HIV/AIDS, Tuberculosis and Malaria: Funding the fund

Atinuke recently completed her national youth service having graduated from a Federal university in 2014, where she studied Pharmacy. She was born HIV-positive in 1990. Now 26, she has lived with the disease all her life. She had once coped with tuberculosis (TB) co-infection, but being the fighter she is, had beaten TB hands down. Both her father and mother are also HIV-positive, everyone is fine now, with undetectable viral loads, a clear indication of the progress in HIV/AIDS treatment.

Atinuke and her family represents a generation of Nigerians whose lives were shaped by HIV/AIDS in its entirety, and they come not in small numbers, with 3.4 million Nigerians projected to be living with HIV/AIDS. For Atinuke and others in her shoes, they got a second shot at life and are able to live productive lives because of the programmes being supported by the Global Fund, which provides treatment which also ensures they can have children who are free of the burden of the disease. It is instructive to note that several others are not as lucky as Atinuke, lacking every access to the life saving treatment they require.

HIV/AIDS remain a major development crisis. Since the pandemic began, it has killed millions, separated families, and destroyed and impoverished communities. In some countries, life expectancy has fallen by more than 20 years. The scale of the epidemic is causing informal social safety nets to collapse. Overall health care is under pressure as health services struggle with mounting demand. Workforces are being decimated, with severe consequences for investment, production, and per capita income while posing as a severe threat to global health, development, and security.

In retrospect, we have to appreciate the tremendous progress that has also been made in the fight against the three diseases achieving life-saving impacts that were unthinkable at the turn of the millennium. In 2000, just 50,000 people were receiving antiretroviral (ART) therapy in sub-Saharan Africa, but by 2011, it had climbed to over 7 million. Now, more than 17 million lives have been saved. Current projections show that more than 2 million lives are being saved each year. About 8.6 million people are receiving lifesaving antiretroviral therapy for HIV and 16 million people with HIV-TB co-infection have been treated. Nearly 3.3 million mothers have received treatment to prevent the transmission of HIV to their babies and 560 million people with malaria have been treated.

However, if global funding for HIV / AIDS and TB were to remain static as we are currently experiencing, some of the consequences would include: 2.6 million new HIV infections every year, of which 1.3 million could be averted through scale-up. In total 3.9 million new HIV infections was projected for the period 2014-2016 and $47 billion of costs throughout the lifetimes of those additional people infected. 3 million less people will be treated for TB and 1 million lives would be unnecessarily lost with uncontrollable multi-drug resistant TB (MDR-TB) if we don’t treat TB now for as little as $30 per patient because MDR-TB can cost up to 1000 times more to treat.

It will also mean 196,000 lives lost to malaria per year and 430 million malaria cases that could have been prevented, according to Cost of Inaction, a report on how inadequate investment in the Global Fund to fight AIDS, Tuberculosis and Malaria will affect millions of lives across the globe.

It is crucial to acknowledge that the fatigue in donor replenishment of the Global Fund is coming at a time that experts have suggested offers the most hope in the fight against HIV, TB and malaria. It, therefore, goes to show that the Global Fund needs a robust infusion of pledges from traditional donor countries, most notably world economic powers such as Germany and China, to successfully hit, and hopefully exceed the fundraising target of $13 billion for the Fifth Replenishment Round.

It is in this regard that we must acknowledge the AIDS Healthcare Foundation (AHF) and its global partners on the launch of the Fund The Fund campaign targeting countries like Germany, Japan and China to act in the interest of humanity and increase their contributions to the Global Fund. Across AHF country programs, Nigeria inclusive, various activities have been launched, ranging from advocacy meetings with country reps at various embassies to staging press conferences to put the issue on the global agenda and highlight the sense of urgency.  In May of 2016, Japan announced a contribution of $800 million for the fifth replenishment of the Global Fund to fight AIDS, TB and Malaria which shows AHF’s effort and messages is reverberating.

Nowhere else can the Global Fund’s impact be louder than Nigeria where the Fund has provided HIV care and treatment to 750,000 people, ensuring TB treatment to 310,000 as it provided 93.4 Million Mosquito nets to households to ward off malaria.

Nigeria also currently represents the Global Fund’s largest portfolio with a total of $1.1 billion allocated to fighting the three diseases from 2014-2016. Unfortunately, since 2010, the Global Fund has never achieved its targeted funding. Therefore, increasing and sustaining the funding to the Global Fund is imperative to sustaining the gains achieved over the last decade, and the last few years in particular.

• Aborisade is a public affairs analyst.