PHOTO: MUKURUKURU MEDIA/SHUTTERSTOCK
PHOTO: MUKURUKURU MEDIA/SHUTTERSTOCK

The COVID-19 pandemic is a global emergency—the kind of crisis that requires solutions on a national and international scale. This is where the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria is especially relevant. The organization’s longtime efforts to establish country-sized health solutions deserves close study as philanthropy hones its own strategies, not only with respect to the current virus, but also future pandemic threats. In particular, leaders at the fund hope that moving forward, the philanthropic sector will place a higher priority on global health security and on forming strong international partnerships that make such work possible.

Founded in 2002, the Global Fund is an independent, multilateral financing entity created to raise money and focus resources to eradicate AIDS, tuberculosis and malaria. Most of the organization’s work is in Africa, Asia and South America, but since inception, it has approved more than $49 billion in funding for work in more than 120 countries. The U.S. government has contributed about $18 billion so far. Instrumental in its formation was former President George W. Bush, who wanted to reduce the heavy toll of AIDS, tuberculosis and malaria in less-developed countries.

Despite its explicit focus on those three diseases, the Global Fund recognized in the first weeks of the year that the organization would have to respond to COVID-19, said John Fairhurst, head of private sector engagement. In addition to its potential direct health impacts, leadership feared the new disease would overwhelm health systems and reverse hard-won health gains in its nations of focus. A research paper cited by the Global Fund and published by Imperial College London estimated that in some regions, COVID-19 could lead to increases in deaths from AIDS, TB and malaria by 10, 20 and 36%, respectively.

“In the world’s poorest countries, weak health systems are already overstretched, and people affected by HIV, TB and malaria will likely be more vulnerable to the new virus,” Fairhurst said. “Ensuring the continuity of existing programs to fight malaria, TB and HIV is critical to both protect people from existing diseases, but also to reduce the strain on healthcare systems.”

The Global Fund has so far made $1 billion available to fight COVID-19 in countries eligible for the organization’s support. The money can be used to shore up health systems dealing with COVID-19, including all the needs typically mentioned in connection with response to the pandemic, such as epidemic preparedness assessment, lab testing, surveillance, infection control in health facilities, and information campaigns. But the funding is also available to ensure the continued operation of the AIDS, tuberculosis and malaria programs that the Global Fund has helped build in concert with governments and communities in the countries where it has been working for 20 years.

In addition to this considerable financial commitment, the COVID-19 pandemic is also prompting the Global Fund to reexamine its methods just as government organizations, businesses and private funders are being forced to rethink their operations and strategies. Fairhurst envisions a future where global health is taken more seriously by more private funders, and where governments, international organizations and the philanthropic sectors forge stronger partnerships—something the Global Fund views as critical to scaling health solutions.

The Global Fund has long received support from foundations, faith-based organizations, and companies to complement the government funding that makes up the large majority of its budget. The Bill & Melinda Gates Foundation, its biggest private funder, has given $2.24 billion over the years. Hundreds of millions have come from other funders with commitments to global health security, including Catholic Relief Services, Chevron, Children’s Investment Fund Foundation and (RED), among others. The Global Fund has also worked with businesses, including Coca-Cola, Google Cloud and Microsoft, to develop and deliver technology solutions and other innovations.

Support from philanthropy is far from universal, however. “We don’t think the private sector—philanthropists and business—have been taking global health security seriously enough,” Fairhurst said. About four months ago, when the COVID-19 outbreak was starting to cross borders and alarm scientists, Fairhurst and Global Fund Executive Director Peter Sands met with a series of philanthropists and business leaders to warn them of the expected severity of the crisis. “We got a resounding ‘Thanks for the call, but I’m not sure it’s relevant to me at the moment,’” Fairhurst said. “If you now went back to those people, I think they’d feel very differently.”

That new appreciation for the fragility of health and life in countries of every level of development and the interdependence of the modern economy means that the global health community has a powerful opportunity to develop a new kind of engagement with private funding. But, says Fairhurst, it’s up to the public health sector to engage more with philanthropy—not the other way around—to show philanthropists how their investments make a difference on the other side of the world and at home, and to work together to strengthen global health today and prepare for the next emergency.

“We need to develop that conversation between the public health community and the private sector,” Fairhurst said. That conversation will have to include not just better explanations of the need for global health security, but also a different kind of working partnership. “We want to engage the private sector in helping us design the solutions of the future and new thinking about how you drive change.”

Again, when it comes to pandemics, national and international infrastructures are crucial. That’s something that private funders and philanthropy can learn from an organization like the Global Fund, which has worked on the ground in countries to make sure that healthcare is delivered the last mile to people in the communities.

“The Global Fund can scale success at a national level,” Fairhurst said. “Private foundations can be much more nimble and innovative in their solutions, but they can’t scale success. But if you bring those things together and be innovative within a scaling structure, we can create change on a huge scale for people.”

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