I thank the Chairman for that introduction and the opportunity to meet the committee. I have already met parliamentary foreign affairs committees in the US, Britain and Norway. It is a privilege to be in Dublin today.
The role the committee may have in advocacy for these key issues of health and development is essential in any democracy. At a time when a number of competing priorities come on the development agenda, advocacy for foreign aid for health is a key priority.
The Global Fund is a young organisation. While only six years old, it has become the major multilateral fund for tackling the three major diseases in the developing world, AIDS, malaria and tuberculosis.
It was created in 2002 when the world realised the extent of the impact of the AIDS pandemic. It was created at a time when the world realised that while we have treatment for patients with AIDS, malaria and tuberculosis, 6 million people die every year of these diseases in the developing world. More than 2.5 million people, 8,000 every day, die from AIDS in the developing world. One child below the age of five years dies from malaria every 30 seconds in Africa although we know how to prevent and treat it. Tuberculosis, a neglected disease, kills the poorest of the poor in the world when easy and cheap treatment for it is available.
The world has realised that health is an investment for development and not an expenditure. In 2002 the former UN Secretary General, Kofi Annan, called for the world to come together in a major effort to fight these three diseases. The Global Fund was created with strong funding from several countries. Ireland was one of the first donors with several donors from the G8.
It was created on the basis of several guiding principles. The fund is a financial instrument and not an implementing agency or another of the existing ones in this area. It exists to raise large amounts of funds and disburse them to developing countries to implement their own programmes, operating with national ownership as a key principle.
The developing countries decide the amounts and nature of the funding. The Global Fund, through an independent panel, reviews requests made and judges them if they are fully relevant and scientifically, medically and programmatically sound. Such programmes, funded by the Global Fund, are aimed at supporting both prevention and treatment, as the two are strongly linked.
The fund is there to impact on AIDS, malaria and tuberculosis. Until 2002, the world was struggling with these epidemics. Now we can demonstrate results and impact. The next slide shows the current regional distribution of our funding, of which 60% goes to sub-Saharan Africa and 70% to low income countries, which is of interest to Irish Aid and the Government, as they place a strong focus on the poorest of the poor. Of the remainder, 13% goes to east Asia and the Pacific, while China is the subject of a big portfolio for us. Eastern Europe and Central Asia, which are highly affected by AIDS, receive 8% of our funds. Latin America also receives 8%. South Asia, principally India, receives 10%, while the Middle East and North Africa receive about 5%.
The next slide shows that we are not only funding governments, government entities or ministries of health. Government entities only account for about 50% of our recipients; 40% of our funds goes directly to NGOs and FBOs. We know in the developing world that these organisations are capable of implementing programmes in areas such as prevention and are often as good as, if not better than, government entities.
The next slide shows figures explaining what has been achieved in less than six years. In six years the Global Fund has committed more than €10 billion to 136 poor countries to tackle the three diseases. Approximately 55% of our funding goes to tackle AIDS, 30% to 35% to tackle malaria and 10% to 15% to tackle TB. While nobody in the developing world was accessing treatment for AIDS in 2002-03, more than 1.4 million people are now supported by the Global Fund in accessing such treatment. A total of 3 million people worldwide are receiving such treatment. The other half are being supported by the US bilateral PEPFAR programme. Some 3.5 million people have been treated for TB, while close to 50 million bed nets have been distributed to prevent children and pregnant women from contracting malaria. This is having an impact, as we can demonstrate in the next slide.
We can demonstrate the impact because the Global Fund is based on the concept of working on an unprecedented scale on development and developmental aid in health to truly make a difference. None of us in public or private entities in any country can do it alone. When it comes to fighting an epidemic, the world must come together collectively. That is what is happening in the Global Fund. There is evidence of decreases in malaria mortality of up to 80% in a number of regions in Africa. There are areas such as Zanzibar where malaria has effectively been eradicated in the past two years. This is also true in Rwanda and parts of Tanzania, Zambia, Zimbabwe and Swaziland.
There has been significant progress in the fight against TB in some of the high prevalence and high burden areas such as China and the Philippines. In addition to the impressive exponential increase in access to anti-retroviral drugs in respect of HIV, there is evidence of a decline in mortality and morbidity in a number of countries, including Ethiopia and Malawi, two of the nine focus countries for Irish Aid.
