“The COVID-19 pandemic is having a catastrophic impact on the most vulnerable communities around the world and threatens progress against HIV, TB and malaria” states the Global Fund. The multilateral organization is seeking an additional US$5 billion to continue to fight COVID-19, safeguard health workers and systems for the provision of healthcare and protect the progress made in fighting HIV, TB and malaria. We asked several experts to share their opinions regarding the consequences of the lack of funds and about possible solutions.
What are the main consequences of this fund running out?
“At first glance, US$5 billion looks like a mighty number but considering that around 120 countries are supported through the Global Fund’s COVID-19 response helps to put this into perspective. These funds are used to support some of the world’s most fragile health systems in not only mitigating the direct impact of COVID-19 on HIV, tuberculosis and malaria programs, but also fighting COVID-19’s ‘shadow pandemics’ such as increased violence against women and girls or an increase in human rights violations against marginalized groups, as well as more generalized health system strengthening and COVID-19 response efforts. In conclusion, many vital and life-saving actions are under threat without adequate funding. Therefore, donors need to understand that this is a one-time call without leeway for second chances.”
“The Global Fund has traditionally concentrated on the three epidemics with the highest impact – HIV/AIDS, tuberculosis and malaria. The diversion of resources to the COVID-19 pandemic certainly made sense at a time when the severity and impact were less clear. However, COVID-19 mortality is now proving to be far below that of the other epidemics in many geographies, particularly in lower income countries in sub-Saharan Africa. The concentration of the severity of COVID-19 on older age groups makes its impact in disease burden metrics such as DALYs (disability-adjusted life years) of far lower significance than that of the Fund’s major priorities. The predicted increases in transmission and mortality from HIV/AIDS, tuberculosis and malaria are due to reduced healthcare access and preventive measures during the COVID-19 response.”
“In my opinion, The Global Fund Response Mechanism running out of funds to fight COVID 19, as part of an integrated strategy, will pose an undeniable threat to fight and mitigate the impact of the disease and its negative effects in delivering HIV, TB and malaria programs to those more vulnerable and in need.”
What actions need to be taken to mitigate the impact of this?
“In order to mitigate the impact of COVID-19 and funding gaps, whatever money is there should be channelled into community-led and rights-based responses – also reflecting the most important lessons learned from the international Ebola response. Communities can react in real-time to new health threats, local women’s organizations know best what protection approaches work in their settings and community health workers are the ones who can help to prevent treatment disruptions.”
“The shortfall in funds directed at the COVID-19 response will have relatively less impact on the target populations of the Global Fund but the consequences of the further diversion of resources to this area from the higher-burden diseases could be relatively catastrophic. This situation could be addressed by returning to the Fund’s main focus areas whilst supporting tailored COVID-19 responses in recipient countries that concentrate on the most vulnerable but minimize disruption to existing essential services.”
“Actions should be directed to build and strengthen existing health service mechanisms and networks, optimizing financial and human resources, protecting life, improving logistics and supply change management to strengthen laboratory capacity for testing. It is also important to build strong monitoring and evaluation systems that do not create parallels between each country’s strategy as this duplicates efforts and burns out health workers which, overall, reduces the impact and effectiveness.”
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