September 11, 2017
The following post was originally published at Devex on Sept. 11, 2017.
Over the past 15 years, the world has come together to respond to a health crisis of historic magnitude by fighting the epidemics of AIDS, tuberculosis and malaria. By tackling the world’s three deadliest infectious diseases, the global community is also paving the way toward universal health coverage. Disease-targeted prevention and treatment efforts are crucial to ultimately achieving the global goal of health services for all. These efforts have yielded incredible results. Just between 2000 and 2015, the number of AIDS-related deaths dropped by 28 percent. During the same time period, malaria and tuberculosis deaths dropped by 50 percent and 22 percent, respectively.
Despite this great progress, there is still work to be done to end these epidemics, and more funding and collaboration across many countries and sectors is needed. Innovative partnerships and financing initiatives, such as social impact bonds and blended finance programs, complemented by steady donor aid, can greatly accelerate the global community’s ability to provide health care access to millions and save millions more lives, while creating economic opportunity that is essential to healthier societies. Below are five successful strategies to explore innovative partnerships and financing to see significant gains in both health and health coverage by 2030.
1. Collaboration is flourishing and must be advanced to save more lives.
The creation of the Global Fund in 2002 contributed greatly to the fight against AIDS, tuberculosis and malaria. By raising and investing nearly $4 billion each year to fight and prevent the three diseases, Global Fund-supported programs have saved more than 20 million lives. The Global Fund is working in partnership with effective bilateral programs, such as the U.S. President’s Emergency Plan for AIDS Relief, known as PEPFAR, and the President’s Malaria Initiative, as well as private sector partners to reach the global targets for AIDS, tuberculosis and malaria. For example, the primary goal to help end the AIDS epidemic is by 2020: 90 percent of all people living with HIV will know their status; 90 percent of all people diagnosed with HIV will be on antiretroviral therapy, or ART; and 90 percent of all people receiving ART will have viral suppression.
These strategically coordinated efforts align resources and create synergies that allow for dramatic expansion of innovative programs. But domestic and private sector investment must continue to grow if we are to see the dramatic shift needed to end the epidemics for good.
Exploring new financial approaches to health
As a public-private partnership, the Global Fund is at the forefront of innovative financing and continues to explore new approaches and stakeholders in health. In Senegal, for instance, a bold mission to eliminate malaria by the end of 2018 is being accomplished by distributing 1 million rapid diagnostic tests and 700,000 antimalaria drug doses, and providing 2.5 million people with insecticide-treated nets.
Supported by the Lives and Livelihoods Fund, an innovative financing approach by the Global Fund, the Bill & Melinda Gates Foundation and the Islamic Development Bank, the goal can become a reality.
2. Encouraging increased domestic financing translates to better health.
Global health is a shared responsibility and more countries are stepping up to the plate. The Global Fund supports greater domestic financing by incorporating requirements for this funding into its own grantmaking model, which has been successful. From 2015 to 2017, Global Fund-supported countries saw a 41 percent increase in domestic financing over the 2012-2014 period. In the Global Fund’s current strategy period (2017-2022), Global Fund support will further catalyze $35 billion in domestic finance for health and drive $230 billion in economic gains.
Domestic financing for health empowers implementing countries with greater ownership and sustainability of their own health programs. For example, the South African government is the largest investor in the national HIV response. In 2016, the government provided more than 75 percent of the funding for HIV/AIDS. In addition, the South African government provides 91 percent of the funding for tuberculosis, with other donor sources — including the Global Fund — providing the rest. Importantly, the South African government plans to further grow its investment in HIV and TB programs by 25 percent over the next two fiscal years (to $1.676 billion by 2020). Increased domestic financing can increase a country’s acceptance of health interventions and more effectively scale and integrate disease programming within the country’s own health systems, leading to improved results through increased health coverage.
3. Private sector partners are investing more than capital, and it’s working.
Private sector partners are increasingly offering resources beyond financing, investing their knowledge, skills and best practices to increase the efficiency and efficacy of global health programs. Project Last Mile, a collaboration among the Global Fund, Coca-Cola, the Bill & Melinda Gates Foundation and the U.S. Agency for International Development, works with national governments to increase infrastructure to support medicine and supply deliveries to areas that otherwise could not access lifesaving treatment. Coca-Cola technicians also train community members on refrigeration repair to help clinics safely store medicines.
This program has been extremely successful. In 2012, two years after launching in Tanzania, PLM supported the delivery of 120 essential medicines to 5,000 health facilities. Previously, medicines were only available to 500 facilities. Nearly 20 million people — more than one-third of the population of Tanzania — now have access to those health care facilities. In addition, the Global Fund recently announced that PLM will expand to Swaziland, where the project will focus on leveraging Coca-Cola’s expertise on marketing approaches to increase demand for HIV prevention services. PLM is progressing well toward its goal of operating in, and positively impacting, 10 African countries by 2020.
4. A win-win for business: Supporting health can also help the bottom line.
Other businesses provide health care directly to their workforce and local communities. Such efforts to innovate beyond financial support create significant economic benefits, as well as better health coverage. For example, three mining and agriculture companies operating in sub-Saharan Africa experienced a 28 percent rate of return after implementing malaria prevention and control programs for employees — that’s a $9 net benefit per employee every year.
Here and elsewhere, we see cases where businesses can achieve success and improve the health of their own workforce through strategic partnerships with global health organizations, national governments and civil society. By building on the core funding from governments, efforts like these can provide a high social return, and yield even greater returns in terms of impact for every dollar that is invested.
5. Keep thinking outside the box to grow financial, social and health returns.
The innovative programs, partnerships and investment strategies highlighted above are just the tip of the iceberg in terms of what partners are doing to raise additional resources for development and engage new stakeholders in providing health coverage and access to treatment. Many other initiatives are underway to spur more innovative health financing — from harnessing development banks, to cutting risk and thus encouraging private investment, to co-financing partnerships. While donor financing from partner countries will remain absolutely essential to make major global health advances, innovative financing can bring significant financial and social returns by supporting programmatic impact, improving data collection and leveraging more domestic investment. We have an opportunity to end the threats of AIDS, tuberculosis and malaria within a generation, and support the growth of UHC in the process.
It’s time to step up groundbreaking financial initiatives and work collaboratively to raise the capital needed. Fortunately, there’s something everyone can do: advocate for steady funding for HIV, tuberculosis and malaria programs, which will support both the growth of UHC and help end the epidemics for good.