Because donor funding for global HIV/AIDS and the Global Fund has been declining, the Global Fund to Fight AIDS, TB and Malaria is in the most dire financial situation it has ever seen since its creation 10 years ago. As a result, the Global Fund board today decided to effectively cancel its Round 11 funding due to lack of resources – an unprecedented act in its history.

The Global Fund will provide for a ‘transitional funding mechanism,’ whereby countries known to be facing a disruption of programs for HIV, TB and malaria before 2013 will be offered a chance to apply for funding to cover their most essential needs. For HIV, this funding can cover medicines for people already on treatment, but does not provide for scale-up of HIV treatment. Funding will also be restricted for treatment of drug-resistant forms of TB.

Zimbabwe © Kenneth Tong/MSF
A pharmacist dispenses HIV medication in Buhera district, eastern Zimbabwe.

MSF calls on the Global Fund and donors to immediately raise the resources necessary for the minimum lifeline the Fund has extended to countries otherwise facing disruptions this year, as well as providing a new regular funding opportunity.

The dramatic resource shortfall comes at a time when the latest HIV science shows that HIV treatment itself not only saves lives, but is also a critical form of preventing the spread of the virus, and governments are making overtures that there could be an end to the AIDS epidemic.

Yet on the ground in hard-hit countries where MSF works, the devastating effects of the overall funding crunch are becoming apparent – for example, Cameroon and Zimbabwe are facing shortfalls in the near future to support people already on treatment, and Democratic Republic of Congo severely caps the number of people able to start on lifesaving HIV treatment. In other countries, such as Mozambique, funding problems have prevented the country from providing earlier treatment and better drugs, as per World Health Organization-recommended guidelines.

Kenya © Sven Torfinn
Catherine Atieno lives with her family in Kibera, a deprived area of the Kenyan capital, Nairobi. She is HIV-positive and has been on treatment for more than seven years. Catherine is a healthy, active individual who, in addition to her normal job, has started up a small sugar plantation.

Other countries may have to put important plans on hold, such as Malawi, which in addition to wanting to scale up HIV treatment, wants to provide earlier and life-long treatment for all HIV-positive pregnant women to not only protect their babies, but to keep themselves healthy.  Some countries, including Kenya, Lesotho and South Africa, had already been told by the Global Fund that they weren't eligible to apply for support from Round 11 because of lacking funding. In those countries, HIV treatment coverage lies at 52 per cent, 66 per cent and 49 per cent, respectively.

“There’s a shocking incongruence between both the new HIV science and political promises on one hand, and the funding reality that is now hitting the ground on the other,” said Tido von Schoen-Angerer, doctor and executive director of MSF’s Campaign for Access to Essential Medicines.  “Donors are really pulling the rug out from under people living with HIV/AIDS at precisely the time when we need to move full steam ahead and get lifesaving treatment to more people.  All governments must chip in to the effort to curb HIV, but especially those with the capacity to really make a difference must urgently step up and support a new funding opportunity for countries by the Global Fund.”

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