As part of the UN Agenda for Sustainable Development, the international community set itself the ambitious goal of eradicating HIV, tuberculosis and malaria by 2030.

Despite the extraordinary progress that has already been made, ending these pandemics and achieving the broader goal of ensuring the health and well-being of all requires the ramping up of efforts to support nations in building resilient and inclusive health systems.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private partnership, has contributed substantially to this effort, by massively scaling up prevention and treatment.

In nations where the fund invests, 18.9 million people received antiretroviral therapy for HIV last year, 5.3 million tuberculosis patients were treated and 131 million mosquito nets were distributed.

These efforts have proved tremendously effective in reducing these pandemics’ death tolls. The latest figures indicate that 32 million lives have been saved since the fund’s creation in 2002.

Over the past decade, the annual number of deaths from HIV, tuberculosis and malaria have been lowered by about a half.

Yet, we are still not on track to eliminate HIV, tuberculosis and malaria by 2030. To achieve this goal, we must not only expand access to treatment drastically; we also need to achieve a sharp reduction in new infections.

Success requires clear political leadership and sustained investment in critical capacities, such as well-trained community health workers, cost-effective supply chains, quality data systems and well-equipped laboratories.

To ensure that health services reach the poorest and most marginalized, barriers to access — such as user fees, human rights-related impediments or gender inequality — must be dismantled. Active community engagement is essential.

Of course, there is no one-size-fits-all solution. Nations and communities need to devise strategies that account for their residents’ needs and reflect the particular disease threats they face.

Moreover, no single external development partner can provide all of the necessary support.

That is why we are calling for innovative coalitions comprising multilateral and bilateral development organizations that leverage their complementary strengths to bolster national capacities.

Such coordinated support is needed most urgently in regions — such as the Sahel in sub-Saharan Africa — that have weak institutions and infrastructure, and that are particularly vulnerable to security threats and environmental crises.

In the Ivory Coast, the fund and Agence Francaise de Developpement (AFD) have invested in building, together with the Ivorian government, a regional bureau for the national medical drug-supply center. This facilitates treatment delivery as close as possible to communities, thereby strengthening the health authorities’ capacity to reach the most vulnerable in a sustainable way.

In the same vein, the AFD and the fund are supporting the Nigerien Ministry of Public Health in its efforts to expand access to health products and strengthen the national laboratory network, thereby improving diagnosis, including for HIV/AIDS, tuberculosis and malaria.

By ensuring synergy among activities and preventing duplication of efforts, we can support Niger in strengthening its health system, including at the community level.

Avoiding silo-based activity is the raison d’etre of the partnership agreement between the fund and the AFD. Under the leadership of national health authorities, we are pursuing greater convergence and synergy among programs to fight HIV/AIDS, tuberculosis and malaria, such as those the fund finances, and initiatives to strengthen health systems, such as those in which the AFD invests.

Underscoring the extent to which these two areas are interconnected, the fund is already the largest multilateral provider of grants for strengthening health systems, investing more than US$1 billion per year.

By combining our organizations’ strengths, we are reaffirming our commitment to ensuring effective cooperation and coordinated action to eradicate HIV, tuberculosis and malaria, and to building strong and resilient health systems, particularly in the most vulnerable nations.

The international community has a shared responsibility to fulfill its commitments without leaving anyone behind.

To end HIV, tuberculosis and malaria epidemics by 2030, a business-as-usual approach would not suffice. We must step up the fight.

That means investing more in health systems and forging effective new partnerships, such as the one between the AFD and the fund.

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PARIS — As part of the United Nations Agenda for Sustainable Development, the international community set itself the ambitious goal of eradicating HIV, tuberculosis and malaria by 2030. Despite the extraordinary progress that has already been made, ending these pandemics and achieving the broader goal of ensuring the health and wellbeing of all will require ramping up efforts to support countries in building resilient and inclusive health systems.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private partnership, has contributed substantially to this effort, by massively scaling up prevention and treatment. In countries where the Global Fund invests, 18.9 million people received antiretroviral therapy for HIV in 2018, 5.3 million tuberculosis patients were treated and 131 million mosquito nets were distributed.

These efforts have proved tremendously effective in reducing these pandemics’ death toll. The latest figures indicate that 32 million lives have been saved since the Global Fund’s creation in 2002. Over the last decade, the annual number of deaths from HIV, tuberculosis and malaria have been lowered by about half.

