Alarming annual Global Fund results: the way forward

Alarming annual Global Fund results: the way forward

The COVID-19 pandemic has reversed the progress made in the global HIV, TB, and malaria responses for the first time in two decades according to the 2021 Results Report released by  Global Fund to Fight AIDS, TB and Malaria today. However, the adaptations and work by communities mitigated some of the worst effects of COVID-19, showing us a way forward on what needs to be prioritised in Global Fund programming. 

Community-led responses are key

The Results Report confirms the importance of community-led responses for resilient health systems. In the Global Fund’s own words, “communities are devising new and innovative approaches for health services to be implemented safely – for instance, shifting to decentralized models of door-to-door health service delivery, or using digital platforms to conduct medical consultations with patients – and mitigate negative impacts on HIV, TB and malaria programs”. The Global Fund’s support to communities has been critical to sustain the provision of essential services and mitigate disruptions of key drugs and laboratory services. In Ghana, for instance, a community-led monitoring framework was developed to monitor quality, accessibility, and affordability of services while documenting human rights violations for referral to legal support services and psychosocial support. In Kenya, advocates used community-led monitoring to collect evidence on barriers to accessing health services and successfully referred hundreds of cases for legal support to a network of pro-bono lawyers.

Global fund global push to save lives

Curbing the effects of COVID-19

These are only a few examples of the amazing work done by communities to curb the effects of COVID-19 and serve the needs of key populations and people living with HIV, TB, and malaria.[1] These stories echo those of our COVID-19 response fund: strengthening health systems through community-led programmes, initiatives and interventions is paramount in responding to pandemics. Ultimately, as inequalities and human rights violations persist, communities are the ones ensuring that no one is left behind. They strive to reach the hardest to reach, bridge gaps in sustaining the provision of essential services, and challenge misinformation and stigmatisation.[2]

The reversed progress in cold facts

Despite the best efforts of the Global Fund partnership, last year the number of people reached by the Global Fund with HIV prevention services dropped by 11% compared to 2019. This comes at a time when prevention services need to be substantially scaled up. Mothers receiving medicine to prevent transmitting HIV to their babies dropped by 4.5% compared to 2019 and the number of people tested for HIV dropped by 22%, holding back HIV treatment initiation in most countries. What this means, in the long run, is that more people will be infected with HIV and fewer people will be diagnosed and put on treatment, which contributes to the ongoing transmission of HIV.

18 months into the COVID-19 pandemic, we expected that results would not be what we had hoped for. It is now well documented that COVID-19 increased inequalities and sexual and gender-based violence, both of which make people more vulnerable to HIV. From our work with partners, we know COVID-19 has had a significant impact on testing and prevention services for key populations who were already disproportionately affected by HIV. Still, seeing the Global Fund’s data is sobering.

Global Fund HIV testing fell in 2020

Reaffirming support in Global Fund

In this context, Aidsfonds reaffirms its total support in the Global Fund. If it weren’t for the Global Fund’s COVID-19 Response Mechanism, adaptation and mitigation efforts, investments in Resilient and Sustainable Systems for Health, innovative approaches such as multi-month dispensing of ARVs, and support to community-led responses, we would be even further off track. Thanks to the work of the Global Fund, we are witnessing some progress – for instance in the number of people receiving ARVs - and containment of the worst effects of the pandemic.

The way forward

While the current situation is grim, the central role of communities in delivering services shows us the way forward. We absolutely agree with UNAIDS’s assessment that we are entering a new era in the fight against AIDS and with the Global Fund, as it states that “just as 20 years ago, when the Global Fund partnership galvanized the world to fight the world’s leading infectious diseases, it is time for another global push to save lives.”

The implementation of the new Global AIDS strategy, which we welcomed, will be paramount to that end. The Global Fund is now in the process of developing its new Strategy for 2023-2028. We are convinced that if communities are meaningfully put at the centre, we can get back on track. Funding will be of the essence which is why we will advocate, and mobilise our partners, activists, leaders and donors to renew their political and financial commitment to an effective AIDS response, including by scaling up contributions to the Global Fund, ahead of its 7th replenishment next year.

[1] More examples of the work done by communities and the importance of their role can be found here: https://www.theglobalfund.org/en/blog/2020-05-12-amid-covid-19-communities-continue-fight-against-other-pandemics/

[2] More on why it is critical to address inequalities for the HIV response can be found here: https://www.theglobalfund.org/en/blog/2021-06-15-we-will-end-aids-only-if-we-reduce-inequality/

Learn more about how we support communities globally

We believe in local community solutions. People in the community know what does and doesn’t work in practice and are aware of the needs, sensitivities and challenges. That’s why we always put local communities at the heart of our programmes.

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