The next slide details a major evaluation decided on at the inception of the fund five years ago. This multi-million euro five-year evaluation is a significant international exercise to assess the fund's organisational efficiency, model, weaknesses and strengths. It will also assess the degree to which what we call the Global Fund partnership environment is working. Since it is a funding mechanism, it transfers funds into countries, but it is for partnerships on the ground — countries, bilateral donors, the multilateral UN system and civil society — to ensure the programmes are supported in such a way as to allow for their implementation.
For the first time, study area 3 will assess the impact of the funding on the three diseases. I hope Ireland and other donors in the rich parts of the world will be convinced that this investment is paying off and that we are affecting the health of people, mortality, morbidity and, indirectly, poverty.
We can skip the next slide and move to the slide labelled "Global Fund and health systems". I want to show the committee this slide at a time when people are asking whether there is enough or too much funding for AIDS, TB or malaria and whether they should invest more in building systems. The disease versus health systems debate is a false dichotomy. People should not believe that when we state we fund the fight against disease, we do not fund health systems. In fact, we are active in funding health systems. As is evident from the slide, 23% of our resources go to support health care workers through training or salaries. In Ethiopia, we have trained and supported 30,000 health care workers to develop malaria and HIV programmes and refurbished 600 clinics that are obviously not just for treating AIDS patients but also whoever presents there. In addition, there is strong evidence in countries such as Haiti, Rwanda and Ethiopia that investing in AIDS, malaria and TB programmes is having a strong impact on health systems. By decreasing the burden placed on countries and their health systems by malaria and AIDS, we free them up. As the Rwandan Minister of Health stated recently, hospitals can become hospitals again because they are not over-burdened with disease.
The next slide shows some of our current innovative actions, including four of the measures we are taking in round 8, our current call for offers for 2008 when we request countries to send us their proposals. Four measures in 2008 add up to a number of innovative models of intervention. The first is dual track financing, that is, a country sending a request can ask that part of the funds go to a principal recipient such as a government entity and part go to a second primary recipient from civil society. This is one more major effort to fund civil society in addition to government.
The second innovation is further increasing our effort to fund health systems. Just as the Global Alliance on Vaccines and Immunisation, GAVI, has, we have a window for funding health systems to which countries can apply. The third innovation is a specific line of funding, called community systems strengthening, that exists to empower civil society and to allow networks to be built and those in the community to handle the flow of money that comes with our grants. We were asked by the board to increase our effort and attention to gender issues, whether for women and young girls in the AIDS epidemic in southern Africa or sexual minorities in other parts of the world.
I refer to our resource outlook for 2008-10. At our last replenishment conference in Berlin in September 2007, co-chaired by Mr. Kofi Annan and Chancellor Merkel, the total of firm pledges received for that period is $9.7 billion, including the three year commitment from Ireland, which I was pleased to sign and confirm with the Minister of State at the Department of Foreign Affairs, Deputy Michael Kitt, a few moments ago. That figure does not include the contributions from Japan and Canada, two major donors that were not in a position to pledge in September 2007 for government transition reasons. It does not include the 2008 and 2009 contributions from the US. I expect the figure to be $12 billion for the next three years. This will allow us to continue the ongoing 550 programmes to which the Chairman referred and to launch new rounds every year of amplitude of $1 billion to $3 billion per year. Even if these figures are impressive, and maybe unprecedented in health and development, they are far below the estimated needs by UNAIDS and WHO for these three killer diseases in the developing world.
On behalf of Global Fund and the millions of people alive thanks to these efforts, I thank the Irish Government, the Irish Parliament and the committee for its support of the Global Fund. I thank the committee for the opportunity to speak here. It is a privilege to speak to foreign affairs committees in parliaments. The commitment of the committee and its involvement in advocacy to keep health and development high on the political agenda on the national and international scene is essential. I do not know how many members are part of the international interparliamentary groups that deal with these diseases but when I travel to countries I see the important role that parliamentary support can play.
I extend to the committee a standing invitation, if ever its members wish to travel, to visit some of the countries concerned. While every developing country is a Global Fund recipient, they might prefer to visit one of the nine countries on which Irish Aid's work is focused. We would be pleased to arrange such a visit. We have already hosted parliamentarians from the US, Italy, Germany, Britain, France, Norway and Sweden and we would be pleased if members could see for themselves the impact of what is decided by this Parliament. I thank the committee for its support and for the opportunity of meeting it.