TUNIS – Gabriel Jaramillo, General Manager of the Global Fund to Fight AIDS, Tuberculosis and Malaria, told a gathering of finance and health ministers that the financing institution offers outstanding value for money by effectively treating and preventing the spread of disease.

In a speech to a Conference of Ministers of Finance and Health by Harmonization for Health in Africa (HHA), Mr. Jaramillo said the changing economic climate had forced the Global Fund to change its operations to make grants more strategic, improve efficiency and become more effective overall.

The Global Fund will invest US$8 billion over the coming 20 months, US$5 billion of it in Africa. Mr. Jaramillo said that with productivity gains and more co-investment by countries that receive grants, there is a tremendous opportunity.

“As a former banker, I know a good deal when I see one,” said Mr. Jaramillo. “There is no better deal that investing to prevent these diseases.”

Mr. Jaramillo urged the ministers not to fear the investment necessary just because the up-front costs look high, because maintaining gains is less-expensive than the initial investments.

“Front-end these programs now, put your skin in the game now, because the out-years will be much cheaper as your number of cases goes down,” he said. “Sustaining your programs is much-less costly than you believe, and the return on investment is potentially huge.”

Mr. Jaramillo observed that the average cost of ARV drugs is now US$ 127 per patient per year, 12 percent less than in 2010, on top of a 27-percent decline the year before. The average cost of insecticide-treated nets is down to US$ 4.50.

He also cited recent analysis about Namibia, where HIV treatment costs approximately US$ 120 million a year, about half of that paid for by the Global Fund. With that investment, 9200 hospital beds were released for other health problems, 1,000 health workers and 550 teachers were kept alive per year,. The country also went from 9,400 hospitalizations to 236 and 2,700 deaths to 56 over five years.

Mr. Jaramillo drew a sharp contrast between the situation today and that of 10 years ago, when international assistance for health saw a huge increase in funding because of three factors – generosity, fear, and a sense of urgency.

“Ten years ago, few people were on ARVs in Africa, and fewer than five per cent of African households owned insecticide-treated nets,” said Mr. Jaramillo. “Today, only generosity is left as a motivator – you have to create the sense of urgency.”

Much work remains to be done, he also said. The current rate of improvement will not be sufficient to reach the health-related Millennium Development Goals by 2015. Only 41 percent of countries supported by the Global Fund are on track to meet the fourth MDG on reducing child mortality and the sixth on combating HIV and AIDS, malaria and other diseases.

“We know what works now—we did not 10 years ago,” Mr. Jaramillo said. “You have become good at this fight. The knowledge base has moved from the North to the South—you now know the most. We want to work with you to make your programs more effective and more efficient.”

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The Global Fund is a unique, public-private partnership and international financing institution dedicated to attracting and disbursing additional resources to prevent and treat HIV and AIDS, TB and malaria. This partnership between governments, civil society, the private sector and affected communities represents an innovative approach to international health financing. The Global Fund’s model is based on the concepts of country ownership and performance-based funding, which means that people in countries implement their own programs based on their priorities and the Global Fund provides financing on the condition that verifiable results are achieved.

Since its creation in 2002, the Global Fund has become the main financier of programs to fight AIDS, TB and malaria, with approved funding of US$ 22.6 billion for more than 1,000 programs in 150 countries (as of 1 December 2011). To date, programs supported by the Global Fund are providing AIDS treatment for 3.3 million people, anti-tuberculosis treatment for 8.6 million people and 230 million insecticide-treated nets for the prevention of malaria. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts in dealing with the three diseases.