HIV testing in Uganda. Adam Jan Figel/shutterstock

HIV testing in Uganda. Adam Jan Figel/shutterstock

The results are in and, judging by the Global Fund’s latest round of fundraising, the world has adopted a new urgency to eradicating three deadly epidemics: AIDS, tuberculosis, and malaria.

 The Global Fund, an international partnership of governments, agencies, and private players, pools the resources to help defeat the three deadly diseases. Working through national committees that direct funding locally, it scales treatments and interventions in more than 100 countries. Since its founding in 2002, the fund is credited with saving 32 million lives, while marching toward the goal of ending the epidemics by 2030. Bill Gates calls it “one of the best and kindest things people have ever done for one another.” 

Since 2005, the Global Fund has asked donors to pledge their support in multi-year increments known as “replenishments,” which help sustain stable, predictable funding for participating countries. Last month at the Global Fund’s Sixth Replenishment Conference in Lyon, French president Macron’s spirited appeal inspired donors to pledge a whopping $14.06 billion over the next three years. In the final hours, the audience dug deep to achieve that goal, including Macron and Gates, who each pledged an additional $60 million. Then Gates, Bono, and Macron nudged things above the finish line by personally committing to raising an additional $100 million. 

The result is the largest amount ever raised for a multilateral health organization. Here are a few takeaways from the last funding cycle.

Philanthropy and Corporations Are Doing More

The big news from this year’s replenishment was the record commitments of private partners, whose pledges broke the $1 billion mark for the first time. Private pledges didn’t appear on donor rolls until the third replenishment, and represented only $359 million of the $11.7 billion raised in 2010—$300 million of which came from Gates.

This year’s private donors to the fund include longstanding supporters, like the consumer marketing initiative (RED), which began funding in 2013 and committed $150 million this year, and Takeda, a global pharmaceutical company that’s been a stalwart supporter since the first replenishment. Among the six new donors were the Children’s Investment Fund (CIFF), which made a $25 million investment in scaling HIV self-testing, as covered by Inside Philanthropy, and the Rockefeller Foundation. 

The Gates Role in Global Health is Getting Bigger

This year’s Gates pledge of $760 million to the Global Fund is its greatest commitment yet. In fact, the contribution is larger than the combined $650 million that the foundation has given to the fund in all past funding cycles. And it’s far more than what all other philanthropies put together pledged to the fund. The Gates Foundation’s commitment is also larger than that of many countries, including Spain and Australia, and nearly as large as that made by Japan, which has the third-largest economy in the world.

This latest chunk of Gates money is coming in a different form: as a promissory note that the foundation says will give “the Global Fund the flexibility and authority to distribute funds efficiently based on immediate needs, leading to greater impact.”

Bill Gates said of his foundation’s support of the fund: “I can’t think of more important work”—high words of praise from a funder who made $5 billion in grants last year to an array of organizations worldwide, but hardly surprising given that the fund saves 100,000 lives a month. What is more surprising is that so few other foundations or billionaires are pitching in to support an organization with such an impressive track record. Although the fund did better this year attracting philanthropic support, only about a half-dozen actual grantmaking institutions pledged money—in an era when the world’s 2,200 billionaires are worth nearly $9 trillion and foundation endowments are larger than ever.

Support from Governments is Rising

The lion’s share of the Global Fund’s support comes from state actors. Both the number and nature of their pledges have risen dramatically over the past 14 years. The first replenishment in 2005 raised $3.7 billion from 33 funders. This year, at the sixth replenishment, 58 countries pledged $12.7 billion—a 280 percent increase. 

The United States’ opening pledge was $600 million back in 2005. That grew exponentially over time before leveling off at around $400 billion in 2010. This year, the U.S. increased its pledge to $4.68 billion, sustaining a 33 percent share of total contributions. Other nations have made similar strides. India’s 2015 commitment of $4 million has grown to $22 million. China more than quadrupled its support during the same period, from $4 million to $18 million. And several new nations came on board this year, including the United Arab Emirates, which pledged $50 million, and Cameron, which pledged $5 million.

Ending Epidemics by 2030

Seventeen years ago, when then secretary-general of the United Nations, Kofi Annan, called for the creation of the Global Fund, the spread of HIV/AIDS, TB, and malaria epidemics seemed almost unstoppable, threatening the world’s economic stability. 

While enormous work is still ahead, tremendous progress has been made toward erasing the diseases from the planet by 2030. Deaths from HIV/AIDS have dropped steadily since 2005, when the disease claimed nearly 2 million lives. In 2017, the toll was just under 1 million. TB deaths have fallen, too. And, despite setbacks, global malaria death rates are down by 60 percent since 2000. 

With the latest global push, the fund will continue targeting the most critical interventions and sustainable outcomes, in hopes of saving an additional 16 million lives. 





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