The Global Fund is currently at a loss, unable to raise the $15 billion they deem necessary to “prevent and treat AIDS, tuberculosis, and malaria effectively on a global scale.” The Global Fund relies on donations from a variety of sectors. The Fund has received about $2 billion in donations from various governments (most prominently the United States at about $837 million and the United Kingdom at about $404 million), $2 billion from charity health organizations, and $95 million from other philanthropic foundations – not insignificant but far from what the Fund estimates as its minimum need. We are facing a wide gap, problematic not only because of its magnitude, but also because we do not have strategies in place to move forward.
The World Health Organization has discussed possibly mandating certain countries to contribute to global health funds. Unfortunately, as of now, this proposal is far from becoming reality. Such a mandate could entirely transform the global health aid industry. Would it give some donors undue say in what diseases are tackled? Which international organization (if any) would have the right to implement such sweeping change?
But is this reason enough to overlook a mandate? We are combating some of the most infectious and deadly diseases in history. Is it responsible to leave funding for treatment and distribution to the wiles of governments that will always find new domestic problems to prioritize?
The fact is, we are brimming with potential. Developed medications and basic distribution and treatment infrastructure are in place (through organizations including the World Health Organization, UNICEF, UNAIDS, Red Cross, Doctors Without Borders, and the Clinton Health Access Initiative), but how do we translate this into tangible results? Developments in world health have been stunted by geography and a constant deferring of funding problems to tomorrow. Are we ready for a new age of accountability, in which responsibility is legally codified?
Without formal and consistent recognition by international governments, the status quo will persist. We will continue to view infectious disease treatment as a charitable option rather than a priority. We should treat this, however, as a humanitarian issue on par with any other. In this case, mandating national contributions to global health could be defended. Moving forward and securing the future of global health would become much easier.
Of course, this is no simple task. Which countries have the right to lead and later enforce these fiscal policies? And, while we are dealing with an issue that should resonate with all people, governments will ultimately need incentives to participate. How can we incentivize governments to give to yet another cause?
Regardless, we cannot wait for a time when every country is ready to help. Global health is as important an issue as any and needs to be addressed in concordance with other priorities like development aid and disaster relief. It becomes a matter (and a choice) of principle in whether international governments will assert health care as a necessity and not a luxury.