L’année prochaine, le Fonds mondial se mettra en quête de moyens financiers pour la prochaine phase de financement 2026-2028. Va alors se poser la question de savoir comment répartir les fonds entre les trois maladies que sont le sida, la tuberculose et le paludisme ?
En tant que représentant de la société civile, Medicus Mundi Suisse fait partie de la délégation canadienne, australienne et suisse au sein du conseil d’administration du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme. Sa dernière réunion s’est tenue il y a deux semaines à Genève. Aucune décision dont je pourrais parler ici en exclusivité n’y a été prise.
Par conséquent, il convient plutôt de faire part de l’état d’esprit dominant qui en dit long sur la situation actuelle dans les institutions mondiales de santé : tension et incertitudes à tous les niveaux. Ce sentiment est motivé par les pressions que subit actuellement la santé globale. Celles-ci sont liées à la soi-disant réduction des ressources financières, aux changements épidémiologiques et à la pression politique.
Concernant la lutte contre le sida, la communauté internationale s’est fixée comme objectif d’éradiquer le virus d’ici 2030. Celui-ci serait tout à fait réaliste sans la pression exercée par la droite et les fondamentalistes religieux sur les droits sexuels et l’égalité des genres. Ce phénomène est mondial, ce qui inquiète fortement les responsables du secrétariat du Fonds mondial ainsi que plusieurs représentantes et représentants du conseil d’administration. En effet, il met en péril les progrès réalisés ces dernières années dans la lutte contre le sida, et donc les investissements financiers consentis.
Malgré les progrès médicaux, la lutte contre la tuberculose et le paludisme doit elle aussi faire face à de grands défis, principalement de nature épidémiologique : l’apparition de résistances rend nécessaires de nouveaux filets de lit plus coûteux, les catastrophes environnementales et les conflits armés anéantissent les programmes de santé existants et les font reculer de plusieurs années.
Le Fonds mondial reste le plus grand bailleur de fonds au monde dans la lutte contre le paludisme et la tuberculose. Cependant, des moyens financiers plus importants y auraient un impact plus fort. Près de 50 % des fonds mondiaux contre le paludisme passent par le Fonds mondial. Cette valeur passe à 82 % pour la tuberculose mais seulement 21 % pour le VIH/sida. Actuellement, les ressources du Fonds mondial sont réparties ainsi entre les trois maladies : les moyens financiers allant jusqu’à 12 milliards de dollars sont destinés à 50 % au sida, à 18 % à la tuberculose et à 32 % au paludisme. La somme excédant les 12 milliards de dollars est répartie à 45 % pour le sida, 25 % pour la tuberculose et 30 % pour le paludisme.
Dans un contexte où les ODD de l’ONU sont encore loin d’être atteints, notamment en ce qui concerne la lutte contre la tuberculose et le paludisme, et dans la perspective du prochain cycle de financement, certains aimeraient voir le fameux Global Disease Split (GDS) modifié en faveur du paludisme et de la tuberculose. Ce débat risque de s’avérer plus difficile. Il faut en effet s’attendre à ce que les ressources du Fonds mondial diminuent lors de la prochaine phase de financement. Ces querelles de répartition pourraient dominer les prochaines réunions du conseil d’administration du Fonds mondial.
Martin Leschhorn Strebel
Réseau Medicus Mundi Suisse
E-Mail
"The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) held its 51st meeting this week in Geneva, Switzerland. While anticipating record disbursements this year, with an unprecedented pace of investment in resilient and sustainable systems for health (RSSH) and pandemic preparedness and response (PPR), the Board repeatedly acknowledged the numerous challenges – including climate change, conflict, displacement, geopolitics, the economic situation, and in particular, the erosion of human rights and gender equality – that undermine the Global Fund partnership’s ability to end the three diseases by 2030."
What is the future for collaboration between the Global Fund, Gavi and the Global Financial Facility? This article reports on these discussions."
