Photo credit: The Global Fund to Fight AIDS, Tuberculosis and Malaria - Photo: 2017

The Global Fund To Fight AIDS Asked to Change Criteria Discriminating Poor Countries

By J C Suresh

TORONTO (IDN) – As this year’s World AIDS Day campaignMy Health, My Right – kicks into high gear, the AIDS Healthcare Foundation (AHF) has called on The Global Fund to Fight AIDS, Tuberculosis and Malaria to end the use of Gross National Income (GNI) per capita as part of the Fund’s grant eligibility criteria, and thus stop discriminating poor countries.

The Los Angeles based AHF is the largest nonprofit HIV organization that provides HIV care to more than 833,000 patients in 39 countries globally, including in Africa, Asia, Europe, Latin America & the Caribbean and the United States.

The campaign focuses on the right to health and explores the challenges people around the world face in exercising their rights. Initiating the campaign, Michel Sidibé, Executive Director of UNAIDS, said: “All people, regardless of their age, gender, where they live or who they love, have the right to health. No matter what their health needs are, everyone requires health solutions that are available and accessible, free from discrimination and of good quality.”

The right to health is enshrined in the 1966 International Covenant on Economic, Social and Cultural Rights as the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. This includes the right of everyone to the prevention and treatment of ill health, to make decisions about one’s own health and to be treated with respect and dignity.

The campaign reminds people that the right to health is much more than access to quality health services and medicines, that it also depends on a range of important assurances including, adequate sanitation and housing, healthy working conditions, a clean environment and access to justice.

If a person’s right to health is compromised, they are often unable to effectively prevent disease and ill health, including HIV, or to gain access to treatment and care. The most marginalized people in society, including sex workers, people who inject drugs, men who have sex with men, people in prisons and migrants, are often the least able to access their right to health; they are also the most vulnerable to HIV.

Most of the Sustainable Development Goals (SDGs) are linked in some way to health. To achieve the Goals, including ending the AIDS epidemic as a public health threat by 2030, will depend heavily on ensuring the right to health for all.

AHF President Michael Weinstein welcomed the appointment of Executive Director of The Global Fund Peter Sands on November 14, and said: “We are disappointed that the Global Fund to Fight AIDS, Tuberculosis and Malaria continues to use per capita income classification thresholds assigned to countries by the World Bank as one of the criteria for awarding grants.”

He added: “It is high time we focused on health rather than just money. It is deplorable that wealthy countries are defining what poverty means for developing countries. By any measure, $2.76 per day is not a middle income.”

Currently, the Geneva-based Global Fund (GF) HIV grant eligibility is primarily based on a country’s World Bank lending group classification, which is tied to its GNI, and secondly based on the HIV prevalence rate as a proxy for the burden of disease, AHF said.

When a country’s GNI per capita exceeds $3,955, the World Bank considers it an upper middle-income country (UMIC). According to the current Global Fund policy, if a UMIC does not have an exceedingly high burden of disease, it is no longer eligible for funding – even if its HIV epidemic is beginning to accelerate.

“The Global Fund has a ‘Transition Readiness Assessment’ tool that considers the economic capacity of UMICs to take over and sustain programs which are currently being funded by the GF,” said Dr. Jorge Saavedra, AHF’s Global Public Health Ambassador and former head of the national AIDS program of Mexico. “Regrettably, this process does not account for the growth of new HIV incidence as part of the formula.”

Dr. Saavedra added: “Right now, a developing country can be cut off from support even if the rate of new HIV infections is skyrocketing and its epidemic is not under control.”

He went on to say: “The use of GNI per capita thresholds developed by the World Bank for lending purposes to developing countries should not be used by the Fund, the GF is not a lending agency but a financial mechanism whose aim is to end AIDS, TB and Malaria. It’s detrimental to global public health and there are better, more nuanced ways of making sure lifesaving support gets to where people need it most.”

For the past several years, AHF has been spearheading a broad-based and global advocacy campaign to push for reforms in the way the World Bank classifies ‘middle-income countries’ (MIC). It held its most recent peaceful demonstration in October 2017 outside the World Bank’s headquarters in Washington, DC.

Building upon its ‘Raise The MIC’ global advocacy campaign, which was launched in 2015 with support from over 300 organizations and advocates in 30 countries, demonstrators called on the World Bank to set the lower limit of the MIC category at or above $3,650 of Gross National Income per capita – equivalent to about $10 per day – to increase poor nations’ access to foreign aid, including HIV/AIDS drugs and other essential medications.

The World Bank currently designates MICs as those with an income of at least $2.76/day – barely above the International Poverty Line of $1.90/day. [IDN-InDepthNews – 26 November 2017]

Photo credit: The Global Fund to Fight AIDS, Tuberculosis and Malaria

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