02 May 2019

Global Fund and access to pharmaceuticals

The latest issue of the WHO Bulletin features 'Ensuring access to life-saving medicines as countries shift from Global Fund support' by  Mercedes Tatay and Els Torreele .

That editorial states
The Global Fund to fight AIDS, Tuberculosis and Malaria has helped the scaleup of life-saving treatments through affordable, quality-assured medicines and diagnostics. However, faced with stagnating donor health funding, in recent years the Global Fund has revised its allocation model and its sustainability, transitions and co-financing policies. 
These policies are driving changes that can have negative implications for people with human immunodeficiency virus (HIV), tuberculosis or malaria. Higher prices of medicines, more use of medicines of unknown quality and more unstable supplies increase the risk of more deaths from these three preventable, treatable diseases, and exacerbate the growing global health challenge of serious drug-resistant infections. The changes also risk undermining opportunities to scale up life-saving innovations. Such innovations include the first new tuberculosis drugs in 40 years, the most effective first-line antiretroviral regimen, and a combination diagnostic platform for HIV, tuberculosis and other pathologies. 
The Global Fund’s revised allocation model continues to prioritize countries with the highest disease burdens and lowest incomes, but presses deprioritized countries to more rapidly mobilize alternative (especially domestic) funds to avoid reversing progress in access to lifesaving medicines. Furthermore, the revised sustainability, transitions and co-financing policy requires all countries, even those with the lowest incomes, to increase their co-financing of disease programmes, including through purchasing medicines and diagnostics. Consequently, many countries shift sooner than anticipated from Global Fund-supported procurement mechanisms to national procurement processes. However, the shift to increased national procurement risks sacrificing the lower prices, quality assurance and sustainable supplies that come with Global Fund procurement