Friends on the Frontline Second Quarter 2014

10 Years of Progress

A Message from Deb Derrick, President of Friends of the Global Fight

Ten years ago this month, philanthropist Ed Scott founded Friends of the Global Fight Against AIDS, Tuberculosis and Malaria. Led by the former President of the Motion Pictures Association of America, Jack Valenti, Friends gave — and still gives — the Global Fund a much-needed voice in Washington, D.C. But it is not just our own 10th birthday that gives us cause to celebrate; rather, it is the astonishing progress that has been made against the three diseases in the past decade. My team and I are honored to be contributing to this legacy. Like you, we understand how imperative it is to maintain momentum; that we must take advantage of the scientific opportunity in front of us to fully control AIDS, tuberculosis and malaria.

Since its inception, one of Friends’ most important mandates has been to advocate for robust U.S. funding for the Global Fund — and we have been busy in June with the congressional appropriations process. The Senate and House Appropriations committees recently voted on their respective spending bills that include allocations for the Global Fund for Fiscal Year (FY) 2015. Both chambers recommended a funding level of $1.35 billion for the Global Fund — with more details on this in the View from the Hill section below.

At the Global Fund Secretariat, rolling resource mobilization efforts continued this quarter. Luxembourg signed a contribution agreement for $10.2 million on May 22, making the country the Global Fund’s fifth largest donor on a per capita basis after Norway, Sweden, the United Kingdom and France. On April 9, following on his personal investment of $65 million to the Global Fund last October — the largest ever made by a private foundation in an emerging economy — Tahir Foundation Chairman Dato Sri Dr. Tahir announced an innovative financing initiative, the Indonesia Health Fund. This collaboration among Dr. Tahir, eight fellow Indonesian business leaders and the Bill & Melinda Gates Foundation has yielded an initial investment to global health of $40 million.

The Global Fund continues to make the most of existing resources, as well. In 2013, it worked with three other major buyers of mosquito nets — the United Kingdom’s Department for International Development, UNICEF and the U.S. President’s Malaria Initiative — to bring their joint purchasing power to the table in procurement negotiations, leading to an estimated cost savings of $140 million in two years. On June 24, the Global Fund announced additional savings of more than $100 million in the procurement of artemisinin-based combination therapies to treat malaria, through price reductions over two years. It is also working with major purchasers of antiretroviral drugs, including the President’s Emergency Plan for AIDS Relief (PEPFAR) and the government of South Africa, to invest more strategically in treatments for HIV.

The Global Fund also recently strengthened its relationship with UNICEF and the World Health Organization (WHO) through new agreements to collaborate for greater impact. The Global Fund and UNICEF announced a new agreement on April 22, through which they will jointly identify countries where investments in lifesaving commodities to prevent and treat HIV, tuberculosis and malaria can be better integrated with health services that support basic maternal, newborn and child health. On May 20, The Global Fund announced a joint agreement with WHO to support countries in developing more strategic and higher-impact investments in the fight against the three diseases.

One major change this quarter was the confirmation on April 4 of Dr. Deborah Birx as the U.S. Global AIDS Coordinator for PEPFAR. Ambassador Birx brings more than three decades of expertise in HIV/AIDS immunology, vaccine research and global health, having previously served in leadership roles at the U.S. Centers for Disease Control and Prevention, the Walter Reed Army Institute of Research and the Walter Reed Army Medical Center. We look forward to working with Ambassador Birx in the months and years to come.

A View from the Hill 

It has been a busy quarter on Capitol Hill. In April, the House and Senate held several hearings on the President’s FY 2015 budget. Friends closely monitored the testimonies of Secretary of State John Kerry, USAID Administrator Dr. Rajiv Shah, and U.N. Ambassador Samantha Powers as they appeared before congressional appropriators and authorizers.

In his opening remarks to the House Appropriations Subcommittee on State, Foreign Operations, and Related Programs on March 12, Secretary Kerry notably said:

“With our core budget request, there’s a $1.35 billion contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. … Because of our leadership, children are waking up today in sub-Saharan Africa who face a very different future from what they did only 10 years ago. … We can be proud of this. Americans — I think we need to talk about it more. We need to get people to see the huge benefit of this [foreign aid] one penny on the dollar investment.”

Friends’ Policy team reached out to key Members of Congress in advance of the consideration of its appropriations bills. In coordination with members of the partner community, Friends worked with the offices of Sens. Chris Coons (D-DE) and Johnny Isakson (R-GA) on a “Dear Colleague” letter to other Members in support of strong funding for the Global Fund, PEPFAR and HIV/AIDS vaccine research in the FY 2015 appropriations bill.

Also in April, Friends arranged for a congressional luncheon, sponsored by Sen. Thad Cochran (R-MS), for Senators and members of the Japanese Diet. While visiting Washington, D.C., the Japanese Diet also participated in a Global Fund-focused dialogue on global health, which centered on malaria investments made by the United States and Japan in observance of World Malaria Day and pegged off of President Obama’s recent trip to Japan.

In May, the Senate unanimously agreed to S. Res. 314, a resolution sponsored by Sen. Coons (D-DE) to commemorate and support the goals of World AIDS Day. Additionally, on May 20, the Senate Committee on Foreign Relations approved S. Res. 426, a resolution to support the goals and ideals of World Malaria Day.

