Lack of funding undercuts opportunities to overcome global health threats

New York - World leaders assessing progress of the United Nations Millennium Development Goals (MDGs) in New York this week could transform the fight against two of the leading causes of childhood deaths-malnutrition and HIV/AIDS-by implementing an innovative funding mechanism for global health, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

The World Health Organization reports that an additional $37 billion needs to be spent on global health every year by 2015 in order to meet the health-related MDGs. The intergovernmental Leading Group recently estimated that a financial transaction tax-a levy as little as 0.005 percent on transactions of the world’s four most traded currencies-could generate an estimated $33 billion a year to implement the latest medical advances against global health threats, including malnutrition and HIV/AIDS.

“For many diseases, we know what we need to do to save lives,” said Sophie Delaunay, executive director of MSF in the U.S. “Our field teams are using new tools and approaches to release children from the deadly grip of malnutrition and to ensure children are born free of HIV, but there is not enough funding for long-term, widespread implementation of effective health interventions. A financial levy for health, by providing a dedicated and predictable funding stream, could mean that patients’ lives are no longer at the mercy of volatile markets and political agendas.”

The political response to recent global financial volatility has had a catastrophic effect on the reliability of funding and foreign aid commitments for global health issues. This has left considerable gaps in the financing of key institutions such as the Global Fund to Fight AIDS, TB, and Malaria, as some donor governments such as the United States, Germany, Italy and Spain, renege on previous commitments or stagnate or decrease their funding.

In Malawi, the government has submitted a Global Fund application for funding to provide lifelong antiretroviral treatment to all pregnant HIV positive women. This would dramatically reduce the transmission of HIV from pregnant women to their children. But given the Global Fund’s constrained budget and the pessimistic predictions around future contributions from donor nations, there is a risk that Malawi will not receive this grant and will not be able to fully implement a program that could greatly reduce the number of children born with HIV. Some countries have already been forced to implement 10 percent “efficiency cuts” to funds approved in the last round of grants

“It is no longer enough to reiterate a commitment to access to care and treatment – to maternal and child health, to the global AIDS fight, “said Delaunay. “Unless alternative funding models are put in place to guarantee long-term and sufficient funding, countries will continue to be limited and these stated commitments will be nothing but rhetoric.”

The lack of sustainable global health funding also undercuts the potential to expand the implementation of highly effective programs to prevent childhood malnutrition, a condition that contributes to the deaths of between 3.5 and 5 million children under five years of age every year. MSF has demonstrated how new treatment tools and approaches make it possible to not only cure, but also to prevent malnutrition for hundreds of thousands of children in the world’s malnutrition “hotspots.” For example, working alongside local organizations in Niger, MSF has treated 77,000 severely malnourished children so far this year. Since July, MSF has also been distributing food supplements to more than 143,000 young children to prevent them from becoming malnourished.

Efforts to combat malnutrition at an earlier stage, such as the ongoing Niger intervention, are crucial in dealing with the recurrent nutritional crises affecting many countries in Africa’s Sahel region. These efforts can only be sustained through long-term financial commitments from main international donors.

According to a World Bank evaluation, it costs $12.5 billion annually to adequately fund recognized effective nutrition interventions in the most-affected countries. An MSF analysis estimates that only a small fraction of this is actually spent annually – just $350 million in 2007.

A financial transaction tax for health could transform some of the world’s malnutrition “hotspots” and put governments much closer to adequately treating and preventing a main cause of childhood deaths worldwide.

One such funding mechanism for health already exists in the form of UNITAID, the international agency that finances HIV/AIDS treatment programs through miniscule taxes on airfares. The International Monetary Fund recently deemed financial transaction taxes feasible, and at the MDG Summit, France and Japan will endorse and promote financial transaction taxes as a promising method to raise funds for development aid.