On 16 November, Médecins Sans Frontières (MSF) sent an open letter to the Secretariat and Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, urging the Global Fund to freeze implementation of its Sustainability, Transition and Co-Financing Policy, adopted in April 2016, until the fund carries out a risk assessment for countries that will see reduced funding allocations as a result of the policy, and until a roadmap for “scaling up access to optimal new diagnostics and treatments has been created.”
The letter reads in part:
Dear Secretariat and Board of the Global Fund,
We are writing to you on behalf of Médecins Sans Frontières (MSF) to convey our concerns about the Global Fund’s policies on allocation, co-financing, and transition, as the Board and Secretariat prepare to roll out its next funding allocations to countries.
New diagnostics and treatments have substantially improved outcomes among people with HIV, hepatitis C virus (HCV) and drug-resistant tuberculosis (DR-TB). But we fear that shifts in Global Fund policies will hinder countries from providing these innovations to patients, and limit their ability to procure -and use -quality and affordable drugs and diagnostics.
MSF urges the Global Fund to freeze implementation of transition plans until a risk assessment of its new allocation policies, strategies for procurement and transition plans has been conducted, and until a roadmap for scaling up access to optimal new diagnostics and treatments has been created. [Emphasis in original.] …
The Global Fund must avoid premature implementation of co-financing and transition policies that would damage services to vulnerable populations, procurement of affordable optimal tools, and scale-up plans where governments are either unwilling or unable to rapidly take over costs previously covered by the Global Fund. Accelerated transitions and hasty application of Global Fund policies may not only undermine progress, but even reverse the gains made.
The international community has committed to pursue aggressive goals for ending the HIV/AIDS, tuberculosis and malaria epidemics by 2030. As the MSF letter articulates, any risks to progress that could result from a funding transition as outlined in the Global Fund’s new policy should be identified and mitigated before the policy is implemented.
In addition, the following elements should be included in a roadmap for scaling up access to optimal new diagnostics and treatments:
- Implementation of the new nine-month regimen for treating MDR-TB, recommended by the World Health Organization in May 2016. The nine-month regimen is shorter and more effective than the previous standard MDR-TB treatment and is a critical new tool in the fight against the crisis of drug resistance.
- Capacity-building to conduct high-quality operational research and implementation science, which would help to improve delivery of healthcare services and help optimise the integration of new diagnostics and treatment regimens within national public health systems.
- An articulated role for the Global Fund in supporting clinical research efforts within low- and middle-income countries, which would help to deliver more effective tools for treatment, diagnosis and prevention over the long term. While the Global Fund is not expected to pay for clinical research, an improved framework is needed for facilitating participation of Global Fund-supported programs in clinical trials.
Click here to read the full text of MSF’s open letter.