The Global Fund continues to rely on Gross National Income (GNI), the World Bank’s faulty country income classification system, to determine which countries are eligible for lifesaving aid.
Under the present system, countries where average income is $2.76 per day are considered middle-income. The new Global Fund Executive Director should end the policy that transitions out such countries, even when HIV epidemics are still on the rise.
Los Angeles, CALIFORNIA (November 21, 2017) AIDS Healthcare Foundation (AHF), the largest nonprofit HIV organization that provides HIV care to more than 833,000 patients in 39 countries globally, including in Africa, Asia, Europe, Latin America & the Caribbean and the United States, welcomes the newly appointed Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria Peter Sands, and calls on him to end the use of Gross National Income (GNI) per capita as part of the Global Fund grant eligibility criteria.
“We are disappointed that the Global Fund to Fight AIDS, Tuberculosis and Malaria continues to use per capita income classification thresholds assigned to countries by the World Bank as one of the criteria for awarding grants,” said Michael Weinstein, AHF President. “It is high time we focused on health rather than just money. It is deplorable that wealthy countries are defining what poverty means for developing countries. By any measure, $2.76 per day is not a middle income.”
Currently, Global Fund HIV grant eligibility is primarily based on a country’s World Bank lending group classification which is tied to its GNI, and secondly based on the HIV prevalence rate as a proxy for the burden of disease.
When a country’s GNI per capita exceeds $3,955, the World Bank considers it an upper middle-income country (UMIC). According to the current Global Fund policy, if a UMIC does not have an exceedingly high burden of disease, it is no longer eligible for funding—even if its HIV epidemic is beginning to accelerate.
“The Global Fund has a ‘Transition Readiness Assessment’ tool that considers the economic capacity of UMICs to take over and sustain programs which are currently being funded by the GF,” said Dr. Jorge Saavedra, AHF’s Global Public Health Ambassador and former head of the national AIDS program of Mexico. “Regrettably, this process does not account for the growth of new HIV incidence as part of the formula.
“Right now, a developing country can be cut off from support even if the rate of new HIV infections is skyrocketing and its epidemic is not under control,” Dr. Saavedra added. “The use of GNI per capita thresholds developed by the World Bank for lending purposes to developing countries should not be used by the GF. The GF is not a lending agency but a financial mechanism whose aim is to end AIDS, TB and Malaria. It’s detrimental to global public health and there are better, more nuanced ways of making sure lifesaving support gets to where people need it most.”
For the past several years, AHF has been spearheading a broad-based and global advocacy campaign to push for reforms in the way the World Bank classifies “middle-income countries” (MIC). It held its most recent peaceful demonstration in October outside the World Bank’s headquarters in Washington, DC. Building upon its “Raise The MIC” global advocacy campaign, which was launched in 2015 with support from over 300 organizations and advocates in 30 countries, demonstrators called on the World Bank to set the lower limit of the MIC category at or above $3,650 of Gross National Income per capita—equivalent to about $10 per day—to increase poor nations’ access to foreign aid, including HIV/AIDS drugs and other essential medications. The World Bank currently designates MICs as those with an income of at least $2.76/day—barely above the International Poverty Line of $1.90/day.
AIDS Healthcare Foundation (AHF), the largest global AIDS organization, currently provides medical care and/or services to over 833,000 individuals in 39 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region and Eastern Europe. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare
Dr. Jorge Saavedra, Global Public Health Ambassador for AHF
+52.55.3233.6432 mobile +1.323.420.5493 mobile [email protected]
Ged Kenslea, Senior Director, Communications, AHF
+1.323.308.1833 work +1.323.791.5526 mobile [email protected]
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