The Big Push to Defeat AIDS, TB, and Malaria, by Mark Dybul

Published: January 21, 2013

Every era offers something special. I think the most special thing about our current time is the incredible opportunity that scientific advances have provided in the field of global health, giving us the ability to completely control highly dangerous infectious diseases such as AIDS, tuberculosis and malaria. The recent progress is breathtaking. If we can harness the funds needed, we can essentially take these diseases off the table as threats to greater development.

Timing is critical. If we do not start to act this year, we may miss that opportunity. As we have learned with other infectious diseases, when you have a window of time to control the spread of a disease, you must take action or else face the risk that the disease finds new forms that are far more complex and expensive to defeat. When that happens, all the investment made so far is effectively lost. We need to redouble our efforts this year to make sure we’re raising the money we need to get this work done. We need to make a big push, to secure the funding we need.

Those of us who work in global health know that there is no greater investment in the world than in prevention and treatment for these terrible diseases. When health professionals working in cities, towns and rural areas in countries around the globe can take action to actively limit the spread of infectious disease, everyone benefits. Not just the patients, who maintain or regain their health, and not just their families which are immediately affected. It is also the larger communities and regions and countries whose economies and social fabric thrive on a healthy population.

It is a great privilege, at this moment in history, to be joining the Global Fund to Fight AIDS, Tuberculosis and Malaria as its new Executive Director. It’s exciting to have the chance to lead this remarkable institution at this time. I am determined to do all I can to help the Global Fund fulfill its mission of investing the world’s money in a way that enables health workers to save millions of lives.

Paradoxically, just at the time when we are making such broad scientific advances in fighting these diseases, we also face global financial constraints. That makes it challenging to take full advantage of the new science. But I am convinced that we can, and must, rise to the occasion. To do so, we must make several moves.

One, we must make our money count. ‘Value for money’ is a term that investment advisers like to use when talking about traditional financial transactions. Investing in health is actually better value for money than almost any investment imaginable. When you can prevent the spread of malaria, and save the lives of millions of young mothers and children with mosquito nets that cost a few dollars, that is an outstanding investment. When you can keep a man or woman with AIDS alive on drugs that cost $125 a year, compared with $10,000 a year just one decade ago, that is an outstanding investment. Great investments are effective, and efficient. In order to raise the money we need for global health, we need to demonstrate to everyone that this money is put to excellent use.

Two, we need to focus on impact. Building impact-measurement into the way that health interventions are designed helps health professionals ensure they are getting value for money. The highly effective grants in the Global Fund portfolio – such as those treating malaria in Ethiopia and HIV in South Africa – focus on impact from the start. Getting managers to consider impact helps programs prioritize activities, identify risks, and steer investments toward gaps in coverage. And then measuring impact, once a program is underway, is important, too. It is good management to know about impact and to evaluate and integrate it into operations. Donors to global health efforts need to know what impact their investments are having, and need to assure taxpayers that their investments are effective.

Three, we have to combine every evidence-based approach that works to prevent the spread of disease. For HIV, for example, there are anti-retrovirals for prevention both for HIV-positive and for HIV-negative people, there is medical male circumcision, there are condoms and there is behavior change. No single effort will get the disease under control. And what works best in one country might not be best in another. So we have to use a combination approach, and we have to support countries as they design programs that they know will be most effective.

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