Yet we are still not on track to eliminate HIV, tuberculosis and malaria by 2030. To achieve this goal, we must not only expand access to treatment drastically; we also need to achieve a sharp reduction in new infections.

Success will require clear political leadership and sustained investment in critical capacities, such as well-trained community health workers, cost-effective supply chains, quality data systems and well-equipped laboratories. To ensure that health services reach the poorest and most marginalised, barriers to health access — such as user fees human rights-related impediments or gender inequalities — must be dismantled. Active community engagement will be essential here.

Of course, there is no one-size-fits-all solution. Countries and communities need to devise strategies that account for their residents’ needs and reflect the particular disease threats they face.

Moreover, no single external development partner can provide all of the necessary support. That is why we are calling for innovative coalitions comprising multilateral and bilateral development organisations that leverage their complementary strengths to strengthen national capacities. Such coordinated support is needed most urgently in regions — for example, the Sahel in Sub-Saharan Africa — that have weak institutions and infrastructure, and that are particularly vulnerable to security threats and environmental crises.

In Côte d’Ivoire, the Global Fund and the Agence Française de Développement (AFD) have invested in building, together with the Ivoirian government, a regional bureau for the national medical drug-supply centre. This will facilitate treatment delivery as close as possible to communities, thereby strengthening national health authorities’ capacity to reach the most vulnerable in a sustainable way.

In the same vein, the AFD and the Global Fund are supporting Niger’s Ministry of Public Health in its efforts to expand access to health products and strengthen the national laboratory network, thereby improving diagnosis, including for HIV/AIDS, tuberculosis and malaria. By ensuring synergy among activities and preventing duplication of efforts, we can support Niger in strengthening its health system, including at the community level.

Avoiding silo-based activity is the raison díêtre of the recent partnership agreement between the Global Fund and the AFD. Under the leadership of national health authorities, we are pursuing greater convergence and synergy among programs to fight HIV/AIDS, tuberculosis and malaria, such as those the Global Fund finances, and initiatives to strengthen health systems, such as those in which the AFD invests. Underscoring the extent to which these two areas are interconnected, the Global Fund is already the largest multilateral provider of grants for strengthening health systems, investing well over $1 billion per year in the cause.

By combining our organisations’ strengths, we are reaffirming our commitment to ensuring effective cooperation and coordinated action to eradicate HIV, tuberculosis and malaria, and to building strong and resilient health systems, particularly in the most vulnerable countries. The international community has a shared responsibility to fulfill its commitments without leaving anyone behind.

To end the HIV, tuberculosis and malaria epidemics by 2030, a business-as-usual approach will not suffice. We must step up the fight. That means investing more in health systems and forging effective new partnerships, such as the one between the AFD and the Global Fund.

Rémy Rioux is chief executive officer of the Agence Française de Développement. Peter Sands is executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. 

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I may be retired from the news business, but I still know a good story when I see one. Reports now tell us that more children than ever are growing up free of deadly diseases such as AIDS, tuberculosis, and malaria.

Just 20 years ago, a very different picture was being painted. AIDS was ravaging an entire generation; hundreds of thousands of children were dying before their 5th birthday simply due to a single bite from a malaria-infected mosquito; and TB spread like wildfire in many impoverished communities, leaving family members sick and unable to work.

My dear friend, the late former United Nations Secretary-General Kofi Annan called the fight against this loss of humanity “the greatest challenge of our generation” and quickly asked the United Nations Foundation, which I had recently launched at the time, to help be a part of the solution.

We joined with a range of partners to support the Global Fund to Fight AIDS, Tuberculosis and Malaria, which brings together governments, advocates, and experts to mobilize resources, coordinate efforts, and invest in innovative programs that are turning the tide against these three devastating diseases.

The work of the Global Fund has changed the landscape when it comes to AIDS, TB, and malaria: 18.9 million more people are now living long lives with HIV treatment and 131 million mosquito nets were distributed just last year to protect children around the world from the threat of malaria. Because of public and private sector partners uniting to take a stand, the Global Fund partnership has saved nearly 32 million lives and reduced the number of deaths caused by these three diseases by 40% in countries where the Global Fund invests its support.