"In October 2023, Gavi and the Global Fund launched four workstreams to strengthen their collaboration, with the recent inclusion of the Global Financing Facility (GFF). Progress was reviewed at the Strategy Committee meeting in March, together with the proposal for a joint working group between Gavi, the GFF and the Global Fund, in the wider context of the Lusaka Agenda. The Strategy Committee supported the continuity of the four workstreams and recommended the creation of a joint working group to facilitate their implementation, subject to clarification and review by the Ethics and Governance Committee. These discussions were presented to the 51st meeting of the Global Fund Board to seek its advice on how to further improve collaboration and communication between the three global health initiatives, as well as the need to identify key missing elements in each of the four workstreams and to support the formation of a joint working group."
"Les États se sont réunis à Oslo pour examiner la mise en œuvre de la déclaration politique contre les bombardements et les pilonnages dans les villes. Les survivants d’armes explosives ont invité les États à agir maintenant. (...) « Les États doivent appliquer des interdictions et des restrictions nationales sur l'utilisation des armes explosives en zones peuplées, afin de réduire les dommages causés aux civils. Nous les exhortons également à cesser d'utiliser les armes les plus destructrices dans les villes. Ils doivent aider les victimes et être plus transparents sur leurs opérations militaires ».
"Maria Marelli, notre physiothérapeute et spécialiste de la petite enfance basée à Genève, était récemment à Rafah pour évaluer la situation. Pourtant forte d'une longue expérience de terrain, elle a été ébranlée par ce qu'elle a vu sur place : elle nous décrit une crise humanitaire catastrophique où les besoins essentiels (eau, nourriture, abris) ne sont plus accessibles."
"Alors que la guerre à Gaza entre dans son septième mois, nous exprimons notre profonde inquiétude quant à la sécurité des milliers de familles qui pourraient être forcées de quitter Rafah pour se rendre à Khan Younès et dans d'autres zones de la bande de Gaza. La menace imminente d'une offensive terrestre à Rafah plonge la population dans une peur effroyable, car elle sait qu'elle n'a pas d'endroit sûr où aller. Les familles déplacées, qui vivent dans des conditions catastrophiques à Rafah où chaque personne n’a en moyenne qu’un mètre carré d’espace pour vivre dans les camps de déplacés, sont confrontées à d'immenses défis et au désespoir, alors qu'elles sont à la recherche d’un abri, de leurs maisons détruites et des membres de leur famille enterrés sous les décombres.
"Das Schweizer Fernsehen strahlte in der 10 vor 10 Ausgabe vom 30. April 2024 einen Beitrag aus dem Caritas Baby Hospital aus. Erfahren Sie mehr über das Schicksal einer Frau und ihres 9-jährigen Sohnes, die aus dem Gazastreifen stammen und aufgrund des Krieges nun aber in Bethlehem gestrandet sind."
"With over 600,000 deaths in 2022, malaria remains one of the biggest health threats particularly in sub-Saharan Africa. Against this background, the Multilateral Initiative on Malaria (MIM Society) 8th Pan-African Malaria Conference is currently taking place in Kigali, Rwanda. Coinciding with this years’ World Malaria Day, the conference brings together 1,500 people from around the world to shape future strategies in the fight against malaria. About 30 researchers and students are representing Swiss TPH at the event."
"In 1974, the World Health Organization launched its Expanded Programme on Immunization. Now, 50 years later, a study shows that an estimated 154 million deaths have been averted thanks to vaccination. In 2024, a child under 10 years of age is 40% more likely to survive to their next birthday. The study published today in The Lancet was led by Swiss TPH in collaboration with WHO and numerous research organisations."
"Novartis and Medicines for Malaria Venture (MMV) announce positive data from their phase II/III CALINA study, demonstrating that a novel formulation of Coartem® (artemether-lumefantrine) developed for babies weighing less than 5kg with malaria has the required pharmacokinetic profile and good efficacy and safety. The trial was conducted in several African countries. Swiss TPH was in charge of carrying out the study in the Democratic Republic of the Congo."
