2010 Funding Scenerios in Brief

The replenishment aims to secure resources for programming from 2011 through 2013. The Global Fund Resource Scenarios paper[1] on the three scenarios presents the following:

  • Scenario 1 (USD13 billion) would not only slow down the momentum; it would likely reverse any progress gained so far. The cost of slowing down momentum would mean future extra financial and public health costs. It also puts a freeze on enrolment of new patients for ARVs, which amongst other consequences will increase the cost of orphan care in the future when children lose their parents to the diseases. In addition, the momentum gained in scale-up against the three diseases – such as the aggressive scale-up against malaria – might be difficult or impossible to recover if stopped now.
  • Scenario 2 of USD17 billion would essentially maintain the current level of financing, but would not seriously allow for acceleration toward achieving the MDG targets in 2015 and Universal Access.
  • Scenario 3 of USD20 billion presents the only option for seriously scaling up interventions towards achieving these targets.

However, there are important gaps that have been identified that were not included in the calculations of the scenarios:

  1. Costs of Diagnosis and Treatment of TB: The timely diagnosis and treatment of MDR TB will reduce the spread of drug resistance and avoid unnecessary mortality and morbidity of MDR TB patients. Strengthened laboratory systems, including newer, more effective diagnostic tools, are critical. Action now will limit the future needs for more costly treatment as well as reduce the huge global public health risk of TB strains that do not respond to any treatment.
  2. Cost of implementing newly published WHO guidelines in Malaria: The move towards universal diagnostic testing of malaria is a critical step forward as it will allow for the targeted use of treatments and help to reduce the emergence and spread of drug resistance. It will also help to identify patients who do not have malaria, so that alternative diagnoses can be made and appropriate treatment provided. The new guidelines will therefore help improve the management of only malaria, but other childhood febrile illnesses.
  3. The Cost of implementing the WHO Treatment Guidelines for ART implies an increase of 50% more people on treatment, and the use of improved (but more costly) first line treatment and higher levels of 2nd line treatment. This is essential to avoid high costs and the economic and social costs of treating later. In addition, aggressive scale-up of earlier treatment initiation would have major collateral benefits, including reduced transmission of HIV.
  4. The Cost of keeping mothers alive so that they can look after their children and their families – let alone fulfilling their right to live. Evidence shows clear linkages between mother and infant survival.
  5. The scenarios also do not include the costs of additional investment in Health Systems Strengthening, Community Systems Strengthening, Sexual Orientation and Gender Identities Strategy, Gender Strategy, nor maximising the role of the Global Fund in MDGs 4 & 5.

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