{"id":6596,"date":"2018-09-13T05:52:55","date_gmt":"2018-09-13T09:52:55","guid":{"rendered":"http:\/\/plataformalac.org\/?p=6596"},"modified":"2018-09-20T19:24:49","modified_gmt":"2018-09-20T23:24:49","slug":"peter-sands-calls-for-increases-in-funding-from-implementing-countries-and-for-healths-share-of-oda","status":"publish","type":"post","link":"https:\/\/plataformalac.org\/en\/2018\/09\/peter-sands-calls-for-increases-in-funding-from-implementing-countries-and-for-healths-share-of-oda\/","title":{"rendered":"Peter Sands calls for increases in funding from implementing countries and for health\u2019s share of ODA"},"content":{"rendered":"
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Source: aidspan.org<\/a><\/div>\n
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Author:\u00a0<\/strong>\u00a0Ad\u00e8le Sulcas<\/span><\/div>\n<\/div>\n<\/div>\n
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Global Fund Executive Director says resilient health systems must be funded domestically<\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n
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\u201cIt is a false dichotomy to have a tension between Universal Health Care or \u2018ending the epidemic\u2019,\u201d said Global Fund Executive Director Peter Sands at the 22nd<\/sup>\u00a0International AIDS conference, where scores of formal and thousands of informal discussions focused on the need to integrate HIV testing, care and treatment into the broader global health agenda.<\/p>\n

\u201cWe will not succeed in ending HIV if we do not build the UHC platform,\u201d Sands said, as a speaker on the panel of a session called \u2018Eliminating the HIV epidemic on the road to Universal Health Care\u2019. Describing the Global Fund\u2019s mandate \u201caround ending the epidemics of HIV, TB and malaria\u201d, Sands said the Fund recognizes that \u201cthat can\u2019t be done without building the component parts of a health system\u201d.<\/p>\n

In two major symposia as well as in a communities\u2019 \u2018networking zone\u2019 townhall-style meeting, Sands repeatedly broadcast another message: That financing for the ongoing global fight against HIV \u2013 and by extension towards UHC \u2013 must be increased. It was widely acknowledged at this conference, including by the International AIDS Society-Lancet<\/em>\u00a0Commission on strengthening the HIV response in the context of a broader global health agenda, that funding for HIV globally has stagnated.<\/p>\n

The IAS-Lancet<\/em>\u00a0Commission reports that from 2013 to 2016, international assistance for HIV was reduced by 20%, from almost $10 billion to $8.1 billion, though the number for 2016 was even lower, at $7 billion,\u00a0a new report by the Kaiser Family Foundation<\/a>(KFF) found. The $8.1 billion attributed to 2017 was partly a result of the timing of U.S. disbursements, including funds appropriated but not spent from previous years.<\/p>\n

The world is not going to be able to work towards ending of the epidemics of AIDS, tuberculosis and malaria \u2013 and towards building UHC as \u201ccomplementary and self-supporting\u201d \u2013 on current resourcing levels, Sands said. \u201cTo pretend that we are is to be kidding ourselves,\u201d he stated. \u201cWe need to be committing more.\u201d<\/p>\n

Where this \u2018more\u2019 might come from \u2013 and according to experts $6 billion is missing for the period between now and 2020 in order to reach \u2018just\u2019 the UNAIDS HIV targets for 2020 of 90-90-90 \u00a0\u2013 comprises three sources, Sands said: public donors, the private sector (philanthropic individuals or corporations), and domestic governments (of implementing countries).<\/p>\n

Three sources of financing for the HIV response<\/strong><\/p>\n

In a separate session titled \u2018Where will the resources come from to end AIDS?\u2019 Sands described the Fund\u2019s perspective on this question in greater depth. First, a small number of governments in advanced economies have invested billions, he said, and continue to, in the fight against HIV, which \u201chas been critical in getting us to where we are today\u201d. Until 2010, development assistance grew strongly, but global health\u2019s share of overall overseas development assistance (ODA) has remained stable, at just over a quarter, suggesting that there is room to increase the health share of ODA.<\/p>\n

Sands added that the Fund needs to continue making the argument for how this money is channelled, citing the \u201cdistinct advantages\u201d of multilateral mechanisms (such as the Global Fund) in order to reduce multiple interactions with governments. \u201cThe Global Fund is a proven vehicle for delivering impact across HIV, TB and malaria,\u201d he said, saying that this was \u201can absolutely critical element in taking us to the SDG3 goal of ending the epidemics\u201d, especially in the runup to the Fund\u2019s 6th<\/sup>\u00a0Replenishment in 2019.<\/p>\n

The second \u2018bucket\u2019 of funding is the private sector, Sands said, and included the Bill & Melinda Gates Foundation and Product (RED) as examples of entities that have made a \u201chuge contribution\u201d to the work of the Fund. But there is an opportunity, he said, to step up the level of engagement and contribution from private individuals, foundations and \u2013 critically \u2013 the corporate sector.<\/p>\n

\u201cWe don\u2019t have enough engagement with the broader corporate sector around health,\u201d Sands said, making the obvious but nonetheless often glossed-over point that most individuals affected by HIV (or TB, or hepatitis C, among scores of other diseases) have worked \u2013 or at some point will work \u2013 for private sector companies. \u201cWe need to engage that element of society more effectively in the fight against these epidemics,\u201d he said, suggesting creative approaches apart from those already employed.<\/p>\n

Sands\u2019 third \u2018bucket\u2019 was domestic resources, an area of financing \u201cwhere we absolutely need to change the game,\u201d he said. Reiterating what he had mentioned in the session on UHC, Sands said that building resilient health systems is not going to be achieved by external resources. \u201cTax systems and governments are not mobilizing enough money. Even if they do, they\u2019re not spending enough of it on health. And even if they are spending it on health, they\u2019re not spending it on HIV and not on key populations \u2013 so we have a lack of political will even where there is the financial capability.\u201d<\/p>\n

Addressing the issue of innovative financing, which in recent years has become an eye-catching mechanism in the global health financing world, Sands declared that \u201cinnovative financing is not a source of money \u2013 it is a mechanism for getting money out of sources; it does not \u2018magic\u2019 money.\u201d<\/p>\n

Returning to the topic of the way forward, Sands outlined three courses of action for funding sources he described: First, that getting more money from \u2018public donors\u2019 required a compelling narrative backed up by evidence of impact. Second, stepping up \u2013 and getting more creative about \u2013 private sector engagement requires overcoming a cultural antipathy between the public health world and the private sector view of the world. Third, that increasing the domestic resources component in the global fight against HIV required sustained advocacy, strong domestic political leadership, and co-financing obligations to \u201cpush governments to make more commitments themselves\u201d.<\/p>\n

\u201cThe idea that this [fight against HIV] can be vanquished without committing serious resources is an illusion,\u201d Sands said. \u201cMy belief is that the money is there, in the world. The question is, do we really want to make the Sustainable Development Goals a reality? If we do, it can be done,\u201d Sands said.<\/p>\n

\u201cIf we just want the warm feeling about declaring that we\u2019ll get there, we simply won\u2019t.\u201d<\/p>\n

For further reading on global financing for HIV as discussed at AIDS 2018, see:<\/em><\/p>\n