Now is not the time to cut funding for HIV and Aids

The Global Fund's decision to cancel grants will reverse the huge gains made in combating Aids, TB and malaria. It just doesn't make sense, either morally or economically.


Funding cuts threaten fight against Aids, TB and Malaria. Photograph: Christopher Furlong/Getty Images
This World Aids Day we have some reason to celebrate: fewer people are contracting HIV. This year the World health organisation reported that increased access to HIV services resulted in a 15% reduction of new infections over the past decade and a 22% decline in Aids-related deaths in the last five years. The tide of the epidemic is turning, and huge gains have been made in treatment, care and support.


But the world risks complacency on three of our most deadly diseases: HIV, TB and malaria. The gains made on HIV have been overshadowed by the decision last week by the Global Fund to Fight Aids, Tuberculosis and Malaria to cancel all new funding for the three diseases until 2014. A similar disregard for health spending has been demonstrated by world leaders gathered in Busan this week to discuss aid effectiveness, indicating that developments at the Global Fund are symptomatic of a wider trend for global leaders to take their eyes off the ball with respect to health.


The Global Fund has for the first time in its 10-year history cancelled funding in its next round and suspended grants to life-saving projects and services because of a failure by donors to meet their commitments.


At the 25th meeting of the Global Fund's board in Accra, Ghana, last week, it voted to cancel all plans for new grant-making until 2014. Two billion dollars is needed to pay for all requests for funding up to 2014.


This is devastating. The fund is the life-blood of HIV, TB and malaria prevention, treatment and care in the developing world. It is the source of no less than 80% of all TB funding, three-quarters of funding for malaria and half of HIV and Aids funding – it is the second biggest funder of HIV and Aids after the US president's emergency plan for Aids relief.


This could sound the death knell for any hopes we had of reaching the millennium development goals on health by the 2015 deadline.


The case for transforming the Global Fund into a sustainable response to the three diseases is a powerful one; this is not in question. Pressure has been coming from donors in response to the fund's own transparent reporting of misuse of monies and corruption by recipients. The fund has reacted robustly, quickly commissioning an independent body to assess its financial controls.


Recommendations from this high-level panel on fiduciary controls and oversight mechanism were focused on evolving the fund from an emergency response to a more sustainable aid one.


But is it right to have a sustainable response that will effectively mean the end of countless projects in the developing world, the loss of countless lives?


In a small country facing major health challenges such as Burundi, the impact could prove catastrophic. The Burundi national TB programme is almost entirely funded through early grants from the Global Fund and was slated to apply for renewal funding next year. Other countries set to apply for new funding to continue expanding Read more