Global Fund to Fight AIDS, Tuberculosis and Malaria

Baroness Jolly Excerpts

Tuesday 4th June 2013 Lords Chamber

[Baroness Jolly]

My Lords, I, too, thank my noble friend Lord Fowler for securing this well informed and timely debate. I realise that I am a newcomer to this field, and recognise that I am among experts with a wealth of experience. However, I hope that what I lack in both experience and expertise I can make up for in strength of feeling and enthusiasm.

I will take this opportunity to build on what the other speakers have said and emphasise the importance of the global fund in the fight against tuberculosis. Ninety per cent of international donor funding to fight TB comes through the fund, mainly because it is such an effective institution but also because TB does not get the profile or attention warranted by the devastation it causes. It is a disease closely associated with poverty, and 90% of cases are in developing countries. In 2011 there were almost 9 million cases of TB and the disease killed 1.4 million people. That is scandalous when you think that the majority of cases are curable with a course of cheap antibiotics. There are 22 high TB-burden countries in the world today, of which six are totally reliant on funding from the global fund, while two-thirds of the budget for the other 15 comes from global fund financing. Let us be clear: for many countries there would be no response to TB without the global fund’s support.

Last summer I was lucky enough to visit one of the projects supported by the global fund in Zambia. We visited St Luke’s Mission Hospital in Mpanshya, which serves a population of over 30,000 people and receives funding from the Churches Health Association of Zambia, or CHAZ, for its work on malaria, TB, HIV/AIDS and preventing mother-to-child transmission of HIV. CHAZ receives a grant from the global fund and is one of two principal recipients of such funding in the country. Through the grants that the global fund has distributed, CHAZ has brought about catalytic change in Zambia. Global fund-supported programmes have diagnosed and treated 44,000 new cases of TB, distributed 1.6 million bed nets to protect families from malaria since 2003, and provide lifesaving antiretroviral treatment to over 450,000 people living with HIV.

On our visit we heard from community health workers who included TB and HIV treatment supporters, traditional-birth attendants and former TB patients. These comments also reflect the observation of the right reverend Prelate the Bishop of Derby, because these people were church-based workers. They were based at this religious foundation, some 200 kilometres east of the capital. They carry out their work entirely voluntarily, covering long distances on foot in order to reach patients. Their commitment to improving the health of their communities was truly inspirational; but this is only one part of the global fund’s portfolio. It really brought home to me the important work that they do and the hope that the projects that they support brings to millions.

It is essential that this work continues in Zambia but also elsewhere. This replenishment year is critical for the future of the fund’s work. It announced in April that it will need $15 billion to tackle the three diseases for 2014-16. Speaking about the call for new pledges, the executive director of the global fund said:

“Innovations in science and implementation have given us a historic opportunity to completely control these diseases. If we do not, the long-term costs will be staggering”.

These costs are not just financial; they are costs in lives.

If this goal were achieved, it would mean that 17 million patients with TB and with multidrug-resistant TB could be treated, saving over 6 million lives over the three-year period; I cannot do the sums, but per day those numbers run to four figures. Some 1.3 million new HIV infections could be averted each year and 196,000 additional lives saved from malaria.

Of the money needed by the fund, the United States has signalled that it could pledge an unprecedented $5 billion. However, according to US law it cannot donate more than one-third of total contributions to the Global Fund. For the US contribution to become a reality, other donors must increase their contributions to commit the remaining funds. I echo the comments of my noble friend Lord Fowler: the UK Government have a key role to play. They can exert leverage on other donors by demonstrating their continued support for the Global Fund with an increased contribution of £1 billion for this replenishment period. An early summer announcement of increased UK funding at this key moment would lay down a marker for other Governments to follow.

This is just not my view. It was shared by the International Development Select Committee last year when it urged the Government to do all possible to commit funds early, and at a time that raises the most amounts of money from other donors. I urge my noble friend the Minister, for the reasons that I have just outlined, to do all in her power to ensure that the Government bring forward this anticipated increased contribution, ahead of the Summer Recess.