The Global Fund to Fight AIDS Tuberculosis and Malaria

{Photo: Gwenn Dubourthoumieu}Photo: Gwenn Dubourthoumieu

The Partnership for Supply Chain Management (PFSCM), an organization formed through a partnership between Management Sciences for Health (MSH) and John Snow Research & Training Institute, Inc., (JSI R&T), uses an innovative consortium model that draws on the capabilities and experience of 13 internationally-renowned organizations. PFSCM harnesses this expertise to strengthen, develop and manage secure, reliable, cost-effective and sustainable supply chains to meet the needs of health care and other public services. Since 2009, PFSCM has leveraged this unique expertise to manage the Pooled Procurement Mechanism (PPM), previously known as Voluntary Pooled Procurement (VPP).

Funded by The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), PPM procures and delivers about $46.6 million in life-saving health care products monthly, including HIV and malaria medicines, test kits, and related commodities. As a managing partner in PPM, MSH has played a key role in the mechanism’s overall management and strategy.

{Photo credit: Katy Doyle}Photo credit: Katy Doyle

Members of the global health community commemorated International Women’s Day (IWD) on March 8 by celebrating recent advances in women and girls’ health and indeed there was much to celebrate: maternal deaths have declined 45% worldwide, The Global Fund to Fight AIDS, Tuberculosis and Malaria has distributed over 450 million bed nets, and over 1 million babies have been born HIV-free thanks to the President’s Emergency Plan for AIDS Relief (PEPFAR); but there is still work to do.  What happens once the day is over? How do we turn that attention into action? How are these issues going to be addressed? After awareness is raised, we still need concerted global action every day of the year if we are to make truly sustainable, impactful improvements in the lives of women and girls’ around the world. Here are a few things I think we can do at the global, US and local level to keep the spirit of IWD alive:

Globally: Elevate women and girls in the Post-2015 Development Agenda

{Photo credit: Rui Pires}Photo credit: Rui Pires

 {Photo credit: Amarachi Obinna-Nnadi/MSH}Dr. Zipporah Kpamor, MSH’s Nigeria Country Representative, speaking during the African Health Innovation meeting in Abuja, Nigeria.Photo credit: Amarachi Obinna-Nnadi/MSH

"Good leadership skills, flexible policies, and constant advocacy will improve health in Africa," said Dr. Zipporah Kpamor during her talk at the Africa Health Innovation meeting in Abuja, Nigeria, on May 7, 2014. As Management Sciences for Health (MSH’s) Nigeria Country Representative and project director for the US President's Emergency Plan for AIDS Relief (PEPFAR)-funded US Agency for International Development (USAID) project, Community-Based Support for Orphans and Vulnerable Children (CUBS), Zipporah is an expert on the conference’s theme: Leapfrogging development challenges to transform Africa’s health. 

Zipporah offered poignant insight on one of the meeting’s discussion topics: Leadership, policy, and advocacy for health in Africa:

Mildred Fernando shares her story of surviving XDR-TB at a symposium in Japan.

I never thought that being sick with tuberculosis (TB) for a decade would lead me to this purpose: being an advocate to fight and eliminate this disease--not just in my country, the Philippines, but all over the world.

I was recently invited by RESULTS Japan to represent TB patients' perspectives in the call for continuous funding from the Japanese government to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). The advocacy activities, led by Results Japan, were in support to the Global Fund Fourth Replenishment which aims to secure financing for the years 2014-2016.

Integrating the Leadership Development Program into Guyana's national nursing school training (watch video): Guyana HIV/AIDS Reduction and Prevention, phase two (GHARP II), a PEPFAR-funded and USAID-supported project.

Developing Strong Health Leaders Saves Lives, the newest edition of MSH's Global Health Impact e-newsletter (subscribe), features:

Children in Yogyakarta, Indonesia, a community supported by TB CARE I volunteers. {Photo credit: D. Collins/MSH.}Photo credit: D. Collins/MSH.

Each year, as many as 64,000 people die from tuberculosis (TB) in Indonesia. Although the Ministry of Health’s (MOH) National TB Program (NTP) has made great progress over the last few years, the country is still one of twenty-two high TB-burden countries in the world. Indonesia is also one of the twenty-seven countries considered to have a high burden of multi-drug resistant TB (MDR-TB). In 2011, the nation reported 6,100 cases of MDR-TB.

Donor funding has been a major factor in the success of Indonesia’s TB program over the last few years, especially The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) grants.  Indonesia has, however, progressed economically and is now a relatively low priority for Global Fund grants, which are expected to end or reduce significantly by 2015.

Despite Indonesia’s economic growth, the sustainability of the TB program will be a major challenge without support from this critical donor, especially during the funding transition period.

Frieda Komba, a licensed drug dispenser in Tanzania. {Photo credit: MSH.}Photo credit: MSH.

Each year over 10 million men, women, and children in developing countries die as a result of our collective failure to deliver available safe, affordable, and proven prevention and treatment. A recent analysis of innovations in products and practices for global health, from the Hepatitis B vaccine to use of skilled birth attendants, revealed virtually none of these life-saving interventions reaches much more than half their target population—even after as many as 28 years of availability. This reflects a vast gap between knowledge and action in global health.

Successful Health Systems Innovations

Low- and middle-income countries (LMIC) benefit from continued innovations in health products and health practices, such as use of misoprostol to prevent post-partum hemorrhage, and technologies such as internet-based mHealth applications to protect the poor from catastrophic health expenditures.  To ensure such innovations achieve large-scale, widespread coverage, they must be accompanied by much more effective health systems innovations.

{Photo credit: MSH, South Africa.}Photo credit: MSH, South Africa.

The prospect that we may see the end of AIDS in our lifetime has never been greater. Over the last decade, the global HIV & AIDS community has achieved stunning successes, including a steady decrease in new HIV cases, a massive scale-up of antiretroviral therapy (ART), and proof that treatment is prevention. As we begin the XIX International AIDS Conference, we are also excited by new scientific advances in prevention and treatment, such as Option B+  for prevention of maternal-to-child transmission (PMTCT). As new possibilities develop, we must also build on the successes of the last decade. Only by "turning the tide together" through the simultaneous pursuit of new possibilities, leveraging of proven interventions for scale and sustainability, and strengthening of health systems overall, can we hope to reach our goal of ending the HIV & AIDS epidemic.

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