The role of private philanthropy in the Global Fund – A call to Action at the World Economic Forum

Here’s a message that always bears repeating: the contributions of private philanthropy, though only 2% of global resources for HIV/AIDS, are catalytic. These resources are invaluable to progress in global health. Consider, for example, the role of private philanthropy in the Global Fund to Fight AIDS, Tuberculosis and Malaria.

To date, the private sector has contributed over $2.7 billion to the Global Fund. In addition to financial resources, the private sector also has provided invaluable technical expertise in key areas such as strengthening supply chains and providing innovative solutions to tracking health data.

“When it comes to backing high risk science and staying patient, philanthropy can complement the government, and serve as a bridge to the private sector.” – Bill Gates[i]

But even with these contributions, and despite the incredible progress the Global Fund has helped to achieve since its inception in 2002, we face an uphill climb. Currently, we are not on track to reach the 2030 global health targets set out by the Sustainable Development Goals (SDGs).

The Global Fund is now embarking on its Sixth Replenishment, an effort to raise the necessary funds to continue fighting AIDS, TB and malaria between 2021 and 2022, years that are critical to SDG-related progress. It has determined that $14 billion is what will be required; these resources would help to save 16 million lives, avert 234 million infections and help the world get back on track toward meeting global health goals. Of that amount, Global Fund Executive Director, Peter Sands, called upon the private sector to mobilize at least $1 billion.

At the recent World Economic Forum, he delivered a strong call to action.

“Infectious diseases aren’t static,” he explained during a panel entitled Financial Innovation for Global Health. “You are either winning against them or they are beating you.”

Though innovative mechanisms like the Global Fund have helped to drive remarkable advancements in global health, the evolving landscape requires that the private sector not just maintain but rather increase resources to fight AIDS, TB and malaria.

Yet, more than three decades into the fight against HIV and AIDS, we still face significant challenges. In fact, the environment in which we work is, arguably, as complicated as ever.

Ill-informed policies, such as the reinstated “Global Gag” rule, pose barriers to progress. [1] Furthermore, while donor government support for HIV/AIDS in low- and middle-income countries increased in 2017, it was primarily due to the timing of the U.S. government primarily due to the timing of the U.S. government contribution and is not expected to continue, despite the fact that these areas of the world are among those most heavily impacted by the epidemic.

In addition, the trajectory of the HIV/AIDS epidemic itself has changed. As Bill Gates explained in Davos, the most likely person to contract HIV today is an adolescent girl in Eastern or Southern Africa. The root causes of this are, as he described them, “a horrible cocktail of all the gender inequalities you can think of.” This trend represents significant risk. According to the Global Fund’s investment case, “If we don’t prevent teens, particularly girls, from getting infected with HIV, the massive increase in the youth population in Africa will lead to more new infections than at the height of the epidemic in the early 2000s.”

Effectively reaching those most impacted by HIV and AIDS requires the difficult work of breaking down social and structural barriers that put vulnerable populations at greater risk. It requires tackling the stigma and discrimination that fuel the epidemic. It requires innovation, collaboration and, of course, resources.

The Global Fund’s investment case puts it in stark terms: “Either we act now to protect and build on the gains we have made, or we see those achievements eroded, infections and deaths resurge, and the prospect of ending the epidemics disappear.”

Contributions from the Gates Foundation will likely comprise the vast majority of the $1 billion in private sector resources the Global Fund expects to raise during this Replenishment cycle. But it is imperative that the broader private philanthropic community join in this effort. Now, more than ever, the private sector must increase support and leverage its unique abilities to respond. We must, as the Global Fund’s new campaign indicates, Step Up the Fight.

“Investing in global health is one of the best investments the world can make. Every US dollar invested in the Global Fund over the 2021 to 2023 period will have a return in broader economic gains of US$19, and of US$2 dollars in direct productivity gains. In addition to saving millions of lives, that’s an amazing return on investment.”

– Peter Sands

[1] The “Global Gag” rule, previously known as the Mexico City Policy and more currently as the Protecting Life in Global Health Assistance policy, restricts international organizations receiving US funding from performing or promoting abortion services. For more details: https://www.kff.org/global-health-policy/fact-sheet/mexico-city-policy-explainer/

[i] https://www.devex.com/news/bill-gates-makes-the-business-case-for-breakthroughs-in-global-health-91850