Blog Contributor:
Todd Summers
Todd leads ONE’s advocacy on global health, especially in support of major funding programs such as the Global Fund and GAVI. Previously he was senior program officer at the Bill & Melinda Gates Foundation and served as the foundation's representative on the Global Fund’s board of directors. He remains vice chair of the Fund’s policy and strategy committee. Todd has more than 25 years of experience in health policy, working in government and non-governmental organizations
May 31st, 2011 2:29 PM UTC
By Todd Summers
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Last week, the Group of Eight countries concluded their annual meeting and issued the requisite communiqués and reports. It’s getting to be a sad affair. For those of us focused on extreme poverty and global health, these summits can bring important promises such as the commitment at the 2005 Gleneagles Summit to double assistance to Africa and provide “universal access” to AIDS treatment and prevention. But more and more, the G8 leaders shy away from making new bold promises, probably because they’re aware as the rest of us that those promises are usually broken.
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May 20th, 2011 2:05 PM UTC
By Todd Summers
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Last week, the Global Fund board of directors met to review a range of issues, the most pressing of which was answering concerns about reports by its Office of Inspector General (OIG) of the theft of money or drugs from Global Fund grants.
It’s an important discussion, but it can also be deflating. Donors are demanding action and threatening reduced funding. So, ONE and other advocacy groups do our best to provide facts and context, knowing that the scale of the problem is much smaller than the political response. At the same time, we’re all appalled. Stealing from the Global Fund is robbing innocent people of the medicines they need to stay alive; put bluntly, here theft is murder.. We also applaud the Global Fund’s work to discover misuse of funding, prosecute the thieves and recover the money.
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Apr 4th, 2011 12:08 PM UTC
By Todd Summers
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A: Measles. Public health officials in Minnesota report 14 confirmed cases of measles, in people ranging in age from 4 months to 51 years old. While eight have been hospitalized, fortunately there have been no deaths. Far away in Africa, health officials in the Democratic Republic of Congo have reported a measles outbreak – this one sadly claiming 106 children so far.
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Mar 25th, 2011 10:38 AM UTC
By Todd Summers
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A little while ago, we asked our friends on Facebook and Twitter to submit their questions on vaccines to me:
We picked a few to answer, and here they are. Take a look:
Ali Gohar Jamali from Pakistan (via Twitter) and Unimke Nawa from Nigeria (via Facebook) asked about ongoing efforts to develop vaccines for AIDS and malaria. Where are we in these processes?
Todd: Malaria is a devastating disease that causes about 800,000 deaths per year and a severe illness in children and adults. There’s been tremendous progress in the last few years, with newly developed insecticide-treated bed nets reaching millions more people thanks to donor support from organizations like the Global Fund as well as great new partnerships. In addition to bed nets, there have been big increases in the use of insecticides sprayed in places where malaria-carrying mosquitoes hide and in treatment of those stricken with malaria using the newest medicines.
Yet this progress has been difficult to obtain and will be hard to sustain. That’s why finding a vaccine to protect against malaria is super important. Thankfully, there’s some promising work being done, most especially by the Malaria Vaccine Initiative that specializes in bringing medical advances to the world’s neediest.
The most advanced candidate vaccine, called RTS,S, is undergoing a large clinical trial now to determine if it’s effective at protecting against malaria. Earlier research was promising, but we won’t know for sure until this study is completed late in 2014. What is known is that the vaccine is not likely to protect all people from all forms of malaria, and indeed its protective benefit could be a lot less than 100 percent. So there would be the challenge of using a partially effective vaccine without slowing down on any of the other malaria prevention and treatment efforts. Beyond this one candidate, there are others following behind.
Work on a vaccine to protect against HIV infection, or to keep HIV progressing to AIDS, has been underway for nearly three decades. While it has proven to be one of the most significant medical research challenges ever, there was great excitement at the end of 2009 when results from a clinical study in Thailand showed promising results. This study, funded in part by the US National Institutes of Health, found “a modest effect in preventing HIV infection in a clinical trial involving more than 16,000 adult participants in Thailand.” Further work will be needed on this candidate, but it was an important step forward.
My unscientific assessment is that there’s great promise, but still many years left before we have a vaccine for AIDS. And that vaccine is not going to look like your typical vaccine: it will be a lot less than 100 percent effective, and it probably won’t protect against initial infection with HIV but rather will keep the virus from progressing to disease. In the meantime, there’s a lot of HIV prevention that can be done with tools already at hand and some other technologies arriving sooner that will help in the battle.
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Mar 24th, 2011 4:26 PM UTC
By Todd Summers
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John Keats, DH Lawrence, Dylan Thomas, Henry David Thoreau. Famous poets that turned words to art. Sadly, they also had another thing in common: tuberculosis. In the late 1800s, TB was tearing through the US and Europe, causing many deaths.
Today is World TB Day, an opportunity to take stock of progress made in ridding the world of this horrible disease and also identifying opportunities to make more progress. For most of us, TB is not a big concern. Once in a while we get a scare –- remember that guy a few years back who flew back to the US even though he’d been diagnosed with infectious TB? -– but for the most part it’s a disease of the past.
Not so for many people living in Asia, Eastern Europe and Africa. About 2 million people die every year from TB, making it one of the world’s top killers. It’s become even more deadly with people with HIV, and is what causes most AIDS-related deaths in Africa.
“Without additional funding in the battle against tuberculosis for research, improved prevention, early diagnosis and treatment, some 8 million people will die from what is largely a curable disease between now and 2015,” according to a statement from UN Secretary General Ban Ki Moon.