Think about that: 32 million lives saved. That’s more than three times the population of the state of Georgia being given the opportunity to live healthy, productive lives all because people came together in partnership to fight, refusing a world where AIDS, TB, and malaria are allowed to destroy our communities.

This is a good news story so far — but how it ends is still to be determined. Right now, the progress we’ve made against these diseases is very fragile and, in some cases, such as with malaria, it’s stalled due to insufficient resources and lack of political will to carry on the fight.

It’s up to all of us to decide whether we protect the progress we’ve made and keep moving forward or become complacent and watch on as these diseases gain ground once again. If we lose progress on health, so much more around the world is at risk — from the stability of communities to the productivity of businesses.

We’re a mere 10 years out from the 2030 deadline to achieve a better future for people and our planet to which we committed under the Sustainable Development Goals – the world’s shared to-do list, adopted by nations worldwide four years ago. The success of the Global Fund’s efforts is linked to the success of these global goals — from ending poverty to achieving gender equality to ensuring health for all.

On Oct. 10 in Lyon, France, many countries and private sector partners stood up for progress, pledging more than $14 billion for the Global Fund’s work over the next three years. While these pledges are very important, they are not enough. All of us, especially engaged citizens like you and me, need to keep raising our voices to make sure that the fight against AIDS, TB, and malaria remains a priority on the global agenda.

We need others to step up the fight and contribute to achieving the world that my friend Kofi envisioned. We need more compassion, more engagement and most importantly, more collective action than we currently see in our often-fractured world. I call on private sector partners, country governments, and global citizens to help us all deliver on our promise for a better world.

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The UN objective of ending epidemics of the three ailments by 2030 remained within reach, he told a two-day donor meeting in the city of Lyon, if countries stepped up to the plate with a sum of $14-billion.

But with the conference due to wind up in the afternoon, the French president indicated there was a race against the clock to reach the target. Based on pledges so far “we are not there”, Macron told delegates.

“The funds that are being asked of us are not… charity. It is a decision to invest against injustice,” said the president, highlighting the disproportionate rate of infection and deaths from AIDS, TB and malaria in poor countries, and among women and girls.

“What we want to do is to make AIDS, tuberculosis and malaria disappear from the face of the Earth,” he added to applause, and announced that France, the fund’s number-two donor, will boost its own contribution by 15 percent.

“The multilateral system is tired,” Macron lamented.

He complained that resolve has weakened in many rich donor countries given that fewer people there are dying of the three diseases and that treatment, particularly for HIV, was readily available.

But they remained rampant in the developing world. “There is a risk of slackening,” he said.

The Fund says $14 billion would help save 16 million lives and avert 234 million new infections.

According to the UN’s World Health Organization, 770,000 people died of HIV-related causes last year. Tuberculosis, a high risk for HIV-positive people, claimed some 1.7 million lives in 2017, and malaria more than 430,000.

The meeting is the sixth to replenish the fund since it was set up in 2002, with prominent supporters including Microsoft founder Bill Gates and U2 lead singer Bono in attendance alongside a number of African heads of state.

But officials said collecting such a large sum could prove challenging, especially as global attention moves from AIDS towards fighting climate change.

Anything more than the $12.2 billion pledged at the fund’s last meeting three years ago in Montreal “will be considered a success”, said an official in the French presidency.

Macron, however, insisted yesterday that $14 billion “is the minimum”, and warned: “I will not allow anyone to leave this room, nor Lyon, until the $14 billion has been obtained.”

NGOs insist even more is needed — as much as $18 billion.

Peter Sands, executive director of the Fund, warned delegates on Wednesday that the world was at a crossroads: “Do we step up or do we slip back against adversaries as formidable as HIV, TB and malaria? There is no middle ground. We’re either winning or losing.”

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The commitments were made on Thursday at the Global Fund’s Sixth Replenishment Conference held in Lyon, France.

“I welcome the commitment made by so many donors under the auspices of France to fully finance the Global Fund for the next three-year period”, said Tedros Adhanom Ghebreyesus, Director-General, of UN health agency, WHO.

“This is critical to provide individuals and communities with the health interventions they need to prevent, diagnose and treat HIV, TB and malaria and to build better and stronger health systems”, he added.

Peter Sands, Executive Director of the Global Fund, said that “everyone in the room today felt the power of a global community coming together to say in one voice: ‘We will end these epidemics’”.

