Supporting local governments to combat HIV 

Dr Greg Munro, CLGF Secretary-General

30 September 2016



The month of September 2016 saw Prime Minister Justin Trudeau hosting the fifth Replenishment Conference of the Global Fund for HIV, TB and Malaria, in Montreal Canada.  It appears to have been a clever choice for a host. Under his leadership and influence a record $12.9 billion was raised in the effort to further resource the eradication of the three diseases by 2030. Commonwealth countries were amongst those who responded generously to the global need.  With an increased pledge of £1.1 billion over the next three years, the United Kingdom was the second largest donor after the USA. Canada pledged 23% more than it had in the previous donor period, Australia pledged A$220 million and even Kenya as a low income country pledged $5 million. The pledge total will save 8 million lives, avert 300 million infections over the next three years and tackle stigma and discrimination related to the three diseases. 

The Global Fund was set up in 2001 and resources country led and managed programmes to combat the three diseases. To date $40billion has been spent or allocated globally with an estimated 20 million lives saved. For HIV alone, the numbers are large. A total of 38 million people are living with HIV and an estimated 40 million have already succumbed to the virus. That is equivalent to the combined populations of Australia, New Zealand, the Pacific islands, Canada and Zambia! Alarmingly almost half (48%) of the global HIV burden is carried by just 13 countries. Of these 13 countries, 11 are Commonwealth countries (12 if we include ex-Commonwealth countries like Zimbabwe). The Commonwealth can (and does) play a significant role in combating HIV through poverty alleviation, youth awareness, gender programmes, tackling homelessness etc, and given the high burden of disease across the Commonwealth we need to continue to do so.

The role of local government in responding to HIV is essential. In Sub-Saharan Africa, 45% of those living with HIV reside in urban areas and cities. It is even higher in Asia.  Increasing urbanisation means that issues such as HIV and TB need to be at the forefront of local government development agendas, and in many cities there are major success stories. The city of Durban /Ethekweni in South Africa now has a transmission rate of HIV from mother to child of less than 1%. In both Francistown and Gaborone in Botswana, 96% of pregnant women now access anti-retroviral medication. Realising the important role city governments have to play in combating HIV, UNAIDS has launched the Fast Track Cities Initiative to increase the level of testing and treatment, reducing new infections and tackling discrimination. Recently the Global Fund has also started to award funding to city initiatives.

The Replenishment Conference on 16-17 September represents a global coalition in action – countries coming together to pool their resources to tackle a global problem, where national issues and imperatives are put aside in order to collectively try and contribute to making the world a healthier and less discriminatory place. Given the burden of disease in the Commonwealth and the importance of action at a city governance level, the Commonwealth Local Government Forum will maintain a focus on HIV in its agenda to support local governments to tackle major developmental community challenges. In so many of our cities, towns and villages, HIV is a very real issue, resulting in much suffering and hardship. The resources, the experience and the innovation to tackle HIV is there. We just need to harness it.

CLGF SG Dr Greg Munro can be contacted on greg.munro@clgf.org.uk. You can also follow him on Twitter @CLGFSG_GMunro