Disease Busters Going Bust

JOHANNESBURG – The Global Fund to Fight AIDS, Tuberculosis, and Malaria marks its tenth anniversary this year against a backdrop of growing protests against global inequality. World attention has been trained on the Occupy movement, which has challenged the “1%” of the global population that exercises disproportionate influence on economic and social policy. But this week, many activists from the developing world – the greatest beneficiaries of the Global Fund – will be focused on efforts to keep the institution viable as it passes the ten-year mark.

When the Global Fund began operations in 2002, it was heralded as an innovative new institution – an organization driven by the idea that people need not die of preventable and treatable diseases simply because they are poor. Indeed, many thought of the Fund as an activist entity, because it focused on three devastating epidemics that have a common denominator: economic and social inequality.

The Global Fund promised the world that it would not become yet another bureaucracy staffed by balding men in grey suits. Instead, it pulled together a diverse staff of smart young management consultants, activists living with HIV and AIDS, committed outreach workers with extensive public-health experience, and economists and lawyers who had helped to force the prices of medicines down in drug-company lawsuits. Together, they represented an energetic team, convinced that if they worked hard enough, they would continue to raise resources for the hopelessly underfunded global response to AIDS, TB, and malaria.

As activists championed the Global Fund, poor countries’ governments embraced it as well. After years of structural adjustment programs, the health-care systems of many developing countries – especially in Africa – had been ravaged, with 30-50% vacancy rates in health-care positions, bare dispensaries, and never-ending queues.