US defunding puts fight against AIDS, TB and malaria in jeopardy
Progress in tackling TB and other killer infectious diseases could be at risk as America and smaller donors pull back their supports, the Global Fund executive director has warned.
The fund, supported by Ireland and other EU countries as well as the Gates Foundation and private donors, spends around $5bn annually tackling AIDS, TB and malaria in over 120 countries.
Peter Sands warned: 'We actually ended 2024 with a real sense of momentum in the fight against TB, but since then we've had some major disruptions to ODA (official development assistance) and global health funding.
'So there is a real risk at this point as to whether or not we can sustain that momentum.'
While the covid-19 pandemic disrupted aid programmes, he said until recently there was 'a strong recovery' in TB statistics. President Trump's shock defunding of USAID and other programmes, as well as cuts by Britain and others, have changed that landscape.
Some 95% of HIV funding worldwide was either through the American PEPFAR funds or the Global Fund.
The sudden drop in American funding is 'a significant concern', according to Mr Sands. 'So in some countries for example we would buy the antiretroviral treatments (for HIV patients) and PEPFAR would pay for the clinics,' he said.
It means these gaps now have to be filled. Mr Sands visited Dublin this week to discuss Ireland's contribution to the fund's next three-year cycle. Ireland has donated over €339m since 2001.
He welcomed Ireland's donations and its 'active engagement' in the board and other works. 'There's a moral argument for stopping so many people dying from a disease we know how to treat and can stop,' he said.
'There's also a more self-interested argument that says we're playing with fire by not getting more on top of it.'
The fund buys from Ireland too including rapid diagnostic tests and medicines mainly for HIV programmes. Last year this came to about $4m (€3.5m). It also supports the buying of medicines at large-scale to negotiate lower prices.
For example, a year's supply of HIV antiviral treatment dropped from $10,000 per person per year in 2002 to about $35 now, he explained. 'So we continue to drive the cost down working with manufacturers,' he said.
Malaria is a particular concern as it is now spreading due to climate change. He added: 'It's the biggest killer of children in Sudan now.
To put in perspective, some of the poorest countries in the world are having an intensity of disease burden that feels like the worst of covid-19 all the time.
'If you go to hospitals and clinics in somewhere like Chad or northern Nigeria 50% to 80% of the activity in those health facilities is malaria all the time.'
In Ukraine, the fund supports a local NGO to run mobile health clinics especially for areas where hospitals were destroyed by the conflict.
'They have a significant HIV and TB challenge which has been made worse by the war,' he said.
Doctors had to develop 'quite sophisticated tracking systems' to make sure people continue to receive the right treatment even when they flee to safer areas, he said.
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