An Australian fair share

The Australian Government’s contribution of $A210 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria for the period 2011-13 is welcome: however, the Australian government has squandered an opportunity to show global leadership by placing health at the highest level of importance in its foreign policy.

At the Global Fund replenishment conference held on October 4, 2010 in New York City, international donors pledged a total of $US9.163 billion. This figure is well short of the $US20 billion which experts say is needed to turn around rises in rates of HIV infections and to provide treatment and care for costs for many people already infected with the disease. The Australian government announced its contribution to the Global Fund for the period 2011-2013 would be $A210 million. Though, Australia significantly increased its support for the Global Fund from its previous contributions, it is well below its expected fair share of contributions to global health.

Due to the significant short fall of funding, which is blamed on the recent global financial crisis and the donor fatigue, the Global Fund will find it difficult sustain the successful financing of HIV, TB, and malaria programs which would strengthen developing countries’ health systems.

Australia should have considered offering a grant of about $A500 million as its fair share for global health as we steadily increase our budget for international development assistance to 0.5 per cent of GNI by 2015. Global health financing is increasingly considered to be on the cutting edge of global foreign policy. A $A500 million grant would have placed Australia as a global leader by showing health to be paramount importance.

The Global Fund is considered an effective model to combat HIV, TB and malaria. It has managed facilitate the treatment of more than four million people in just five to six years. This success prompted many global health policy leaders to ask for a greater role for the Global Fund in addressing the global health burden and in strengthening the health systems of developing countries.

Global health policy experts increasingly see the role of health financing as part of the financing of fundamental infrastructure development in developing countries to ensure a healthy population. An unhealthy population and the subsequent disease burden can eat up the developmental benefits of many developing countries. Human security and stability is strongly linked to a healthy, disease free population.

In contrast, Australia is willing to spend more than 3 per cent of GDP, which is about 10 times the amount of all the developmental assistance we make, on arms and ammunition, which in reality we may hardly use.

The real threat to Australia may not be from a marauding neighbouring army or a couple of thousand desperate refugees, but the health risks associated with a new virus or bacteria. Many diseases are everywhere in the world, including Australia. Australians are increasingly globetrotters and any one can unwittingly bring home some of those viruses and bacteria. It is in Australia’s own interests to contribute generously to a Global Fund to tackle world-wide disease.

All though Australian direct aid to countries like Papua New Guinea has achieved modest success, the Global Fund model of health financing is considered to be superior. Overall, more than $US12 billion has been spent in 144 countries. The Global Fund is known for its rigorous independence: the fund depends on the voluntary country co-ordination mechanism (CCM) for the good governance of the grants given to each country. Many of the CCM need support for to ensure good governance practices are met. For example, the Global Fund recently froze its support of the Philippines Tropical Diseases Foundation due to poor governance practices.

The Australian additional aid to the Global Fund could have been earmarked for strengthening the good governance of the grants given to each county.

Currently Australia is ranked somewhere about number 16 in the donors to the Global Fund. An Australian grant of $A500 million, would have placed Australia as a global leader in health financing, while enhancing its global foreign policy profile.