"En 2024 au Népal, il arrive encore, au cours des soins de santé, que des femmes et des nouveau-nés soient victimes de violences verbales ou physiques, de stigmatisation, de discrimination, d’examens médicaux effectués sans leur consentement, ou encore de violation de confidentialité. Enfants du Monde, en collaboration avec l’ONG locale Green Tara Népal et le Centre National de Formation en Santé, participe aux efforts du pays pour améliorer la qualité des soins avec une formation qui a été proposée à près de 200 prestataires de soins de la Province de Lumbini. La formation utilise des techniques d'apprentissage innovantes et offre un soutien pour faciliter un changement de comportement qui se sont révélées efficaces, avec une adhésion forte des prestataires aux valeurs liées au respect des droits des femmes et nouveau-nés dans les soins. Ces résultats prometteurs ont convaincu le Centre National de Formation en Santé à reproduire la formation à l’échelle nationale qui prévoit son intégration dans le curriculum national de formation des accoucheuses qualifiées."
« Grâce au projet de santé “De personne à personne”, la situation sanitaire sur place s’est sensiblement améliorée. »
"L’auxiliaire de santé Rashmila n’a pas hésité à quitter son emploi bien rémunéré de conseillère en études stratégiques à Katmandou pour dispenser des soins médicaux aux habitant·e·s du district reculé de Sindhulpalchok, au pied de l’Himalaya. Il lui a fallu plus d’un an pour gagner la confiance de la population locale – à force de persévérance, de courage et d’une bonne dose d’humour."
"Im zentralafrikanischen Tschad ist die Müttersterblichkeitsrate rund 140-mal höher als in der Schweiz. Die Berner Organisation Women’s Hope International hat eine Hebamme portraitiert, die sich mit einfachen Mitteln aber viel Herzblut für sichere Geburten in ihrer Heimat einsetzt."
Medienmitteilung
"Mitte Mai, an der 98. Generalversammlung von SolidarMed im Neubad in Luzern, übernimmt die Juristin Eliane Kiener die Geschäftsleitung von Jochen Ehmer. Zuletzt war sie für die Direktion für Entwicklung und Zusammenarbeit (DEZA) in verschiedenen Positionen und Ländern tätig. Der Public-Health-Experte Ehmer wird der Organisation erhalten bleiben und die neugeschaffene Stelle als «Leiter Medizin und Public Health» übernehmen."
Documentation MMS Conference 2024
Young people face considerable challenges in addressing their SRHR needs, encompassing prevention of unintended pregnancies, sexually transmitted infections, early marriage, and sexual coercion and violence. In many countries in the global South there is an overarching issue exacerbating these SRHR challenges which is the lack of solutions tailored to the youth's unique needs and societal contexts. The MMS SRHR Conference 2024 explored what kind of locally led and low cost innovations are in place to reach young people, who are the drivers of such projects and initiatives and how can these locally led innovations be scaled up.
Conflict, climate disasters and regressive reproductive rights deny pregnant women access to a doctor or midwife, Save the Children reports
"Women in countries affected by conflict are three times more likely to go without a skilled birth attendant, and three times more likely to give birth outside of a health facility, according to a new report by Save the Children. Climate disasters and regressive reproductive rights and education are also denying pregnant women access to a doctor or midwife, the charity said."
Gh5050 is launching its first ever report on planetary health at the Planetary Health Summit (PHAM2024) in Kuala Lumpur, Malaysia.
"As Earth’s natural systems deteriorate, marginalised communities bear the brunt, often excluded from solutions. Our report delves into how gender considerations shape global responses to planetary health crises. Our analysis of 114 organisations reveals gaps in gender integration in planetary health efforts. While some recognise gender inequalities’ structural roots, many overlook gender entirely. Transformative gender justice demands inclusive leadership. While progress has been made in gender parity, disparities persist—particularly in representation from low- and middle-income countries. This report complements our annual Global Health 50/50 Report, highlighting organisations’ commitments to gender equality in global health."
Malaria remains a huge health challenge in the African region, which is home to 11 countries that carry approximately 70% of the global burden of malaria.
"In a significant step forward for malaria prevention in Africa, three countries—Benin, Liberia and Sierra Leone—today launched a large-scale rollout of the life-saving malaria vaccine targeting millions of children across the three West African nations. The vaccine rollout, announced on World Malaria Day, seeks to further scale up vaccine deployment in the African region. Today’s launch brings to eight the number of countries on the continent to offer the malaria vaccine as part of the childhood immunization programmes, extending access to more comprehensive malaria prevention."