Thanks to a lot of work by partners across the world, there’s been great progress. More and more people are diagnosed and treated, and that’s thanks in large part to increased funding through the Global Fund -– a key focus of our ONE advocacy work. About two-thirds of all donor support for TB flows through the Global Fund, and this has helped many poor people get the treatment they need. There’s also a good strategy in place, thanks to the Stop TB Partnership, an active coalition of more than 1 thousand organizations working together to eliminate TB.
Still, there’s a lot more to do. On the prevention front, there’s still a shocking disconnect between HIV and TB services –- even though we know that the rate of TB is much higher, and more deadly, among people living with HIV. Those managing programs and funding need to do much more to ensure that HIV and TB are treated as one in the many countries where they’re raging together.
On the research front, there are some new diagnostic tools to help quickly identify people with active TB, including those that have developed drug-resistant TB (you get drug-resistant TB when the systems for providing regular TB fail, leaving patients vulnerable to mutating viruses that are harder and more expensive to treat). The Foundation for Innovative Diagnostics (FIND) has an active effort on TB that’s really focused on addressing real problems in developing countries that don’t have lots of expensive laboratories, microscopes, and trained personnel).
The world needs a vaccine for TB! There is one now, called BCG and developed about 90 years ago, and it’s used to protect infants but it doesn’t protect them from adult forms of TB and is only partially effective. The Aeras Global TB Vaccine Foundation is leading in this area; they’re hopeful that a vaccine will be ready by the end of the decade. Let’s hope they’re right!
So what can you do to save the poets of today and tomorrow? Help us keep up the pressure to fully fund the Global Fund. The fights still on, sadly, and it’s caught up in the big budget debates going on in many donor capitols. Join ONE, and respond when we ask –- we really do need your voice to help support political leaders to do the right thing.
Photo of Henry David Thoreau courtesy of Wikimedia commons
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Feb 4th, 2011 6:12 PM UTC
By Todd Summers
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Before departing for the weekend, we’re going to bump this blog post to the top of the feed. If you haven’t yet, please read it:
We’re big supporters of the Global Fund to Fight AIDS, TB, and Malaria here at ONE, with so many of our members helping raise awareness about the great work it’s doing to save lives. Despite fantastic results — providing AIDS treatment for 3 million people, anti-TB treatment for 7.7 million people, and 160 million insecticide-treated bed nets for prevention of malaria – the Global Fund is under attack.
Columnist Mike Gerson has just written an excellent column on this issue that’s published in today’s Washington Post. We encourage you to read it, and share it widely!
We at ONE have been working hard to respond to this wave of negative coverage of the Fund, which is based almost entirely on one initial press report that took incidents in a few countries where funding was misappropriated – incidents caught and identified by the Fund itself! – and twisted them to imply that fraud was widespread. We blogged here on this, joining other allies in trying to get out the facts. It’s been tough, with so many being all too willing to believe the worst.
We’re also pleased to hear that the Global Fund announced today that it is taking some extra measures to increase its vigilance, including an external review of all of its financial safety systems. Those already in place are robust, but this might help assuage the donors. The Global Fund needs to deal with this problem to be sure, but its most important work is to speed resources to countries fighting three raging epidemics and the sooner it can get back to that the better.
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Jan 24th, 2011 5:42 PM UTC
By Todd Summers
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This post is also featured at the Huffington Post.
Over the weekend, the Associated Press filed a story about corruption involving a small number of grants made by the Global Fund, an international partnership that channels funds to fight AIDS, TB and malaria from donors, like the United States, to some of the poorest countries in the world. It’s always interesting to me when stories create news with misused facts and salacious headlines. So I thought it might be useful to have a little background and perspective from someone who’s spent a lot of time with the Global Fund.
The AP report was correct in saying that the Global Fund’s Inspector General has taken an aggressive approach to rooting out and publicizing incidents of fraud and abuse, but the story erred by extrapolating the findings in a few countries to tarnish the entire grant portfolio. Let’s put this to rest: there is absolutely no evidence that there is widespread fraud or corruption of Fund grants. On the contrary, of the $13 billion disbursed by the Global Fund to date, only a portion has been audited by the Global Fund’s inspector general, and of that only a relatively small amount — US $43 million — has been rescinded.
Now just because the percentage of grants found to be misused is relatively small doesn’t mean it’s okay — just the opposite. That’s still a lot of money, and it should piss off anyone who cares about the world’s poorest. We should not rest until all taxpayer supported programs can report no misuse of funds — including those administered right here at home.
While I was thinking about this over my morning coffee, I spied a New York Times front-page article that started, “Since the government took over Fannie Mae and Freddie Mac, taxpayers have spent more than $160 million defending the mortgage finance companies and their former top executives in civil lawsuits accusing them of fraud.” Now I’m willing to bet that all those gloating over the Global Fund stories won’t get nearly so exercised about this kind of pervasive corruption.
I also don’t want to fall into the trap of denying there are problems. We will undoubtedly hear about other instances of abuse. So I’m thankful that the Global Fund and its partners, especially the countries that desperately need the money, take this all very seriously.
There’s already lots of work underway to continue to make improvements. The Fund is pursuing suspected corruption aggressively, usually in close cooperation with local authorities: corrupt officials are going to jail, funds are being returned, new safeguards are being put in place. At the same time, the Global Fund is working hard to strike a balance, continuing its policy of zero tolerance for corruption while not becoming so risk adverse that it can’t get its job done.
So in the end what’s the conclusion? We should celebrate the openness of the Global Fund, even if the information it provides can be abused. We should fight hard to support programs that improve global health AND governance and transparency — fighting for funds needed to save lives and at the same time to build robust systems and checks and balances needed to guaranty their effective use. And we should feel proud that we’ve helped the Global Fund weather this storm and continue its amazing work to save lives.
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