, programs for AIDS, TB and malaria are the closest the health system comes to universal coverage. In our work to ensure that everyone, everywhere has the health services they need, we should build on the infrastructure created by these investments and take on board the key lessons we have learned.
First, we must recognize that ending AIDS, TB and malaria is a key milestone towards UHC. Each year, more than 2.6 million die from these three diseases. But progress towards ending these diseases is faltering, in part because of inadequate funding and waning political support. We must redouble our efforts to end these diseases. A key step is to close the gap in the Global Fund’s 7th replenishment, mobilizing to meet the full $18 billion target.
Second, investing in AIDS, TB and malaria helps build stronger, more inclusive health systems. The Global Fund invests over $1 billion each year in strengthening health systems. For example, the response to AIDS, TB and malaria has massively strengthened laboratory systems, as we saw during COVID, when Botswana leveraged lab infrastructure built with AIDS funding to identify the Omicron variant.
Third, AIDS, TB and malaria investments have catalyzed the creation of service systems specifically designed for the most marginalized populations, who are often poorly served by facility-based health services. Reaching the most vulnerable and the chronically underserved is essential to achieve UHC. Disease-specific programs have helped strengthen and sustain community systems, hiring and deploying community health workers and mainstreaming community-generated innovations, which play a central role in reaching the marginalized.
Finally, the fight against AIDS, TB and malaria has shown the value of inclusive, participatory health governance. Civil society, affected communities and the private sector are active participants in governance of the Global Fund – not only at global level, but also in Country Coordinating Mechanisms that develop funding proposals and oversee implementation of country grant programs. This approach has not only generated high-impact investments that have saved more than 50 million lives, but it has also broadened support for health investments and ensured that programs meet the needs of the most vulnerable. Only through governance mechanisms that engage and empower communities will it be possible to build people-centered health systems that deliver quality care for all.
I urge the political declaration to include: 1) a recommitment to ending the AIDS, TB and malaria epidemics; 2) a recommendation for UHC efforts to take on board key lessons from the response to AIDS, TB and malaria, including the importance of inclusive governance; 3) an emphasis on investment in health and community systems; and 4) a call for additional pledges to the Global Fund to meet its 7th replenishment target. Thank you.