Gabriel Jaramillo, the general manager of Global Fund to Fight AIDS, Tuberculosis and Malaria, has urged a gathering of finance and health ministers from across Africa to invest in tackling the three diseases in what is increasingly a tough economic climate.
In a speech at the Harmonization for Health in Africa conference (4-5 July, Tunisia), Mr. Jaramillo said the Global Fund will invest US$8 billion over the coming 20 months, US$5 billion of it in Africa. He said that, with productivity gains made by the Global Fund and more co-investment by countries which receive grants, there is a tremendous opportunity to improve the lives of millions by providing money for health.
“As a former banker, I know a good deal when I see one,” said Mr. Jaramillo. “There is no better deal than investing to prevent these diseases.”
Jaramillo urged the ministers not to fear the investment necessary just because the up-front costs look high, because maintaining gains is less-expensive than initial investments.
“Front-end these programs now, put your skin in the game now, because the out-years will be much cheaper as your number of cases goes down. Sustaining your programs is much-less costly than you believe, and the return on investment is potentially huge,” he said.
Jaramillo also observed that the average cost of antiretroviral (ARV) drugs is now US$ 127 per patient per year, 12% less than in 2010, on top of a 27% decline the year before. The average cost of insecticide-treated nets is down to US$ 4.50.
He also cited recent analysis on Namibia, where HIV treatment costs approximately US$ 120 million a year, about half of which is paid for by the Global Fund. With this investment, 9,200 hospital beds were released for other health problems, and 1,000 health workers and 550 teachers’ livelihoods were provided for per year. Over five years, the country went from 9,400 HIV-related hospitalisations to 236 and 2,700 AIDS-related deaths to 56.
Jaramillo drew a sharp contrast between the situation today and that of 10-years-ago, when international assistance for health saw a huge increase in funding because of three factors – generosity, fear, and a sense of urgency.
“Ten years ago, few people were on ARVs in Africa, and fewer than 5% of African households owned insecticide-treated nets. Today, only generosity is left as a motivator; you have to create the sense of urgency and much work remains to be done,” he added.
The current rate of improvement will not be sufficient to reach the health-related millennium development goals by 2015. Only 41% of countries supported by the Global Fund are on track to meet the fourth MDG on reducing child mortality and the sixth on combating HIV and AIDS, malaria and other diseases.
“We know what works now; we did not 10 years ago,” Jaramillo said. “You have become good at this fight. The knowledge base has moved from the North to the South—you now know the most. We want to work with you to make your programs more effective and more efficient.”
Mr Jaramillo added that the economic downturn has forced the Global Fund to change its operations to make grants more strategic, improve efficiency and become more effective overall and it now offers outstanding value for money.