The Heart of the Matter in the Fight Against AIDS, Tuberculosis and Malaria

Published: September 23, 2013

 The last century brought with it a landslide of medical breakthroughs, from penicillin to a polio vaccine. But scientific discovery is just the first step. Only when these tools move out of the laboratory and into the hands of people do we begin to feel their transformative impact.

 
 In the late 1990s, new antiretroviral therapy promised hope in the fight against HIV/AIDS. Access to the drugs was suddenly turning the modern plague into a treatable condition. Yet despite its lifesaving power, the expensive treatment was out of reach for much of the world’s population, which meant HIV remained a death sentence for millions.
 
 International leaders fomented change in 2002. UN Secretary General Kofi Annan called for action. The United States under President Bush created an Emergency Plan for AIDS Relief (PEPFAR). And, collectively, the world created the Global Fund to Fight AIDS, Tuberculosis and Malaria. This public-private partnership and financing institution set out to support treatment, prevention and care for HIV/AIDS, as well as the other two deadly diseases, in hard hit communities worldwide.
 
 Since 2002, working closely with local partners and other donors–including the United States’ PEPFAR and President’s Malaria Initiative programs–the Global Fund has helped save millions of lives. In a little over a decade, HIV/AIDS treatment has increased more than twenty-fold, malaria cases have fallen by half, and deaths from tuberculosis have decreased dramatically.
 
 We stand now, though, on the cusp of yet another breakthrough in getting medical tools to fight AIDS, tuberculosis and malaria into the hands of those who most need them. Ten years of epidemiological and implementation experience has shown us that some of the populations that are hardest to reach because of geography, stigma or criminalization are also often at the highest risk for communicable disease.
 
To truly bring the three diseases under control, a successful strategy requires that marginalized groups receive the public health attention they need–and are treated with the dignity they deserve. Focusing on these groups is not only the right thing to do, it’s also the medically smart thing to do.
 
The Global Fund has financed health interventions for those facing the greatest need and the greatest risks since its inception. The organization prioritizes support for marginalized populations–the geographically isolated, women and girls, men who have sex with men, commercial sex workers, migrants and others.
 
Through the "country dialogue" process at the center of its new grant making structure, the Global Fund is attempting to bring more parties to the table, to ensure that no one is left behind. And today the Global Fund is even better incorporating human rights concerns into its work, with enhanced tracking of support for vulnerable populations, improved training for grant managers, and a new human rights reference group.
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