The international partnership raises, manages and invests money to support programmes in more than 100 countries that address the three diseases, mostly in sub-Saharan Africa.

The Fund reported that many donors at the conference stepped up their pledges, citing the urgency to take decisive action.

For example, the United States will provide $1.56 billion a year, maintaining more than 30 per cent of all contributions. France’s pledge of $1.29 billion included an extra $60 million announced by President Emmanuel Macron in a final push to meet the overall $14 billion target.

Private donors also pledged more than $1 billion, which is a Global Fund first. The Bill & Melinda Gates Foundation led efforts with a pledge of $760 million, while (RED) pledged US$150 million, alongside supporters such as Comic Relief, prominent businessman Sri Dato Dr Tahir, and the global pharmaceutical company, Takeda.

Replenishing the Global Fund is critical, said the World Health Organization chief: “It’s not just an investment in one organization or three diseases; it’s an investment in our shared vision of a healthier, safer and fairer world. Ultimately, it’s an investment in people”.

Maurine Murenga, who was diagnosed with HIV in the early 2000s, and who serves on the Global Fund Board, thanked all partners for recognizing the need to focus investments in programmes that specifically address the disproportionate effects of HIV on women and girls.

“Those of us who survived HIV are here thanks to the Global Fund, but millions are still dying unnecessarily because they cannot access these life-saving programs,” she said.

“Young women and girls have to be at the center of the response to HIV in Africa. It is unacceptable that young women and girls are still twice as vulnerable to HIV in sub-Saharan Africa and six times more vulnerable in the worst hit countries. We know change is possible and we have to act now.”

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The Global Fund to Fight AIDS, Tuberculosis and Malaria on Wednesday opened a drive to raise $14 billion to fight the global epidemics but face an uphill battle in the face of donor fatigue.

Host President Emmanuel Macron is to chair the final day of the two-day meeting in the French city of Lyon on Thursday and meet African heads of state.

The fund has asked for $14 billion, an amount it says would help save 16 million lives, avert “234 million infections” and place the world back on track to meet the UN objective of ending the epidemics of HIV/AIDS, tuberculosis and malaria within 10 years.

“I count on every one of you to bring together the financing necessary to give the Global Fund the means necessary to support the worst affected countries,” said French Health Minister Agnes Buzyn as the meeting opened.

“We are here to send a strong signal. A collective, universal and ambitious signal,” she added. 

The UN’s World Health Organization says 770,000 people died of HIV-related causes last year. Tuberculosis, a high risk for HIV-positive people, claimed some 1.7 million lives in 2017, and malaria more than 430,000.

– ‘Anything more a success’ –

The meeting is the sixth to replenish the fund since it was set up in 2002, with prominent supporters including Microsoft founder Bill Gates and U2 lead singer Bono in attendance.

But officials said ahead of the meeting that collecting such a large sum could prove challenging, especially as global attention moves from AIDS towards fighting climate change.

Anything more than the $13 billion pledged at the fund’s last meeting three years ago in Montreal “will be considered a success”, said an official in the French presidency.

Macron, however, made it clear at the UN General Assembly in September that he expected no less than $14 billion, saying “no-one any longer can understand” that people are unable to access medicines for the deadly disease trio.

NGOs insist even more is needed — as much as $18 billion. 

– ‘Less not acceptable’ –

Some countries have announced their contribution. The US is the number one donor with a $4.68 billion contribution voted by Congress.

Britain is set to pledge $1.7 billion and Germany $1.1 billion. It remains to be seen what France will contribute, although Macron has vowed it will be worthy of the country’s historical status as the Fund’s number two donor.

France also wants the private sector to play a bigger role, and the fund is seeking $1 billion of the total from the business world.

“No amount less than $14 billion will be acceptable,” the AIDES and Coalition PLUS NGOs said in a statement, urging France to ramp up its contribution by 25 percent.

“We are here to remember that behind this financial bargaining there are human lives,” said AIDES president Aurelien Beaucamp.

AIDES said that as things stand now, the meeting risks falling $200-$500 million short of its target.

Macron will meet leaders including Niger President Mahamadou Issoufou and Cameroon President Paul Biya, while Rwandan President Paul Kagame is also set to be in attendance.

The Global Fund groups states, NGOs and private firms to support public health programmes around the world, investing about $4 billion every year.

