Early in my career, long before I joined the Global Fund, I worked as a medical doctor in South Sudan, Uganda, Bangladesh and El Salvador, where humanitarian crisis and refugees abounded. I worked with internally displaced populations in South Sudan and later with Sudanese refugees in Uganda. I coordinated health surveillance at Rohingya refugee camps in Bangladesh. My first concern was always getting people healthy. I saw the physical and emotional suffering of children, women and men who had been forced to flee their homes.
As we mark World Refugee Day, we are reminded that every day, thousands of families are forcefully displaced as a result of war and persecution. When people abandon their homes and communities, they also leave behind their family doctors or nurses who know them. Many interrupt treatment, which spreads drug resistance, and makes them vulnerable to new diseases.
No numbers can capture the trauma that human beings go through when their lives are severely disrupted. However, the current refugee crisis is reaching an enormous magnitude: As of end 2016, there were 22.5 million refugees, over half of whom were under the age of 18; 40.3 million internally displaced persons; 2.8 million asylum seekers. No single government or organization can address it alone.
The Global Fund partnership was created 15 years ago to free the world of the burdens of HIV, tuberculosis and malaria, and to invest in resilient and sustainable systems for health. Today, to end the epidemics and address new emerging threats to global health security, we need to reach the most vulnerable people, with prevention and treatment services, wherever they are.
The Global Fund is focusing on health needs in challenging operating environments by increasing our flexibility, speed of response, and partnerships with emergency responders and community groups on the ground. We must address health needs where they are, especially when people in need are forced to move across borders.
In Rwanda, for example, the Global Fund and UNHCR, the UN Refugee Agency, are working together to address health needs for Burundian refugees. Under an Emergency Fund grant, both agencies are providing refugees services that include access to HIV testing and counselling, treatment to prevent mothers from passing HIV to their babies, antiretroviral therapy for people living with HIV, indoor residual spraying of homes and schools to ward off mosquitoes, and screening and treatment services to patients with TB.
In Eastern Africa, where conflicts and political instability forced many families to flee and seek asylum in neighbour countries, the Global Fund and the Intergovernmental Authority on Development regional bloc are supporting refugee populations in 20 refugee camps in several countries, including those that have hosted large refugee populations in recent decades.
In the Middle East, where many countries are coping with the effects of war, humanitarian crises and large numbers of internally displaced people and refugees, another regional grant is providing TB, HIV and malaria services in Syria, Yemen, Jordan and Lebanon.
We must also track how long-term investments can contribute to the prevention of crises, and to build a response to internal displacements and refugee crisis. Much of the Global Fund’s work focuses on building stronger and more resilient systems for health, both to deliver reductions in HIV, TB and malaria, and to prevent, detect and respond to new disease outbreaks. We saw the devastating impact of weak health systems during the Ebola outbreak in West Africa. When strong health systems succeed, communities thrive and countries grow economically, and people can have the opportunities and dignity they deserve. Few investments can contribute more to thriving communities and global health security than training and retaining community health workers and nurses, improving local health clinics, deploying secure supply chains that deliver diagnostics and treatment when and where they are needed.
In our highly connected world, an infectious disease outbreak anywhere is a threat to us all. We are constantly reminded that diseases know no borders. Fighting malaria resistance in the Mekong, drug resistant TB in Eastern Europe or Ebola in West Africa is our shared responsibility. On World Refugee Day, we should remember the best way to improve health and prevent new diseases from spreading is to meet the needs of the most vulnerable amongst us, especially those forced to flee their homes and cross national borders.
Marijke Wijnroks, Interim Executive Director of the Global Fund. Photo: © UNHCR/Dominic Nahr.