Andrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | Hansard source

In combating international poverty one of the few really great successes has been the global fund to target these three major infectious diseases world wide. As we have already heard, they kill around 3½ thousand people every day and result in thousands of additional infections and enormous morbidity for families, particularly in developing economies.

The origins of the fund go back prior to the year 2000, when a number of leading economists looked at ways to provide a carrot—effectively, a reward—for both nations and corporations that invested heavily in the solutions to what at that time were unsolvable problems—the top three killers. Malaria, TB and HIV had for a long time taken hundreds of thousands of lives in the decades preceding the year 2000. Only then did a guy called Jeffrey Sachs, working together with Michael Kremer from the School of Economics at Harvard, first talk about a global fund.

The initial concept was to have donor nations in particular put money aside that would serve to be a carrot attracting investment into new forms of pharmaceuticals that could one day help us to win this titanic struggle. In the intervening period, of course, the large nations, and particularly the G8 nations, got together with the pharmaceutical manufacturers and negotiated some very impressive breakthroughs where these expensive drugs, particularly the HIV drugs, could be provided at just a fraction of the market price. So all of the negotiation around the global fund was then able effectively to be turned into a leveraging instrument which, unlike the UN bodies with which it was working, did not have major in-country offices and did not seek to tell nations what to do. Instead, it just focused on the simple principles of working with national priorities and working as leverage rather than simply as a provider of services. It sought, where it could, to leverage in-country expertise, to do independent evaluation and to be completely balanced in the way they approached these three great killers. They did not focus unfairly on one intervention, one region or one disease.

That was the essence of the global fund, and we have had three commitments to replenishing it. The most recent was on 4 and 5 October in New York, and was quite successful. There the second replenishment of $9.7 billion was increased to $11.7 billion. Over those three replenishments we have seen jumps of 80 per cent and then most recently 20 per cent. It is very promising that most of those who contribute funds have actually backed up the talk with walk. The moneys that have been committed are coming through. In fact, in the most recent replenishment, where they have achieved $11.7 billion, about $2.52 billion of that is expected to come when these donor nations are able to fund those commitments.

The estimation is that we need $20 billion over this three-year period. In reality, we have just under $12 billion. That tells us that we are getting somewhere near but still not close enough to what would be the ideal target. We know from national plans in the 83 nations that are afflicted with malaria, of the 112 with TB and around 140 combating HIV that the two really great challenges will be predominantly men having sex with men as the chief threat in HIV transmission and women having babies who are HIV positive. They will be the two key focuses around HIV because we are seeing an explosion—a radical jump—that has actually caused a J-curve in the reporting of HIV in these nations.

With multidrug resistant TB, again, the challenge is to get the suite of drugs correct and to have them available in all nations. That was the real success of the last three-year period. Obviously, with malaria, it is insecticide impregnated nets that are available to people to reduce the chance of infection with malaria, particularly around dusk and while sleeping.

I will now turn very, very briefly to those three millennium goals. The ones we are most optimistic about are: 6, which is the reduction of the dreadful communicable diseases; they are also contributing to goal 4, around child mortality being halved, and 5, maternal mortality being halved. The communique that came out from the most recent meeting in New York was really encouraging. They are pointing at country-coordinating mechanisms, CCMs, that allow this effort, which is fundamentally a financial instrument, to get down into countries and leverage the ability and the capacity on the ground. That means that it is being implemented slightly differently in each country, a real change from the struggle that these agencies have had before to coordinate multiple donors and to work with local capacity.

Finally, it is good to see ACFID right here in Australia recommending with its five health-related recommendations: that 20 per cent of Australia’s aid be health related, 15 per cent be family planning related, a focus on avoidable blindness and of course their recommendations around treatment of those three conditions. We welcome the government’s increased commitment of $210 million. This is only one per cent of what is needed and is well short of our GDP as a contribution to global GDP, but still it is a very important contribution towards the Millennium Development Goals that could well be achieved by 2015.

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