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Access to Medicines and the Global Fund

April 1, 2015

The affordability, availability, and financing of medicines and other health commodities has always been a central issue for the Global Fund to Fight AIDS, Tuberculosis, and Malaria, its donors, recipient countries, and affected communities. Given the significant amount and proportion of Global Fund grant funding that goes to health commodities procurement, the strategic and operational components of their procurement and price strategies, and the availability of suppliers and access to their products, are key to ensuring availability and affordability of medicines. Current and proposed policies have created a growing concern that the Global Fund is fundamentally altering its approach to access to medicines. There appears to be a progressive rollback of its previous position of the promotion of generic competition as a key driver for lowering costs to a more opaque, centralized, collaborative approach with both generic producers and originators that risks reducing individual country ownership and threatening the continued supply of low-cost generic production. In addition, given the increasingly global spread of patenting, it is critical to also explore additional ways to challenge (and overcome) the high prices of new medicines.In light of these concerns, advocates should explore whether and how to expand and connect activities in relation to the Global Fund and access to medicines issues more broadly. To help promote that debate, this paper provides a preliminary identification of five areas that illustrate these concerns, and where the Global Fund's present or future policies could either enhance or limit the potential to use generic competition, rights-based advocacy, and/or its public purchasing power to lower the price of medicines. 

The Global Fund at a Crossroads: Informing Advocacy on Global Fund Efforts in Human Rights, Support to Middle-income Countries, and Access to Medicines

April 1, 2015

There is an urgent need to revive and re-energize civil society advocacy to hold the Global Fund to Fight AIDS, Tuberculosis, and Malaria accountable to its origins and founding principles. Recent changes in Global Fund policy and practice have taken it away from the country-driven character that set it apart from other aid agencies. It risks becoming less centered on rights-based strategies to support national responses to AIDS, TB, and malaria.In April 2015, the Open Society Public Health Program convened a consultation of experts and advocates concerned about the future of the Global Fund, particularly in these key areas:preserving support to important programs in middle-income countriesrealizing the Global Fund's human rights objectivessupporting access to essential medicinesWithout concerted and well-informed efforts by advocates the Global Fund risks repudiating its own history, undermining its investments, and damaging its stature as a leader in global health. Furthermore, the Global Fund's ambitious strategy to end the epidemics by 2030 will be a pipe dream without a reinvigoration of commitments in these three key areas. This briefing paper summarizes the deliberations of the consultation, and provides recommendations that the Global Fund should undertake in order to uphold its founding values.

Undermining the Global Fight

November 1, 2014

In its 2012–2016 strategy, the Global Fund to Fight AIDS, Tuberculosis, and Malaria changed the way it allocates financial resources. The "New Funding Model" uses a measure of disease burden and poverty to pre-determine allocations to countries for their fight against AIDS, TB, and malaria. At the same time, the Global Fund has prioritized efforts to reach socially excluded groups—men who have sex with men, sex workers, and people who inject drugs. These two objectives are at odds, and may mean that the Global Fund is pulling away from the countires and the populations that need it most. Using available data, Undermining the Global Fight examines the impact the Global Fund's withdrawl from middle-income countries may have on key populations, and highlights the need for increased funding of human rights–related programs.This report is a resource for advocates working to assess the impact of the New Funding Model and to help shape the next five-year strategy.