INTERVIEW — PETER SANDS, EXECUTIVE DIRECTOR OF THE GLOBAL FUND The Global Fund finances efforts to defeat HIV, tuberculosis and malaria around the world. Since its creation in 2002, the partnership has parceled out more than $50 billion in around 100 countries. You're hunting for your next three-year round of money, how is it going? The next replenishment conference will be hosted by President Joe Biden in New York (in September). And my target is raising $18 billion, a 30 percent increase compared to 2019. When you do the math on what's happened to HIV, TB and malaria as a result of Covid-19, we've basically gone backwards or stayed flat across most metrics. What is the U.S. putting in? They've been explicit in their intent to put in $2 billion for financial year 2023 and $6 billion in the three-year cycle. So we have to find $2 for every $1 we get from the U.S. We're at the real crunch point, right now. Where should we watch next? We have to broaden the donor base. Germany might be saving something for the G-7 summit at the end of the month, and we got the first private donations at the World Economic Forum. Now we're talking to middle-sized donors and asking them to step up by more than the 30 percent increase we're aiming for overall. What's the one thing you wish more potential donors understood? People who lack proper nutrition are more vulnerable to infectious diseases. Most conflicts kill more people from infectious diseases than they kill from bullets and bombs. My point is that all these crises aren't sitting in neat little boxes. It's not that we have a war, or a pandemic, or a debt crisis, or a food crisis. From the point of view of the people who are most at risk, all these things kind of pile on top of each other. We've got to get better at managing the interactions between cascading crises. Who are your big targets? Australia is a significant opportunity. Let's just say that they're at a fraction of where Canada is. A quarter of the world's TB is in India. But India is our single largest source of supply (of drugs). So India is in transition and it's an opportunity for leadership in a fund they have benefited from massively. Which government agencies will make this happen? Development [aid] ministers have typically been the interface point. But the calls on development budgets at the moment are [huge]: They've spending on Covid, Ukraine, now the food crisis. But now health ministers are looking at it from a health security point of view and finance ministers are looking at it from an economic security point of view. Gita Gopinath , who's the first managing deputy managing director of the IMF, spoke at the launch of our investment case. That would never have happened before. When it comes to preparedness, what's common across pandemics? It's exactly the same capabilities. The existing infectious diseases — if we are blunt about it — were and really are pandemics, only we don't call them that because they don't affect people in rich countries. So how do we avoid getting caught out next time? Being more intentional about building multipathogen capabilities now [in the wake of Covid]. Preparedness has a very sharp decay curve: People lose interest pretty quickly. This is a solvable problem, and it would require a tiny fraction of what we have deployed on Covid overall to prepare for it. Is it likely we'll need to see a debt renegotiation to free up the money for investing in pandemic preparedness? It is going to be extremely challenging. We now also have the knock-on consequences of war in Ukraine. So energy prices, food prices and all that kind of stuff [are] going to put more pressure on government budgets. If you look at the World Food Programme's modeling of the impact of the food crisis, it's very highly correlated with the countries we are most focused on.
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