Friends on the Frontline Third Quarter 2013

The Time Is Now to Step Up the Fight Against AIDS, Tuberculosis and Malaria

A Message from Deb Derrick, President of Friends of the Global Fight — August 21, 2013

Why now? It’s a question that is posed to Friends frequently. What makes the current moment so critical in our quest to defeat AIDS, tuberculosis and malaria?

A terrific set of answers was offered up by several Global Fund partners during the June Global Fund Board meeting in Sri Lanka.

  • Dr. Timothy Hallett of Imperial College showed that the new ability to focus medical interventions on high HIV concentration centers can increase their impact up to 21 percent and reduce the cost per infection averted by 66 percent. He also made the case that such an approach could effectively control the HIV/AIDS epidemic.
  • Lucica Ditiu of the Stop TB Partnership showed how the current slow-but-steady approach to fighting TB could lead to its control — in eight generations. Meanwhile, new diagnostic tools and drugs can vastly accelerate our timeline for reining in this global threat.
  • Robert Newman, Director of the World Health Organization’s Global Malaria Program, said that a decade of investment in malaria has led to a 33 percent decline in malaria cases in Africa. He also noted that there have been resurgences of malaria within a year where programs have been interrupted.

Executive Director Mark Dybul summarized this situation saying that we were at an historic moment in time, one in which scientific advancements, improved epidemiology and a decade of implementation experience point to an ability to defeat these three diseases. But, he warned, “windows of such magnitude rarely stay open for long.”

The gains we have made against these three diseases are substantial. They are also fragile and can easily be lost. Sri Lanka’s efforts against malaria – which you can read about in more detail in this newsletter — provide an example of how this delicate balance can play out on the ground.

This urgency is what drives Friends’ support for a good outcome at the Global Fund’s Fourth Replenishment conference this year — a conference that will help to determine how much money the world has to fight HIV/AIDS, tuberculosis and malaria for years to come.

The Global Fund’s 29th Board Meeting in Colombo, Sri Lanka, presented a powerful intellectual jumping off point for me. But perhaps the most compelling part of my time in Sri Lanka was talking to patients and caregivers at Global Fund sites. Through these conversations, I had the chance to hear first-hand about the impact the organization and its partners have had on individuals and communities.

For instance, I met K Persis, who worked in the Anuradhapura Teaching Hospital as a health worker, where he contracted tuberculosis in 2007. After nine months of treatment — financed by the Global Fund — he is now back to full health and has returned to his job at the hospital.

This lifesaving work is a direct result of the U.S. government’s strong and consistent support for investments in the Global Fund. This support was demonstrated again by both the House and the Senate appropriators when they, in their committee bills, each allocated $1.65 billion in funds for the Global Fund for FY 2014, a process you can read more about in the appropriations update below.

As the Global Fund pursues its replenishment goal, the contributions of current donor governments will continue to be critical, as will those of the private sector, domestic co-investment and emerging economies. Certainly, there will be challenges. But the opportunity before us is one that comes about only once in a lifetime. New advances in science, epidemiology and implementation provide an ideal environment in which, working together, we can leave an indelible legacy of lives saved.

A View From the Hill: FY 2014 Appropriations Update

In July, the House Committee on Appropriations marked up a bill that provided President Obama’s full funding request for the President’s Emergency Plan for AIDS Relief (PEPFAR), including fully funding the $1.65 billion request for the Global Fund. The same bill also exceeded the request for tuberculosis, funding the program at $236 million, and provided $650 million for malaria programs.

Also in July, the Senate Appropriations Committee approved its FY 2014 State Department and Foreign Operations funding bill. Within it, the Committee provided more than $6 million for activities to combat HIV/AIDS, including $1.65 billion for the Global Fund. The bill also provided $225 million for tuberculosis and $667 million for malaria programs.

These bills may or may not be signed into law given continuing U.S. budget negotiations and a looming budget deadline of the end of September. But the support for the Global Fund shown by the President and by both the House and Senate Appropriations Committees marks an important milestone as the U.S. seeks to finalize its budgets and leverage other donor contributions for the Global Fund’s Fourth Replenishment conference.

A Life Saved: Local Leadership and International Support Halt Malaria in Sri Lanka

The island of Sri Lanka is prone to endemic malaria because of its tropical climate and regular monsoons. A recent civil war also wreaked havoc on its health systems. Despite all this, with local dedication and international support, the country’s fight against malaria has proved one of the great health success stories of the past decade.

In 1999, the nation faced more than 250,000 diagnosed malaria cases. It rallied political and financial resources, both internally and from international organizations like the Global Fund, to beat back the mosquito-borne disease. By 2012, the number of indigenous malaria cases had fallen to just 23 – a staggering reduction of 99.9% in just 13 years. Today, Sri Lanka is on the verge of malaria elimination.

This achievement is in large part thanks to the work of people like Dr. W.M.T.B. Wijekoon, the Global Fund Country Director for Sri Lanka, who previously ran the country’s Anti-Malaria Campaign in rural northern districts. He and his wife both contracted malaria several times, but he ultimately managed to decrease the number of malaria cases in the region tenfold.

Dr. Wijekoon warns that the fight is far from over. Imported cases from neighboring India and elsewhere have the potential to spread quickly, given Sri Lanka’s climate and large mosquito population.

The country is therefore working to ensure that the monitoring and testing strategies that helped wipe out malaria continue to guard against its resurgence. Teams from the Anti-Malaria Campaign crisscross the country, collecting and analyzing mosquito specimens. In addition, mobile malaria clinics conduct spot-screenings in the most high-risk areas. And a combination of civil society and health ministry staff are mobilizing communities, scientists and healthcare providers to make sure the disease remains in the history books, where it belongs.

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 in defeating AIDS, tuberculosis and malaria:

  • In August, Jason Koebler wrote about a promising new malaria vaccine trial for VICE magazine’s Motherboard, quoting Dr. Anthony Fauci of the NIH and Friends’ President Deb Derrick.
  • In July, Friends Board Member and Global Health Corps CEO and Co-Founder Barbara P. Bush reflected on the launch of PEPFAR — and the moment her career plans changed — on Forbes.com.
  • In a two-part post in June for the Humanitas Global Development Blog, Deb Derrick highlighted the Global Fund’s expanded efforts to promote human rights in its new funding model.
  • On AIDS.gov in August, Global Fund Attaché Michael Johnson, MD, discussed the recent critical work of the Global Fund and PEPFAR to fight HIV and AIDS in Haiti.
  • As part of the “Big Push” campaign on the Huffington Post, in June, Friends outlined the Global Fund’s plan for mobilizing $15 billion for its Fourth Replenishment through four pillars: traditional donors, the private sector, domestic co-investment and emerging economies.
  • Thokozile Beatrix Phiri, whose life and family were irrevocably changed by HIV-TB co-infection, recounted how she became an advocate for global health and Here I Am ambassador for the Global Fund in this July interview by Elaina Ramsey at Sojourners.

This post was originally published in August 2013.