Future challenges facing the Global Fund to Fight AIDS, Tuberculosis and Malaria include raising $8 billion amid a worldwide recession as well as bolstering global health care systems and financing a better pay scale for health care workers in the developing world.

In a program titled “The Global Fund and the U.S. in Their Next Phase”—the first in a series of Kaiser Family Foundation webcasts focusing on global health policy—Global Fund executive director Michel Kazatchkine, MD, acknowledged that the fund has been able to improve global health by increasing the number of people who receive treatment for HIV/AIDS and tuberculosis and by protecting more people from malaria worldwide. Though significant progress is evident, he said, the institution has become a “victim of its own success.” The fund anticipates needing $8 billion in 2010 as it faces a funding gap of $5 billion to reach its prevention and treatment goals.

“As the needs grow, if the funding remains steady, we will lose,” Kazatchkine said. “We will lose a lot, and becoming slow on funding and expanding on global health is very dangerous.”

Kazatchkine emphasized that donors must address the funding gap; the United States is the Global Fund's largest contributor, donating close to 30 percent of the group's resources. While he explained that the current economic recession has forced many governments and public sectors from the industrialized world to reallocate their receding funds, Kzatchkine urged the new U.S. administration and Congress not to disregard the developing world, which is also impacted by the financial crisis.   

Another challenge the fund faces is sustaining global health systems, which include health insurance, the health care workforce and the systems that monitor, evaluate, distribute and supply health care. The Global Fund has devoted 35 percent of its monies to bolster these systems, with close to $4 billion committed to health care workforces in developing countries.

These countries are experiencing a shortage of health care workers because skilled employees are drawn to better pay in Western countries, many of which have relaxed their immigration regulations to recruit migrants in areas such as hospital personnel. Kazatchkine maintained that strengthening health care systems must be addressed at the same time as financing AIDS, TB and malaria programs.
 
“My message is: Health, we all understand, is a priority in development. It is an investment for development. It is an investment for overall security,” Kazatchkine said. “We can't build a globalized world where hundreds of millions of people will be kept in disease, hunger, poverty and illiteracy.”