This letter was sent to Senator Bob Carr on 22 March, 2012, shortly after he was sworn in as the Australian Minister for Foreign Affairs.
Congratulations on your recent appointment as Minister for Foreign Affairs. Given your responsibility to oversee Australia’s expanding aid budget, we are heartened by your strong and continuing commitment to international development, and look forward to working with you.
As a collective of civil-society organisations that support Australia’s increasing leadership on issues of global health, we urge you to make the battle against HIV/AIDS, tuberculosis and malaria a priority. In demonstrating this, we request the Australian Government to contribute an additional $AUD 100 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) this financial year.
1. The Global Fund – a decade of life-saving aid
Established in 2002, the Global Fund is the leading international funding mechanism for AIDS, tuberculosis (TB) and malaria: supporting over half of all those on antiretroviral treatment and representing 83 percent of international commitments for TB and two-thirds for malaria. Since its inception, the Global Fund has helped to save nearly 8 million lives - an estimated 4,000 lives saved every day, making it one of the most successful public health efforts in history.
In the fight against AIDS alone, 6.6 million people in low and middle-income countries now have access to life-saving AIDS treatment, up from 200,000 a decade ago. Today, 48 percent of all people on AIDS medication depend on the Global Fund for their treatment. According to recent reports from the World Health Organization (WHO) the numbers of deaths from TB and malaria have also fallen dramatically thanks to the Global Fund. Such progress would not have been possible without the funding provided by the Global Fund over the last decade.
2. Funding crisis threatening Global Fund’s life-saving work
Against this backdrop of success and impact, the Global Fund’s live-saving work is now at risk. Following lower than expected financial contributions by some developed countries – not matching the pledges they made in 2010 - the Global Fund Board meeting in November 2011 was forced to cancel its next round (Round 11) of grant-making and announced that it would not be in a position to make any new grants until 2014. This not only prevents the needed expansion of activities but threatens many existing programs.
Much of our own experience in many of the world’s poorest countries, coupled with the latest scientific evidence, makes clear that this funding crisis could not have arrived at a worse time. 2011 not only brought the first reduction in fatalities from HIV/AIDS, but also a series of major scientific breakthroughs against the disease, including a landmark scientific trial which showed that treating HIV positive people early with life-saving antiretroviral therapy (ART) has the added benefit of preventing sexual transmission of the virus by 96%. Expanding access to ART could thus be one of the best ways to turn the AIDS epidemic around.
Additionally, despite the emergence of ever-more resistant forms of TB, efforts to expand effective diagnosis and treatment for people with drug-resistant TB will now be further delayed as a direct result of the shortfall in funding being faced by the Global Fund. The introduction of better treatment for young children with malaria that could save many more young lives, as recommended by WHO in 2011, might also now be delayed. For each of these three diseases the downward trend in their morbidity graphs achieved over the last two years will now inevitably be reversed to an upward trajectory as the current successful impact of the programs in place will be reduced.
3. Opportunity for Australian leadership
We applaud the Australian Government for increasing its contribution to the Global Fund by 57 percent at the last replenishment round in 2010. This established Australia as a significant player in the international donor community. We now ask that you continue this leadership role by working with other key donors - such as the United Kingdom and United States - to provide supplementary funding to the Global Fund. Specifically, we request the Government to contribute an additional $100 million this financial year. Such a commitment will actively encourage other donors to do the same, generating sufficient new funding so affected countries get a new opportunity to submit proposals in 2012, in particular for HIV and drug-resistant TB treatment scale-up.
In addition to contributing an additional $100 million to the Global Fund this financial year, Australia should continue to explore ways to increase funding for bilateral HIV/AIDS, TB, and malaria programs in those countries in our region most in need. In particular, we encourage AusAID to scale up HIV and drug-resistant TB programs in countries that will be most impacted by the Global Fund shortage, such as Myanmar. Finally, any additional funding announced this financial year should not detract from the need for Australia to contribute its fair share - a significantly increased amount over that pledged in 2010 - in full at the next crucial replenishment round of the Global Fund, currently scheduled to take place next year. Our per capita support for the Global Fund is currently $3.40(USD) per Australian – too low given the proven effectiveness of the Global Fund and considering the size of the challenges from these three diseases. In comparison, Norway is contributing $16.40 per Norwegian this year, France $7.30 and Canada $5.30.
Ultimately, the Australian public want an aid program that is focused on delivering real results for the world’s poorest. By demonstrating leadership through contributing additional funds to the Global Fund, Australia has the opportunity to draw public attention to the life-changing impact that our foreign aid dollars are having. Such a life-saving intervention will highlight very clearly, and publically, that aid can and is making a huge difference, buoying public support for the Government's commitment of achieving the Millennium Development Goals through increasing foreign aid spending to 0.5% of gross national income by 2015-2016.
Under your leadership, Australia has the opportunity to lead the world closer to the end of three horrific diseases which currently kill over 4 million people each year, by ensuring that the Global Fund has the resources it needs right now to continue to fund the expansion of effective, high-impact, life-saving programs. Australian leadership—in contributing additional funding to the Global Fund alongside other key donors—will determine the future of the fight and the futures of millions of people around the world. We look to your support in helping to bring this about and would welcome the opportunity to meet with you to discuss this request in person.
Bill Bowtell, AO
Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria
Médecins Sans Frontières Australia/Doctors Without Borders (MSF)
World Vision Australia
Rob Lake and Don Baxter
Executive Director and Advisor for International Programs
Australian Federation of AIDS Organisations (AFAO)
Global Poverty Project
Results International (Australia)
Dr Brenda Crabb
CEO Burnet Institute