The global fight against HIV requires strengthening the Global Fund

The sobbing is what I remember the most.

Several times every hour, mournful cries echoed over the open corridors of Central Hospital in Lilongwe, Malawi, prompting us to pause our clinical rounds as we mourn the loss of another young woman’s life to HIV. Providing clinical care without access to HIV drugs in 1999 was too painful and left me and my fellow Malawians deeply affected. Since then, I’ve experienced many ups and downs in Medicare and public health, but I’ve never seen a set of inequalities so annoying or in need of change.

Although it seemed like an eternity, the world acted in a big way three years later. In the midst of my medical residency at Harvard University in 2002, I was invited to a meeting about a fund being created to support access to treatment and prevention of HIV, tuberculosis and malaria in the hardest-hit countries. Shortly thereafter, I returned to Malawi to support efforts made locally through the Malawi Vice President’s Office to draft an application to the newly drafted Malawi. Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).

Malawi leaders recognized the immense power of listening to those on the front lines, and called provincial health officials from the far reaches of the country to a meeting to incorporate their ideas into the request. The writing team worked tirelessly to craft a plan that could be implemented and quickly built out of the existing health system. Led by government, civil society, religious leaders and others, Malawi’s proposal was among the first to be approved by the Global Fund.

This funding started saving lives on Day One by purchasing life-saving antiretroviral therapy, establishing longitudinal care programs, and supporting prevention programs to break stigma and fear to increase testing. Now, 20 years later, that funding is ready for the most significant replenishment ever – an $18 billion target to get “Back to the right track“The setbacks associated with COVID and the achievement of the 2030 goals are fast approaching.

President Biden’s leadership in Hosting the next Seventh Renewal Conference In New York tomorrow — along with his $2 billion 2023 budget request — he should be commended for setting a standard that donor countries, foundations, and the private sector must urgently meet.

The Global Fund’s initial grants, along with the US President’s Emergency Plan for AIDS Relief (PEPFAR), have saved a generation. For example, continuous progress is enabled in Malawi 93 percent of people with HIV know their HIV status, and 91 percent of those who qualify for HIV treatmentThis resulted in a rapid decrease in the death rate. Although there is still much more to be done, maternal treatment has enabled 100,000 babies to be born without HIV, and new HIV infections in Malawi have done so. By more than 80 percent since its climax.

Today, the Fund has provided this kind of wonderful support to 155 countries, More than 50 billion dollars have been spentIt is estimated that she saved an astonishing number 44 million lives. And as it did in Malawi, it encouraged governments and civil society not only to take a leadership role, but The A leadership role in defining the national response to HIV. And when troubles occur, the Global Fund takes transparent procedures To hold governments and other actors accountable, while ensuring that health gains are preserved.

It also invests together with other donors. During my tenure as chief medical officer of PEPFAR and as deputy global AIDS coordinator during the Obama and Biden administrations, we worked in close partnership with the Global Fund to strategically align our funding. Meeting with governments and civil society in more than 30 countries during that time has convinced me that the multilateral and bilateral approach has been the yin and yang of public health, allowing for agility, responsiveness, and country leadership.

Today’s historical moment rivals that of the days before the founding of the Global Fund. We have experienced a massive new pandemic that has claimed millions of lives. However, this time the fund played a foundational role in supporting partner countries to detect, prevent and respond to the coronavirus, and to reduce relapse against HIV, tuberculosis and malaria. Likewise, PEPFAR, the US President’s Malaria Initiative (PMI) and others have performed admirably by protecting the gains and serving as a tool to provide global health security. Their success and momentum should be built on, not squandered.

It is unreasonable today to imagine a world without the Global Fund. It provided hope and fulfilled the promises of partnership between nations and the solidarity of humanity. However, we cannot achieve our 2030 goals or strengthen the position on pandemic preparedness unless we match our ambition with the current threats we face. If we’ve learned one thing since those tragic days before the creation of the Global Fund, it’s that we should never go back.

Charles B. Holmes, MD, MSc in Public Health He is director of the Center for Innovation in Global Health at Georgetown University, Professor of Medicine at Georgetown University School of Medicine, and Distinguished Scientist at the O’Neill Institute for National and Global Health Law. Previously, he served as chief medical officer and deputy coordinator for the US President’s Emergency Plan for AIDS Relief (PEPFAR) during the Obama and Biden administrations.

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