Disease fears prompt launch of Middle East fund

The Global Fund's Middle East Response fund will pool resources to prevent and treat malaria, TB and HIV/AIDS in six countries

The Global Fund, a Switzerland-based financing organisation, is set to launch a new, pan-regional fund this July to tackle malaria, tuberculosis (TB) and HIV/AIDS in the Middle East. The initiative is part of a $70m push to drive back these diseases as war heightens the risk of increased infections and drug resistance.

“Aid must follow the people. Diseases don’t respect borders,” Norbert Hauser, chair of the Global Fund’s board, told Philanthropy Age. “As people move from one country to another, it becomes harder to cover the last mile.”

The Middle East Response fund pools resources to prevent and treat the three diseases in Palestine, Syria, Lebanon, Jordan, Iraq and Yemen. The scale of the grant has not yet been determined but will be based on need, said Hauser.

The spread of infectious diseases, such as TB, is exacerbated by moving populations. Lebanon and Jordan host 1.5 million and 700,000 refugees, respectively, while Iraq contends with more than 3 million internally displaced people.

More than 4.8 million Syrians have fled their homeland to neighbouring countries since 2011, mostly to camps or informal settlements with limited health facilities.

Consolidating funding into one regional grant provides NGOs more flexibility to treat populations in flux and react to realities on the ground, rather than tying them down to specific countries, said Hauser.

"The new grant structure aims to streamline implementation, saving money and helping the Global Fund reach more people," he added.

The Middle East Response began as a $3.3m emergency grant, set up in 2014, for refugees in Jordan and Lebanon. The worsening crisis in Syria has prompted the organisation to ramp up funding. The Dutch Postcode Lottery and the Bill & Melinda Gates Foundation have each contributed $2.8m (€2.5m) to the pooled grant so far. No Middle East donors have contributed yet, said the organisation.

The Global Fund has seen an increase in the caseload of TB, an airborne bacterial infection, in the region as conflict cuts short courses of treatment. The fund has recorded more than 400 new cases in Lebanon and Jordan since 2014.

“It is paramount that you don’t stop TB treatment before the full course has been administered,” said Hauser. “When people have to move from one country to another, treatment is disrupted and they develop drug resistance.”

A recent report commissioned by the UK government found the global financial cost of inaction on drug resistance would be $100 trillion a year by 2050, and cause the loss of 10 million lives annually.

A patient with a drug-resistant strain of TB needs to take 14,000 pills over the course of 24 to 36 months, compared to six months for the normal regimen, and risks spreading the more resilient form of the disease to others, said Hauser.

“One person with TB can infect between 15 and 20 others,” he added.

As well as the Middle East Response – which still has “a lot of unfunded demand”, according to Hauser – The Global Fund is this year looking to attract $13bn to finance its global grants for the next three years. The fund’s replenishment conference will take place in September in Canada, with pledges already received from the hosts as well as New Zealand, the EU, Luxembourg and Portugal. The US has committed to giving $1.35bn each year – or one-third of the total budget.

A fully-capitalised Global Fund could save the lives of 8 million people and avert 300m new infections, according to the organisation. Such measures would cut the global health bill by an estimated $290bn, said Hauser.

To date, the Global Fund has allocated grants to 50 of the 57 Organisation of Islamic Cooperation (OIC) countries. By 2015, almost $8bn had been spent tackling the three diseases in OIC member states, including treating 250m malaria cases and 5m TB cases. Kuwait and Saudi Arabia have been donors to the fund since 2003 and 2004, respectively.

The ever-rising numbers of the displaced means traditional aid responses must adapt, for example in the distribution of goods, said Sandra Irbe, a Global Fund advisor. A family in Yemen that has received a bed net to safeguard against malaria will need another one if they are forced to flee war with few belongings, she said.

Established in 2002, The Global Fund finances NGOs and governments to fight AIDS, TB and malaria as epidemics. It has helped save 17 million lives and is on track to reach 22 million by the end of this year, according to the body.

Photo credit: The Global Fund/ Tanya Habjouqa