June 1, 2021
The old adage “don’t let a crisis go to waste,” never had more resonance. The COVID-19 pandemic is very far from over, and the unacceptable global disparity in access to COVID-19 vaccines, tests, treatments and personal protective equipment (PPE) requires immediate action. While we improve today’s COVID-19 response, it is also imperative that world leaders use the current disaster to drive decisive action against pandemic threats of tomorrow. The Biden Administration is to be commended for calling for the establishment of a new pandemic preparedness and response financing mechanism before the end of this year.
Whatever form a financing mechanism takes, the Global Fund to Fight AIDS, Tuberculosis and Malaria should be at the forefront with a central organizing role. The organization was founded nearly 20 years ago in the midst of an out-of-control AIDS pandemic with the urgent mission to help countries confront the biggest infectious disease killers. Since then, its work with partner governments and organizations has saved over 38 million lives.
The Global Fund model of working in partnership, supporting evidence-based interventions, promoting services that respect human rights, and advancing implementing countries as the leads in decision making is also the right model for sustainable pandemic preparedness and response. In many ways, the Global Fund has already been doing this work even before COVID-19. A January analysis in the Lancet found that over a third of the organization’s investments support health security.
Building off of its investments in AIDS, TB and malaria responses and in health systems, the Global Fund was able to pivot at the beginning of the COVID-19 crisis to help countries swiftly respond to the new pandemic. It has quickly become the primary channel for providing grants to low- and middle-income countries for COVID-19 tests, treatments (including oxygen), PPE and critical support for health and community systems. The U.S. government strongly endorsed the Global Fund’s pandemic response capabilities by committing $3.5 billion to the Global Fund’s COVID-19 response in March.
Crucially, Global Fund work in health security is integrated with the organization’s efforts to fight AIDS, TB and malaria and strengthen related areas of health systems. The organization is poised to enhance this work. The critical elements of pandemic preparedness and response programming will be able to leap into action more rapidly and reliably in the future if they are being utilized today. As former CDC Director Tom Frieden recently observed, “… the most effective emergency response systems build on robust, scalable systems that respond to everyday events.”
But what would happen to the efforts to end the AIDS, TB and malaria epidemics were the Global Fund to expand its work on health security? This is a question that would deserve ongoing attention, with transparency on financing and progress toward targets. Yet we also have to appreciate that there is no ending the AIDS, TB and malaria epidemics if new pandemics are not prevented and controlled. COVID-19 is the obvious case in point: it has seriously disrupted services and threatens to set back progress on AIDS, TB and malaria by many years.
As someone who comes out of the AIDS movement, I see a greater Global Fund role in pandemic preparedness and response as an enormous opportunity to advance progress on AIDS, TB and malaria. It would allow for identifying synergies in health service delivery and epidemic response. It would avoid further siloing of global health investments. When the next pandemic threat comes, expanded Global Fund engagement in health security would help maintain AIDS, TB and malaria services.
The responses to AIDS, TB and malaria are not served by separating them from what is likely to be expanded global investment in pandemic preparedness and response in the years to come. And centering pandemic preparedness at the Global Fund is the surest way to integrate human rights-based approaches, given the Global Fund’s track record of promoting equality and civil society representation and rights.
Certainly, no single organization is suited to support all aspects of health security. Yet with a history of strong results and consistently high marks for transparency and independent oversight, the Global Fund is prepared for a major role in the next evolution of the global health architecture. No start up time is required: the Global Fund has a powerful network of implementing partners in 130 countries and is helping governments and communities tackle AIDS, TB, malaria and COVID-19 today.
History tells us that without action in the time of crisis, the sense of urgency will be lost. The Global Fund has the values and results the world needs in any pandemic preparedness system. As governments negotiate a strengthened pandemic preparedness and response architecture over the coming months, they should explicitly place the Global Fund at the front and center of their plans.
Chris Collins is President & CEO of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria