New Funding To Fight Infectious Diseases Is At Risk, Despite Halving Of Child Deaths Since 1990

The global fight against AIDS, tuberculosis, malaria and other infectious diseases has helped reduce the number of children dying under the age of five years from 12 million in 1990 to less than 6 million today. The Global Fund to fight these diseases needs $14-16 billion to fund its next three years of work – including at least $1 billion from the private sector.

The lion’s share of funding comes from governments, but unless the sector can make taxpayers more aware of successes over the past 20 years, the funding may even shrink, said Bill Gates, Co-Founder of Microsoft and Co-Chair of the Bill & Melinda Gates Foundation. “We don’t have broad voter awareness that locks in the current level of generosity,” said Gates, adding that his own foundation – which has donated around $10 billion to date – remains committed to providing the same level of investment in the future.

The Sustainable Development Goal for Health aims to end all deaths from AIDS, TB and malaria by 2030. But to achieve this will take not just new money but better use of data and innovation. One challenge for the private sector is to radically speed up the time it takes for new drugs to reach the developing world. Instead of a 20-year time lag, “we as an industry need to bring innovations to reach everyone on the planet within a year or two,” said Vasant Narasimhan, Chief Executive Officer of pharma giant Novartis.

The tiered pricing system pioneered by Gavi, the Vaccine Alliance, whereby richer countries subsidize the R&D costs of drugs used by the world’s 70 poorest countries, still works. But the sector needs to invest in entrepreneurs as well, such as companies like Zipline, which delivers blood packets by drone across Africa. Other innovations include global impact bonds, which have raised $6.5 billion for Gavi over the past two decades.

“Every country, no matter how poor, must contribute to its own immunization programme,” said Gavi’s Chair, Ngozi Okonjo-Iweala. One way they could release fresh funds would be to tackle tax evasion and money laundering. The good news is that money spent on combating infectious diseases delivers a 20-fold return on investment.

Noncommunicable diseases are becoming an even greater challenge than infectious diseases. “I look at the burden of hypertension and the capacity to manage it, let alone diabetes and obesity, and I see systems that are going to collapse,” said Narasimhan. However, creating a new Global Fund for Noncommunicable Diseases is not the answer. “Our central strategy should be to address risky behaviour [leading to noncommunicable diseases] by investing in public healthcare,” said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). He argued that political commitment is more important even than money. The United Kingdom, for example, started the National Health Service at a time when the post-war economy was “in a shambles”.