Ein Gastkommentar von Ilona Kickbusch
"Im Zusammenhang mit den Diskussionen der Weltgesundheitsorganisation (WHO) um ein Pandemieabkommen reden Kritiker von einer «WHO-Diktatur». Davon kann keine Rede sein, die Mitgliedländer sind denn auch weit davon entfernt, eine Einigung zu erzielen. Die Fehlinformationen zu den derzeitigen Verhandlungen am Sitz der Weltgesundheitsorganisation (WHO) in Genf nehmen zu. Besonders laut sind jene Stimmen, die einen drohenden Souveränitätsverlust der Nationalstaaten und eine «WHO-Diktatur» am nahen Horizont herbeireden. Sie wissen offenbar wenig über den Standardablauf internationaler Verhandlungen – oder wollen das gar nicht wissen."
"We bring you this edition as these negotiations appear to be at a tipping point that would determine whether countries will be able to continue with these discussions or if this will fail." - Priti Patnaik
"WHO member states finally began text-based negotiations on a new Pandemic Agreement at WHO this week after more than two years since the process commenced. This comes far too late, with just over a handful of negotiating days left to conclude this process. As a result, the risk of a weak text emerging out of this process is nearly certain now."
"“Get this done” – and if you disagree, don’t block consensus, was the heartfelt plea made by World Health Organization (WHO) Director-General Dr Tedros Adhanom Ghebreyessus to member states negotiating a pandemic agreement on Friday (3 May). Tedros was addressing the ‘stocktake’ in the middle of the final 10-day meeting of the intergovernmental negotiating body (INB), and it was clear that member states were nowhere close to the finish. “You are here for the same reason this organisation was created in the first place – because global threats demand a global response,” said Tedros."
In this story we look at key, contentious provisions on equitable access of medical products and on financing – on which hinges the final deal on the IHR amendments.
"Negotiations on the International Health Regulations go down to the wire as countries were unable to complete the discussions at the end of the final meeting of the Working Group to amend the IHR, that concluded this week. Riding on a constructive approach and an overall positive momentum, countries made steady progress under the decisive leadership of co-chairs Abdullah Asiri and Ashley Bloomfield, but a few areas of contention remained as the clock ticked away towards the conclusion of the meeting on April 26, Friday. The working group decided to buy additional time to conclude the negotiations and are expected to meet on May 16-17 to complete the process. More time is needed to reach consensus on key contentious matters including on technology transfer, a dedicated fund, governance of an implementation committee, among other areas, diplomatic sources said."
"The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), warmly welcomes the launch of the Africa Health Workforce Investment Charter, which was signed today in Windhoek, Namibia, at the Africa Health Workforce Investment Forum. The African continent bears a quarter of the global disease burden and endures over 100 health emergencies a year. Yet half of the global shortage in health workers affects the continent, which has only 4% of the global workforce. To date, 1 in 3 qualified health workers in Africa is unemployed or underemployed, given challenging macro-economic contexts, imbalances in health labor markets, unfavorable working conditions in health, and safeguarding and security risks. The World Health Organization (WHO) forecasts that its African Region (47 countries) will face an estimated shortfall of 5.3 million health workers by 2030."
Statement by the World Health Organization (WHO)
"WHO is deeply concerned that a full-scale military operation in Rafah could lead to a bloodbath. More than 1.2 million people are currently sheltering in the area, many unable to move anywhere else. A new wave of displacement would exacerbate overcrowding, further limiting access to food, water, health and sanitation services, leading to increased disease outbreaks, worsening levels of hunger, and additional loss of lives."
“The world is off track to reach most of the Triple Billion targets and the health-related Sustainable Development Goals,” said World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus. His comments were part of the WHO Results Report 2023 released on Tuesday. The triple billion targets involve one billion more people benefitting from universal health coverage (NO), one billion more people better protected from health emergencies (NO), and one billion more people enjoying better health and well-being by 2025 (YES)."
