Spotlight on Global Fund Replenishment: an Interview with Chris Collins, Friends of the Global Fight

Every three years, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the world’s largest global health funder, embarks on an effort to mobilize the resources it needs to fight AIDS, tuberculosis and malaria. Later this year, France will host the 6th such Replenishment, where donor countries and the private sector will pledge their contributions. Earlier this year, at the Replenishment Preparatory meeting in New Delhi, the Global Fund announced its fundraising target of a minimum of $14 billion. Of that, it is asking for $1 billion from the private sector.

Recently, FCAA had the opportunity to speak with Chris Collins, President of Friends of the Global Fight, an organization advocating for U.S. investment in the Global Fund. Below, read what Chris had to say about Replenishment and the important role the private sector has played – and must continue to play – in the Global Fund’s efforts.

The Global Fund investment case was recently shared. What can you tell us about the funding targets, specifically those set for HIV/AIDS? 

Each fundraising cycle, the Global Fund undertakes a modeling exercise in order to determine progress to date and what resources will be required to achieve global health goals going forward. Through this process, it was determined that, in order to get the world back on track with all three epidemics, at least $14 billion is required between 2020 and 2022.

For HIV, in particular, the Global Fund identified some really important priorities. The world has made progress toward meeting the 90-90-90 targets. Where we’ve built programs to scale, we’ve seen results. But HIV infection rates remain far too high with 1.8 million people still infected each year. We need to do a variety of things in order to change this. We need to focus on the groups that are most affected, such as adolescent girls and young women in Africa. We need to think about things in a new way.

The goal set for private sector resources as part of Replenishment is $1 billion. Can you tell us the business case behind that target?

The private sector has been hugely supportive of the Global Fund in the past. Since the Global Fund’s inception in 2002, the private sector has contributed $2.7 billion, which is incredibly significant. During the last Replenishment, the private sector doubled its commitment. So, we are on the right track. But Peter Sands, the Global Fund’s Executive Director, feels we can do even better.

There are a lot of reasons why working with the Global Fund is an attractive prospect for the private sector. For one thing, like the private sector itself, the Global Fund is very bottom line and results oriented. In addition, the Global Fund has always involved the private sector in its work in a variety of ways. It does so, for example, by sharing its expertise in areas like supply chain, procurement and IT. In addition, there is a private sector delegation to the Global Fund Board, so they are involved in setting policy, as well. And, of course, better health and stronger health systems provide opportunities for the growth and expansion of the private sector into new countries.

What are the key milestones between now and Replenishment of which FCAA members should be aware?

We just completed one important milestone – the Replenishment Preparatory Conference in New Delhi. It was the first time this meeting has been hosted in an implementing country. India has really stepped up in addressing its own tuberculosis epidemic. Having the meeting there was an important acknowledgement of that progress.

The meeting was intended, in large part, to lay out the investment case. And, by all accounts, it was very successful. Luxembourg, the first country to pledge its contribution in this cycle, increased financing to the Global Fund by 11 percent. Ireland then pledged to increase its contribution 50%. These are all very positive signs.

As you might expect, though, we are eager to hear from the big donors – Germany, the EU, France, Italy, Japan, the UK – about what they plan to do. In order to counteract new threats that have slowed progress and enabled the diseases to gain ground, such as shortfalls in funding and increasing insecticide and drug resistance, we are really looking for increases from all the big donors. But these decisions will be made as part of the various countries’ budgeting timelines and each one is different.

The U.S. is, of course, the largest donor to the Global Fund. And, while it has always received strong, bipartisan support, we don’t know whether the Administration will make a pledge this year. The President’s FY20 budget is set to come out the week of March 11, so we will soon see. But regardless of what is requested in the President’s Budget, Congress will make the final funding decision and it has consistently rejected steep cuts to the Global Fund. My organization, Friends of the Global Fight, is working very closely with Congressional appropriators to ensure that the Global Fund receives $1.56 billion for each of the next three years. This is consistent with the U.S.’ role as a leader in fighting the three diseases. Former Senate Majority Leader, Bill Frist recently spoke to the importance of U.S. leadership in global health, saying:

“I support President Trump’s pledged investment in domestic public health but believe we must also continue to build on our nation’s 15 years of global leadership in combating HIV/AIDS. Around the world, there are still nearly 37 million people living with HIVmore than 900,000 AIDS-related deaths a year and nearly 1,000 adolescent girls and young women infected with HIV every day. We can and must lead the global fight to end this pandemic.”

How can private funders engage with the Global Fund around Replenishment?

One of the single most important things the private sector can do is to fund advocacy. It is going to take the concerted effort of many groups to get the U.S. and other governments to increase their pledges. It is a unique opportunity to drive necessary funding into global health. But we won’t be able to do that without a strong advocacy effort.

Funders should also consider what their own organizations can do in terms of advocacy. Keep an eye out for sign on letters and other activities, which allow you to offer your support. The more voices we can get from different constituencies, the better. The next two to three months will be a particularly good time to undertake some of these activities.

One trend that we see in our resource tracking data is that the concentration of funders is very small – in 2017 the top 20 funders were responsible for 89% of the funding – and over the years, we’ve seen a number of funders leave the field of HIV and AIDS. Is this a trend that you’ve seen in terms of private sector engagement in the Global Fund?

Overall, donor aid for HIV has flatlined, at best. But, we’ve seen real continued enthusiasm for the Global Fund among policy makers. The Global Fund has helped to connect the dots, showing how a robust response to HIV, and ramping up to eventually end the epidemic, is a pathway to expanding primary care and, ultimately, achieving universal healthcare. Policy makers can see a demonstrable return on investments made in HIV.

But we need to make clear that there is no time to move backward. We need robust civil society engagement, to amplify the voices of marginalized populations and those most impacted by HIV, and we need to talk about the consequences of decreased funding. We can’t let up.

We also need to articulate how to use the fight against HIV as a way to achieve wider global health goals. Investing in the Global Fund, and in HIV in particular, is an important tool to achieving these other critical goals.