On June 19, the Senate Appropriations Committee approved its FY 2015 State, Foreign Operations and Related Programs (SFOPS) bill, including $1.35 billion for the Global Fund — the same amount requested by President Obama in his FY 2015 budget proposal and the most the U.S. government can give at this time given the 33 percent cap on its contributions.

The House Appropriations Committee passed its FY 2015 SFOPS spending bill on June 24, with an allocation of $8.307 billion for global health, including $1.35 billion for the Global Fund and $4.32 billion for PEPFAR — a $300 million increase from the President’s FY 2015 budget request.

Donors Save Lives: Out of Tragedy Comes an Opportunity in Nicaragua

Over the past decade, Nicaragua has made dramatic progress in the fight against malaria. The poorest country in Central America, it has struggled to recover from the damage caused by civil war in the 1980s, a struggle that was compounded by 1998’s Hurricane Mitch, which devastated the country’s infrastructure and economy.

Nicaragua used this natural disaster as an opportunity to step up its fight to control malaria. The disease is native and endemic; but amidst the influx of hurricane-related funding, country leaders directed some of the funding toward rebuilding the country’s malaria control program. And the number of malaria cases started to fall. The number of confirmed cases in 1996 was 70,000. By 2008, that number plummeted to 762.

Since 2004, Nicaragua has implemented three grants worth more than $15 million from the Global Fund to push the country toward complete malaria elimination. Focusing on the reduction of transmission in 36 high-risk municipalities, the country has seen its malaria incidence decrease further – to approximately 21 cases per 100,000 people in 2012.

Today, with the support of the Global Fund and other partners, Nicaragua has already achieved the Millennium Development Goal target of 75 percent reduction in malaria. It has also developed capacity for a national monitoring and evaluation system that has since been integrated into the national health systems, facilitating long-term sustainability. As a result of these efforts, some areas of Nicaragua are now entering the pre-elimination phase — with a very low incidences of malaria even in peak malaria season.

Finally, the government is doing what it can to take over some of the costs of its own malaria programs. For example, though Global Fund financing is currently used to purchase rapid diagnostic tests and cover the costs of procuring and distributing long-lasting insecticide-treated nets, the Nicaraguan government now covers the cost of all malaria medications

For more examples of how the Global Fund is supporting countries as they take control of the three diseases, read the Friends Steps Toward Sustainability report.

Highlights from the Fight

Below are a few resources where you can learn more about the work of Friends of the Global Fight and the opportunities before us to defeat AIDS, tuberculosis and malaria:

  • Friends was a member of the host committee for the 5th Birthday and Beyond Congressional “Thank You” Event on June 25, celebrating U.S. leadership for healthy children worldwide.
  •  Leading up to the 5th Birthday and Beyond event, Deb discussed the role the U.S. government has played in improving child survival rates over the last 25 years in The Hill’s Congress Blog on June 17.
  • On June 9, the Center for Strategic and International Studies’ Global Health Policy Center hosted an event, “A Strategic Approach to Global Tuberculosis,” to discuss the major findings and recommendations of a working group that examined how tuberculosis relates to U.S. national interests.
  • Global Fund Executive Director Dr. Mark Dybul delivered a TEDxAmRing talk in Vienna, Austria, on May 30 to address the global AIDS, tuberculosis and malaria epidemics, recent progress, next steps, and why we can’t let up now in the fight against these diseases.
  • On May 22, a study was released in Science Magazine detailing a promising new preliminary malaria vaccine that is based on antibodies found in malaria-resistant children in Tanzania.
  • The Centers for Disease Control announced on May 14 a new recommendation that Americans who are most at risk for HIV/AIDS exposure take a daily antiretroviral drug regimen prophylactically.
  • In a May 12 op-ed in the Houston Chronicle, Dr. Helene Gayle, CARE CEO and president and Friends board member, recalled the early days of the AIDS epidemic, and discussed domestic and global progress and the power of U.S. investments in the fight to defeat HIV/AIDS.
  • On April 30, Deb Derrick spoke on Capitol Hill at the amfAR conference “Making AIDS History,” along with the president of the World Bank, Dr. Jim Kim; Partners in Health co-founder and chief strategist, Dr. Paul Farmer; and the U.S. Global AIDS Coordinator, Ambassador Deborah Birx.
  • For World Malaria Day, on April 25, Friends spoke with Dr. Scott Filler, the Global Fund’s senior disease coordinator for malaria. Dr. Filler talked about the progress in the fight against malaria as well as some of its most pressing challenges, including artemisinin resistance in the greater Mekong region.
  • On April 24, Global Fund Executive Director Dr. Mark Dybul and Senegal’s Minister of Health, Dr. Awa Maria Coll-Seck, reflected on World Malaria Day — highlighting Senegal’s efforts to edge out the disease and challenges in the global fight to defeat malaria.
  • Finally, Friends was pleased to host Shu-Shu Tekle-Haimanot, Senior Specialist on Advocacy and Partnerships at the Global Fund, who traveled to Washington for an April 22 Kaiser Family Foundation panel discussion, part of the organization’s ongoing efforts to map the donor landscape. At the event, titled “The Challenge of Donor Coordination in Health,” Tekle-Haimanot focused on the importance of domestic financing.

This post was originally published in July 2014.