January 4, 2008

AIDS Activists Call On Global Health Organizations to Revise Their Global Health Plan

This past November, the leaders of eight international health organizations—the Bill and Melinda Gates Foundation; the GAVI Alliance; the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; the UN Population Fund; UNICEF; the World Health Organization and the World Bank—released Scaling Up for Better Health, a joint plan intended to show health care agencies around the world how to improve their quality of care. At first read, the plan seemed to be one that should be supported by those supporting people living with HIV/AIDS around the world. However, a closer read of the plan’s final draft prompted the International Treatment Preparedness Coalition (ITPC)—endorsed by AIDS activists, health experts and human rights advocates around the world—to write a letter to the heads of the eight health organizations to express fear that the proposed plan might have been inspired by recent public commentary that the world is spending too much money to fight AIDS.

The letter states: “At face value, the Scaling Up for Better Health plan, which is in fact a cluster of recent global health initiatives encompassing Germany's Providing for Health, Canada's Catalytic Initiative to Save a Million Lives, the United Kingdom’s International Health Partnership, and Norway’s Deliver Now for Women and Children; and which has recently been endorsed by all of you, could only make us happy. However, when reading the final draft note of November 1, 2007, combined with our experience in developing countries, we fear that this new initiative might undermine some existing efforts to realize the right to health. In particular we fear that this new initiative might be inspired by recent public comments, according to which the world is spending too much on the fight against AIDS. If this were the intention, we could certainly not support this initiative. The world is not spending enough on the fight against AIDS and the world is not spending enough fighting against other health crises and problems. Only if this is explicitly acknowledged as the foundation of the Scaling Up for Better Health plan, we would be willing to support this plan.”

The letter then spells out several key conditions that must be met before the ITPC will support the plan. These conditions include: the plan’s recognizing that health is a human right; the adoption of a sustainable health care aide system that operates on an uninterrupted basis; the acknowledgement of the importance of the right to health above macroeconomic concerns; an allowance for appropriate responses to health crises; a balanced approach to the integration of “vertical,” or disease-specific, health interventions; a transparent overview of contributions and grants; and a push to ensure that civil society is included in all stages of the plan’s decision-making processes.

“We are the consumers (and often providers) of health care, we have a vested interest in seeing programs succeed in reaching their goals,” the ITPC letter concludes. “We are able to provide an independent voice from our countries’ villages to our nations’ capitals describing what we need in real terms and what is and isn’t working on the ground. We are willing to work together, but our conditions for collaboration are clear.”

POZ asked Gregg Gonsalves, a well-known international AIDS activist currently with the AIDS and Rights Alliance for Southern Africa in Capetown, also a signatory of the letter, why he feels the letter was sent. “We sent [it] because several major funders of AIDS programs are considering moving away from disease-specific funding, and these policy changes are imminent,” he said.

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