It says it has helped save 32 million lives and provided prevention, treatment and care services to hundreds of millions of people, while the number of deaths caused by AIDS, TB and malaria each year has been reduced by 40 percent since 2002 in countries where the Fund invests.

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It has been difficult to scroll through my newsfeed on social media for the past couple of months without feeling alarmed. In Bangladesh, a dengue fever outbreak was dire. There was panic, with people urgently seeking blood, information on which hospitals had available beds, and complaining about the rising prices of mosquito repellants. On a single day in August, nearly 2,500 dengue patients were admitted in hospitals in the country, breaking all records. It has been the worst outbreak in the country’s history.

Dengue is a mosquito-borne viral infection with flu-like symptoms, which can cause lethal complications especially among children, the elderly, and pregnant women.

In the last 50 years there’s been a 30-fold increase in dengue cases. Among an estimated 2.5 billion people at risk for dengue, 70 percent of them are in the Asia-Pacific region.

The numbers are telling:

• Philippines declared an epidemic, with 622 deaths, and dengue affecting a staggering 146,000 people.
•  In Thailand this year, the numbers doubled from last year to 20,000 cases, with children suffering the most.
• From January to August, 200,000 people in Sri Lanka contracted dengue, and more than 100 died.

There is no specific treatment for dengue, but early detection and proper medical care can lower mortality to below one percent.

Changing patterns of rainfall, humidity and temperature linked to climate change are leading to longer breeding spells for the mosquito species that carries the virus, and shortening disease incubation times.

This is causing dengue epidemics to become much more unpredictable in terms of when and where they occur, and their scale, overwhelming health systems.

Rapid and unplanned urbanization, living conditions for the urban poor and lack of sanitation are all contributing to a surge in numbers of people catching vector-borne diseases such as dengue.

Governments are responding to these outbreaks the best they can. Emphasis has been on effective vector control, mass media awareness campaigns, and strengthening health systems to deal with the increasing numbers of patients.

However, preparedness is key, and early warning systems are essential to increase our ability to predict, detect early and respond to outbreaks.

Viet Nam is pioneering a system that can serve as a model for other countries. The country is using satellite data on precipitation and atmospheric pressure, combined with health and water information to produce a dengue-forecasting model designed for this new reality.

The initiative is supported by the UNDP, the World Health Organization, the UK Space Agency, HR Wallingford, the London School for Hygiene and Tropical Medicines, the UK Meteorological Office and Oxford Policy Management.

The innovative approach looks at dengue and the health effects of climate change as an interaction between the environment and public health.

When complete, beneficiaries will be able to receive alerts for dengue outbreaks, and policy-makers will be able to look at assessments of vector-borne disease risk under future climate and land-use change scenarios.

A recent study estimated that two billion more people could be affected by dengue by the year 2080, and that increase comes largely comes from population growth in areas already at risk.

The world can learn from Viet Nam.

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Britain is pledging almost half a billion pounds a year to fight Aids, malaria and tuberculosis around the world.

Announcing the funding at the G20 summit in Japan on Saturday, Theresa May will call on leaders of the world’s largest economies to step up their own efforts to tackle the deadly diseases.

The UK’s three-year pledge will see around £467m a year given to the Global Fund, which provides medication for over 3 million people living with HIV, as well as treatment and care for 2 million people with tuberculosis, and 90 million mosquito nets to prevent malaria.

The prime minister is to tell G20 leaders: “We need urgent international action and a truly collective response if we are to tackle threats to global health security, prevent infections spreading across borders, and halt the continued spread of deadly diseases.

She will ask them to “follow the UK’s lead in supporting the vital work of the Global Fund and its relentless efforts to tackle Aids, malaria and tuberculosis around the world”.

The Global Fund says it needs to raise another £11bn at a conference in Lyon, France, in October, if it is to keep its work on track.

In 2016, Britain pledged to contribute £1.1bn over three years to the Global Fund to fight Aids, malaria and TB.

Since 2002, the fund is believed to have helped save more than 27 million lives in over 100 countries and to have reduced the number of deaths from the three diseases by more than a third. 

But Aids, malaria and tuberculosis continue to claim around 2.5 million lives a year, with a child dying from malaria every two minutes.

Billionaire philanthropist Bill Gates said the UK’s pledge was “a positive step forward in the global fight against these diseases, and will help to save millions of lives”.

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