Nearly one-fifth of Global Fund-supported programs are in French-speaking countries, collectively known as La Francophonie. Five francophone nations – France, Belgium, Switzerland, Luxembourg and Canada – have been solid supporters since 2002, working to defeat diseases that once seemed unstoppable. New donor countries including Benin, Côte d’Ivoire, Senegal, and Togo are increasing their support, creating a surge of commitment and stronger health systems across the francophone world.
The impact is unmistakable. More than 2 million lives have been saved in 28 francophone countries through Global-Fund supported programs, helping families from the Caribbean to West and Central Africa to Southeast Asia.
To date, the Global Fund has invested approximately US$6.9 billion in francophone countries . The majority of the Global Fund investments in La Francophonie are in West Africa, which carries a significant proportion of the world’s malaria and HIV burden.
As a result of Global Fund-supported programs in francophone countries since 2002:
West Africa, which is predominately francophone, is disproportionally affected by malaria, and accounts for half of the global burden. More than 313 million people are at risk, particularly young children and pregnant women, who are more likely to die of the disease. Through effective partnerships, the Global Fund is supporting mass distribution campaigns to enable countries like Côte d’Ivoire to achieve universal insecticide-treated net coverage to protect families. This and access to treatment and prevention services have led to a 66 percent decline in malaria mortality between 2000 and 2015 across francophone Africa.
Jeanine Vavisoa is in charge of the community health center in the village of Vohidrotra, Madagascar, which provides treatment for malaria and other diseases. Around 65 percent of the population in Madagascar lives in rural areas. For a patient suffering from malaria, having a health center within walking distance can mean the difference between life and death. With Global Fund support, the country aims to reduce malaria-related deaths to zero by the end of 2017.
Following the tragic death of his daughter 10 days before she was due to return back to school in 2009, ElHadj Diop decided to make the fight against malaria his life struggle. “In 2009, we knew nothing of this disease, which was causing 40 percent of the deaths in our commune and harming the education of our children.” Through programs supported by the Global Fund and with the awareness and education efforts of Mr. Diop and health workers on how to prevent and treat malaria, the Thiénaba commune in Senegal now has more than 20 malaria-free villages and its mortality and school absenteeism rates have been reduced to nearly zero.
The HIV burden is lower in francophone Africa countries than the rest of the continent; however it accounts for 13 percent of new HIV infections in sub-Saharan Africa. Through Global Fund-supported programs, antiretroviral treatment coverage in these countries dramatically increased from 3 percent in 2005 to 38 percent in 2015. This has resulted in a dramatic progress, including an 88 percent drop in AIDS-related deaths in Rwanda and a 45 percent decrease in incidence rates in Cameroon.
At the Halles Clinic, Dady Camara, a former sex worker, welcomes, advises and guides some 40 people daily who are seeking information on their sexual health and HIV prevention and treatment. With Global Fund support, this clinic opened in 2010 to offer services tailored to the needs of key populations in Bamako, Mali. The clinic now has an active file of 600 people. It also provides regular medical follow-up and treatment to more than 100 men who have sex with men and more than 50 sex workers, two key population groups that are at heightened risk of HIV and often face reduced access to services and marginalization.
More women have access to antiretroviral treatment in the Democratic Republic of Congo. The number of women living with HIV who received treatment increased by 17 percent between 2010 and 2014, and the Global Fund supports women-led community organizations working to address gender-based violence – a risk factor for HIV transmission.
Through Global Fund-supported programs, mortality rates due to TB dropped by 66 percent in Cambodia and 71 percent in Central African Republic between 2000 and 2015. These countries, along with Viet Nam and the Democratic Republic of Congo, are part of the 30 nations considered to have a high burden of TB. Partnerships with organizations like Expertise France, the Stop TB Partnership and UNITAID are increasing impact, reducing treatment times for multidrug-resistant TB, increasing rapid diagnostic testing to improve case detection, and providing important TB/HIV integrated diagnostics.
Countries or regions affected by poor governance, disasters or conflict require flexible approaches to deliver needed services and medicines. Eight of the 28 francophone countries where the Global Fund supports programs are considered challenging operating environments – including Haiti. Despite massive challenges such as natural disasters, poverty and political instability, Haiti has made tremendous progress. The number of people on antiretroviral therapy for HIV has more than doubled in the past five years, and the Global Fund is collaborating with the World Bank and the United States Agency for International Development to strengthen TB/HIV services.
Prisoners are at greater risk for TB and HIV because of the conditions in prisons and because they are often denied services that are available outside the prison. Sanitary conditions at the overcrowded Abidjan Detention and Correctional Center in Côte d’Ivoire are a challenge – but a unique partnership between the University Hospital of Bordeaux, Expertise France and the Global Fund is providing full case management for inmates with TB or HIV, resulting in better health for inmates.
The fight against AIDS, TB and malaria can only be won by building strong, resilient systems for health, something that was highlighted by the 2014-2015 Ebola outbreak in West Africa. Countries with stronger health systems, such as Senegal and Mali, were able to contain the epidemic more quickly than others in the region. The Global Fund works with countries and partners to improve health care and systems to fight AIDS, TB and malaria – and to address new and emerging health threats like Ebola, creating healthier communities across La Francophonie.
Francophone countries have been a strategic area of focus of the Global Fund since its inception in 2002. In 2000, AIDS, TB and malaria seemed unstoppable. Five francophone nations – France, Belgium, Switzerland, Luxembourg and Canada – joined the Global Fund to fight back against these diseases. Their sustained commitment over the last decade, coupled with strategic partnerships and increased domestic financing, has led to transformative results in francophone countries and has saved more than 2 million lives as of the end of 2015.
Photography (in order of appearance): Senegal – The Global Fund / Didier Ruef; Madagascar - The Global Fund / Georges Mérillon; Senegal – The Global Fund / Nana Kofi Acquah; Mali – The Global Fund / Nana Kofi Acquah; Democratic Republic of the Congo – The Global Fund / Lionel Healing; Haiti – Jonas Bendikson / Magnum Photos for the Global Fund; Côte d’Ivoire –The Global Fund / Georges Mérillon.
Published 22 November 2016