What the Global Fund gave us was 17 years of scaling up lifesaving HIV and TB treatment and pooling volumes in order to negotiate lower prices that are transparent.
What the Global Fund gave us was setting a standard of quality for HIV and TB medicines, requiring approval from WHO Prequalification or stringent drug regulatory authorities (SDRA) for any meds purchased with Global Fund funding.
What the Global Fund gave us was a workaround to the widespread problem of drug and diagnostic corporations not registering their products with national authorities. Because Global Fund-supported drugs qualify for import waivers, used in many countries in lieu of national registration. Also, Global Fund-supported procurement qualifies for an exemption from national VAT in many countries, helping to keep prices low.
So what happens when countries, whether through co-financing agreements with the Global Fund or as part of transitioning from Global Fund support, shift purchase of HIV and TB medical tools from Global Fund-supported procurement to national systems. What falls away and who is advocating on behalf of people living with HIV and TB to ensure affordability, quality, and supply are not compromised? Who is keeping track of the problems that are already occurring on the ground? While we have information from the Global Drug Facility on TB-related issues, we don’t have such an accounting for HIV or malaria.
Please find a MSF policy brief – BEWARE THE GLOBAL FUND PROCUREMENT CLIFF- regarding some of these questions and our asks of national governments, the Global Fund, and donors: