AIDS, tuberculosis, malaria: France is acting
The challenge remains immense, despite the progress made. We have been, and remain, at the forefront of the struggle for global health, through our expertise and our contributions to the multilateral funds, to meet Sustainable Development Goal 3 and end these pandemics.
The international community’s commitment, especially through the creation of the Global Fund in 2002, has helped bring about immense progress against major epidemics – we hope to end them by 2030.
But this progress remains fragile. Poverty, weak health systems, gender inequality, stigmatisation, human rights violations and more all reduce access to prevention, screening and treatment tools.
On top of that, the progress made over the past ten years is threatened by increased resistance to treatment and to insecticides.
So there is a real risk of a rebirth of the major pandemics. To counter this risk and to end pandemics by 2030, the Global Fund’s resources must be increased, as must domestic spending by States for health.
AIDS is the leading cause of death among women aged 15-44 around the world and among adolescents (aged 10-19) in Sub-Saharan Africa. Although AIDS-related deaths have halved since 2005, the disease still kills over 770,000 people per year. New cases are growing in around 50 countries. In 2018, 1.7 million people were infected for a total of 37.9 million people carrying HIV, of which only 23.3 million had access to antiretroviral treatment. That year, The Lancet’s HIV commission warned that there was a risk that the epidemic resume.
While the number of tuberculosis-related deaths has fallen by 37% since 2000, tuberculosis is currently amongst the 10 leading causes of death in the world, and the most lethal infection. In 2017, 10 million people were infected and 1.3 million people died – mostly amongst the most vulnerable populations. According to the WHO, multidrug-resistant tuberculosis (MDR-TB) is one of the biggest threats to global health security: 400,000 cases, of which only 160,000 have been detected.
Although half of the world’s population live in regions in which there is a risk of malaria transmission, the death toll has been reduced by 60% since 2000. But after years of constant reduction, malaria cases are once again rising. In 2016, the WHO warned about the risk of a further outbreak of the pandemic, with the number of cases up by five million on 2015. 219 million people were infected in 2017.
Pregnant woman and children continue to be the most affected subgroups. In 2017, two-thirds of the 435,000 people who died of malaria were less than five years old. Sub-Saharan Africa remains the hardest-hit region, with 93% of all malaria deaths (WHO, 2017).
Over recent decades, France has been actively working against HIV/AIDS, tuberculosis and malaria as a mainstay of its strategy for global health. This political and financial action is reinforced by our large contributions to multilateral funds.
The Global Fund to Fight AIDS, Tuberculosis and Malaria
Since its creation in 2002 on the initiative of France, the European Union and the G7, the Global Fund has saved 32 million lives and reduced the number of deaths per year due to AIDS, tuberculosis, and malaria by 40%.
The Fund has invested over 41.4 billion dollars from over 60 countries, the private sector and NGOs since 2002 to support national programmes to end AIDS, TB and malaria as epidemics in 142 countries. It is the main international investor in the fight against pandemics in developing countries, representing 20% of the total investment in fighting AIDS, 65% for tuberculosis and 57% for malaria.
A unique structure:
- The Fund’s Board includes not only donor countries and recipient countries, but also NGOs, the communities affected by pandemics, and the private sector, as voting members.
- In recipient countries, the funds are requested and their use is supervised by the Country Coordinating Mechanism: national authority representatives, technical and financial partners, the affected populations and the NGOs.
- The Global Fund does not intervene itself, but instead finances local structures to implement the funds. In Geneva, the Secretariat is composed of approximately 750 staff, responsible for day-to-day management, strategy implementation and organizational policies.
France provides key political and financial support for the Global Fund, of which it is a founding country and the second-largest contributor in the Fund’s history.
Due to the size of our financial support (over €4.61 billion since 2002), France has a permanent seat on the Board of the Global Fund and sits on two of the three permanent committees that prepare and monitor the Board’s work (the Strategy Committee and the Audit and Finance Committee). Within these forums, France defends the founding values of the Global Fund including the role of affected populations and civil society in drawing up and implementing the programmes, the situation of fragile countries and key populations, and a human rights-based approach.
Since 2011, part of our contribution is the technical expertise that we provide to member (or observer) states from La Francophonie who are also Fund recipients. We do this through our operator Expertise France and the ‘5% Initiative’ (Initiative 5%).
France showed its commitment to the Fund once again by hosting the 6th replenishment conference in Lyon on 9 and 10 October 2019. The donors pledged US$ 14.02 billion for the next three years. France also committed to increasing its contribution by 20% to reach US$ 1.429 billion. It is the largest amount ever raised for a multilateral health organization, and the largest amount by the Global Fund.
This replenishment conference took place at a critical time, when political and financial commitments of the international community were needed to avoid an outbreak of the pandemics. Its success is crucial if we are to meet the Sustainable Development Goals (SDGs) to put an end to AIDS and other large pandemics by 2030.
More information on the conference.
Unitaid, innovating for global health
International innovation is an important tool to reach the SDGs by 2030. Unitaid works to find and distribute means of preventing, diagnosing and treating HIV/AIDS, tuberculosis and malaria faster, more effectively and more cheaply to countries in the global South. The organisation is active in all the steps leading up to the larger-scale roll-out of these innovations. The Global Fund or any other donor or government can then fund implementation on a very large scale.
In their current strategy, Unitaid expanded its field of intervention (infant fevers, cervical cancer). About 11% of the portfolio comes from cross-cutting projects, mainly in partnership with the Global Fund and the WHO, or the Medicines Patent Pool, created by Unitaid.
Unitaid, a partner of the WHO, was launched in September 2006 following an initiative by France and Brazil. France is the organisation’s leading donor with over €1.7 billion in contributions since its creation (60% of the organisation’s resources since its creation)
Unitaid has close ties with innovative financing: France’s contributions are financed by the solidarity levy on airline tickets (specifically created for this occasion) as well as the financial transaction tax. These innovative financing mechanisms have paved the way in France for stable and predictable fundraising dedicated to global health and the fight against climate change, which are now under the umbrella of the French Social Development Fund.
Gavi, Global Alliance for Vaccines and Immunisation
The Global Alliance for Vaccines and Immunisation (GAVI), finances the introduction of vaccines to protect children in the world’s 73 poorest countries. This public-private partnership is aimed at saving the lives of children and protecting people’s health by increasing access to vaccines in poor countries. Since its creation, 760 million children have been vaccinated through GAVI and 13 million deaths have been prevented.
France joined the Alliance in 2004. Its financial contribution for the 2016-2020 period totals €465 million which includes one direct contribution (€100 million) as well as the use of an innovative financing mechanism.
France was one of the founding members of the Alliance and is the second-largest contributor in terms of volume to the International Finance Facility for Immunisation (IFFIm). The IFFIm receives donation pledges from donors over a long period which it converts, through bond issuance on securities markets, into funding which is immediately available for the GAVI Alliance. Between 2007 and 2026, France will have given €1.39 billion to the IFFIm.
Updated: 07 October 2019