Global Fund can improve world health
Even in a time of great political uncertainty, there are still truths that can be known. One surprising certainty is that it is possible to relatively inexpensively improve the health of millions of people around the world. Congress should keep this in mind as it sets its budget priorities in the coming months.
Over the past 20 years, the United States has led the investment for global health during both Republican and Democratic administrations and congresses. For example: The United States is the lead contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This support started as part of President George W. Bush’s President’s Emergency Plan for AIDS Relief (PEPFAR), and Congress continued to provide significant funding to it throughout the Obama administration. The results of U.S. investment in global health are encouraging. Thanks to Global Fund programs, 9.2 million men, women and children are receiving lifesaving antiretroviral medications, 15.1 million have been tested and treated for TB, and 659 million mosquito nets have been distributed. In January, the World Health Organization noted that AIDS is no longer one of the top 10 causes of death in the world.
Both effective and efficient, the Global Fund uses sound business practices to support programs that are highly likely to work, then monitors those programs to ensure that they are working, and only funds succeeding rounds if the programs are proving to be effective. The Global Fund then works with local governments to enable them to absorb more of the program costs. Because it is multinational, both in terms of donor nations and recipient nations, the Global Fund can contract for less-expensive drug prices. Most important, it is effective: AIDS is dramatically declining. Malaria, largely through the provision of insecticide-treated bed nets, is decreasing. The nations of Argentina, Costa Rica, Iraq, Morocco, Oman, Paraguay, Sri Lanka and United Arab Emirates were recently declared malaria-free. Tuberculosis, an ancient scourge, has been decreasing as well.
As these diseases become better controlled, there may be a tendency to conclude that we can decrease funding to fight them. But, of course, when funding is decreased, the incidence of disease rises again. Tuberculosis provides a dramatic example of the need for continued funding: Though the death toll from tuberculosis is declining, the number of cases of drug-resistant tuberculosis is growing. Drugresistant tuberculosis is much more difficult and expensive to treat. Adequate funding is needed to keep this threat at bay. Tuberculosis knows no borders: It is spread by a cough and kills more people in one month than the entire worldwide Ebola outbreak of 2015. While malaria rates are falling dramatically, more than 3 billion people remain at risk of malaria. And the antiretrovirals that prevent the worsening of AIDS must be taken continuously to control the disease.
The Global Fund has had longterm, consistent bipartisan support since its creation 15 years ago. And just last month, upon learning of President’s Trump musings about cutting the foreign aid budget by 37 percent, 121 three- and four-star generals and admirals, including Gen. David Petraeus, wrote a letter to U.S. House and Senate leaders stating that it is essential for the security of the United States that funding for foreign aid not be cut.
Decreasing funding to fight killers such as AIDS, TB and malaria now would be tantamount to saying that we are winning the battle, so let’s pull our troops back from the front line. We have come a long way in reducing these diseases. We must continue adequate funding of the Global Fund so that we can eliminate the threats of AIDS, TB and Malaria forever.