Slow Progress 23 Years After Landmark Abuja Declaration
"African governments are falling far short in their commitments to prioritize public spending on health care, contributing to widespread inequalities in healthcare access and outcomes, Human Rights Watch and the Kampala-based Initiative for Social and Economic Rights (ISER) said today. As the 23rd anniversary of African Union states’ historic commitment approaches, new data reveal alarming stagnation, widening regional inequalities, and pointing up the need to correct course."
Many lower-income countries are spending less on health than they did before the COVID-19 pandemic at a time when donor funding is on the decline.
"In Washington, D.C., where health and finance ministers, global health leaders, and international funders gathered for the World Bank’s Spring Meetings, these are ways of talking — or not talking — about a growing fear: A large group of countries are facing an alarming health funding landscape. “We have a problem globally,” health economist David Evans said Thursday at a forum on health financing. The problem, Evans said, is particularly acute in a group of 28 low- and middle-income countries whose governments are spending less on health than they did before the COVID-19 pandemic, with no prospect — according to International Monetary Fund projections — of returning to those pre-pandemic levels in the next five years."
"This year marks the 15th anniversary of the first publication of the framework of “planetary boundaries,” which describes the biophysical limits of Earth systems that, if breached, could have devastating consequences for humanity. Six years after this publication, the report of the Rockefeller-Lancet Commission on Planetary Health defined the concept as “the health of human civilisations and the natural systems on which they depend.” Though progress has been made in the field of planetary health, we need stronger commitment and action for justice and transformative change."
Outgoing special rapporteur David Boyd says ‘there’s something wrong with our brains that we can’t understand how grave this is’
"The race to save the planet is being impeded by a global economy that is contingent on the exploitation of people and nature, according to the UN’s outgoing leading environment and human rights expert. David Boyd, who served as UN special rapporteur on human rights and the environment from 2018 to April 2024, told the Guardian that states failing to take meaningful climate action and regulating polluting industries could soon face a slew of lawsuits."
Les plus pauvres du continent africain et la production agricole locale sont mis en danger par la hausse des températures, qui n’est pas assez documentée, estime, dans une tribune au « Monde », Marie de Vergès.
"A Kayes, une ville du sud-ouest du Mali, le mercure est monté le 3 avril jusqu’à 48,5 °C. Du jamais-vu dans le pays. La veille, 5 000 kilomètres plus à l’est, au Soudan du Sud, les écoles venaient tout juste de rouvrir après deux semaines d’interruption forcée pour cause de températures insupportables, avec des pics à 45 °C. A Kinshasa, la capitale de la République démocratique du Congo, les dernières semaines se sont aussi déroulées dans une ambiance suffocante. « La chaleur, on dirait une publicité de l’enfer », grinçait mi-mars sur X l’un des habitants de la mégapole."
Brussels says it is too often trying to do "everything, everywhere, all at once."
"A 20-page thunderclap hit European development watchers this week when Politico published the European Commission's draft vision for how its development policy should look for the next five years. However, anyone “truly shocked" — as the NGO confederation CONCORD claimed to be — by the document’s plan for development assistance to be recast as “investment” in a three-part offer (together with trade and macroeconomic assistance) to countries in the global south has not been paying attention. The commission has been talking like this for years."
By Ilona Kickbusch and Louise Holly
"In the Lancet Series on the commercial determinants of health, authors warn that policy inertia is enabling the products and practices of some commercial actors to cause substantial harms to health. In the digital environment, the actions of commercial actors (including those involved in social media, information and communications technology, and digital health solutions, to name just a few) are contributing both directly and indirectly to health and wellbeing."
"Artificial Intelligence (AI) can save lives – but “we need to get the regulations right,” according to Dr Ricardo Baptista Leite, CEO of HealthAI, the agency responsible for artificial intelligence in health. To address the urgent need for the robust regulation of AI in the healthcare sector, HealthAI has initiated a worldwide community of practice (CoP), the organisation said last week. This initiative aims to strengthen each nation’s capacity to create well-informed regulations that promote AI’s ethical and fair utilisation in healthcare."
Date limite: 31 mai 2024
"La Centrale Sanitaire Suisse Romande (CSSR) met au concours le poste de : Chargé·e de projet 50 %. Les tâches principales concernent la gestion directe de plusieurs projets de développement en collaboration avec nos partenaires sur le terrain, le suivi de la situation locale en matière de santé, et la prospection occasionnelle pour de nouveaux projets. Envoyez par e-mail votre dossier complet (lettre, CV, certificats…) à: a.martenot@css-romande.ch."
Medicus Mundi International (MMI) "After the series of “EB TODAY” civil society meetings related to the 154th Session of the WHO Executive Board and two well-attended intersessional civil society check-in meetings on 20 March and 23 April, join us again on Tuesday 14 May 2024 to jointly look ahead to the 77th World Health Assembly. …and bring along your input and your questions and calls!"
SoldarMed "Am Donnerstag, 16. Mai 2024 findet die 98. Generalversammlung von SolidarMed im Neubad in Luzern statt. Mitglieder und Interessierte können sich an diesem Anlass informieren und Fragen einbringen. Im Anschluss an die ordentliche Generalversammlung hält SolidarMed-Vizepräsidentin Bernadette Peterhans einen kurzen Einstieg in das Thema «Lautes Leid gegen stille Not: Wo ist die Gerechtigkeit?». Anschliessend diskutieren Dr. Andreas Missbach (Geschäftsleiter Alliance Sud) und Dr. Bernhard Steiner (Kinderarzt und Luzerner SVP-Kantonsrat) darüber, welche Solidarität wir uns wünschen und wie wir uns angesichts dieser Weltlage gerecht verhalten können. Jérôme Martinu (eh. Chefredaktor Luzerner Zeitung) moderiert das spannende Gespräch. Wir freuen uns, wenn Sie sich an der Diskussion einbringen."
Graduate Institute - Global Health Centre "Each year during the World Health Organization (WHO)’s World Health Assembly (WHA) happening in May, the Platform hosts a series of side events and discussions around critical global health issues, raising awareness among member states attending WHA meetings. During the Geneva Health Week, the Platform provides important exposure for a wide range of global health actors, enhancing collaborations and partnerships for future discussions and events."
Terre des Hommes Fondation "The operationalization of the humanitarian-development nexus in health plays a crucial role in strengthening the surveillance, preparation, and response to healthcare crises by local health systems and communities, especially in the current context of local conflict and global climate change. (...) This event is expected to generate a wealth of knowledge, insights, and collaboration opportunities that can further support the integration of development and humanitarian efforts in the health sector. By analysing experiences, sharing good practices, highlighting policy changes, and addressing challenges, the event can contribute to a more cohesive and effective approach to respond to health crises in complex and dynamic environments."
Hôpitaux Universitaires de Genève "Depuis les années 70, les pratiques des communautés hospitalières ont profondément évolué à la lumière des enjeux de santé publique, notamment la transition épidémiologique ou les impacts environnementaux sur la santé. Les perceptions éthiques dans les soins et la recherche ont également été profondément revisitées. Des attentes légitimes et partagées visent une équité Nord-Sud dans les projets de coopération hospitalière, que ce soit dans les objectifs, les modalités de mise en œuvre ou les financements. Les forces et faiblesses des systèmes de santé, mises en évidence lors de la pandémie COVID-19, imposent de réfléchir à nos pratiques. Enfin, les efforts nécessaires de décarbonation sont par également à intégrer dans les projets de coopération hospitalière internationale. Le séminaire, hébergé par les Hôpitaux universitaires de Genève, abordera ces questions en associant étroitement les différents acteurs concernés et cherchera à identifier les bonnes pratiques à mettre-en-oeuvre."
Medicus Mundi International (MMI) "The organizing team wants the Code to be(come) a strong, relevant, and effective instrument, at the same time acknowledging the dire realities behind the somewhat flattering and rather data-driven reports that Member States are submitting. What are the stories of health and care workers brave enough to undertake their move to another country? What are the realities of health workers in countries with health and care worker shortages? Is it at all possible to achieve the ideal of the so-called ‘triple win’, i.e. benefits for migrating health and care workers, for sending countries and for receiving countries? We will explore these questions through testimonials and stories by people grounded in reality, and you will have the opportunity to engage in the discussion with your own perspectives. Come and join us."