Members from communities and civil society presenting the India Investment Case 2021 to the participants that joined virtually
The India Working Group for Health Advocacy (IWG), together with Global Fund Advocates Network Asia-Pacific (GFAN AP) launched the India Investment Case 2021 in New Delhi, India on April 25, 2022, which brought together over 20 communities and civil society representatives, technical partners, and ministry of health officials – including Dr. Shobini Rajan, Deputy Director General, National AIDS Control Organisation India (NACO) and Alternate Board Member of the South East Asia Constituency on the Global Fund Board; David Bridger, UNAIDS Country Director, India; Dr Rochana Mitra, Interim Chief Executive, Alliance India; Manoj Pardeshi, General Secretary, National Coalition of PLHIV in India (NCPI+); Mona Balani, Project Director, NCPI+; Ashi, Saba and Dinesh Kumar, TB champions from Jahangirpuri and Nehru Nagar, Delhi; Simran Bharucha, Community Representative; Gitanjali, Coordinator, India CCM; Sowmya Gupta, Deputy Program Manager, The Humsafar Trust; Vijay Singh, Love Life Society; Dr Raghavan Gopa Kumar, National Coordinator, Touched by TB; Ira Madan, Technical Expert – Community Systems Strengthening, NACO; Dr. Mayur Trivedi, Associate Professor, Indian Institute of Public Health Gandhinagar; Dr Rajesh Rana, Director, Plan International (India Chapter), along with members of the IWG and GFAN AP team.
The India Investment Case 2021 builds on the India Investment Case 2019, which was developed and launched by the IWG alongside the Preparatory Meeting for the Sixth Replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) hosted by the Government of India in February 2019. The 2021 report provides a snapshot of context-specific and strategic financial needs necessary to effectively sustain and strengthen the HIV, TB and malaria responses in India especially in responding to the uncertainties emerging from the COVID-19 pandemic and to strengthen health and community systems, particularly placing communities at the centre of responses.
The launch of the India Investment Case 2021 shared key messages for increased and sustainable domestic investments in health and better-nuanced funding for, and from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), and for the doubling of the Gross Domestic Product (GDP) allocation for health in India from 1.2% to 2.5%; as well as for an increased pledge from the Government of India for the Seventh Replenishment of the Global Fund.
Blessina Kumar, CEO of Global Coalition of TB Activists (GCTA) and IWG member, provided an overview of the IWG and its purpose.
Abhina Aher, a renowned transgender activist and a member of the IWG, emphasised the critical role of India as an implementer of Global Fund grants and as a donor to the Global Fund. “Whenever Global Fund raises money, they develop a global investment case that captures the financial needs but also the number of lives that have been saved so far and the number of lives that can be saved. Similarly in India with a high burden of HIV, TB and malaria we need to be looking at evidence-based advocacy. Our wants are clear – we need to raise money for the Global Fund and India needs to step up during the Seventh Replenishment, India on the national level needs to invest more on health, and at least 5% of its GDP nationally”.
Despite HIV, TB and malaria communities and civil society have previously worked vertically in silos, on the ground level the community is the same – the same individual can be affected by HIV and TB and malaria. Since the Sixth Replenishment of the Global Fund, the IWG has been able to bridge these three verticals and bring people together across the three diseases and now we work in collaboration and enhanced coordination. Our voices together are making more impact
Providing an overview of the Investment Case, Sonal Mehta, Director for IPPF South Asia Regional Office and IWG member highlighted the critical role played by communities and civil society fighting the three diseases and emphasised the need to increase financing to build, strengthen and sustain community systems as part of the fight against HIV, TB and malaria: a key ask of the India Investment Case. The India Investment Case 2021 recognizes the adverse impact of COVID-19 on the three responses, on health and community systems and on human rights, gender and community responses. India’s response to the pandemic reiterated the serious threat to its fragile and struggling health systems with high out of pocket expenses to the public.
Rachel Ong, Regional Coordinator of GFAN AP added, “Global health is a huge and key issue for India especially in the international space, it is important to recognize the work that the IWG is doing is not just about the three diseases, the aim is to make sustainable investments in health overall and to support the country in meeting its Sustainable Development Goal targets and to achieve UHC. The effort and aim is to move closer to UHC in a cohesive and coherent manner. India’s contribution is not just about being the largest pharmaceutical and providing affordable drugs to the world, its leadership on global health such as India’s contribution to the Global Fund is exemplary for other countries in the world. India has a huge spotlight given that it will be hosting the G20 next year in addition to holding the Board Member Seat for the South East Asia constituency of the Global Fund Board. There are many things India can put on the table for an equal partnership with the Global Fund and rally other donors to fulfil their commitments to HIV, TB and malaria and achieve UHC.”
I am here first in my capacity as a strong ally of the communities and civil society, and secondly in my capacity as the Alternate Board Member of South East Asia Constituency to the Global Fund Board. I am really happy to see the hard work of people to produce the document which will help us in advocacy efforts and to prioritise the understanding of the Indian Government in terms of making the pledge [for the Seventh Replenishment]. This is something that is not only being highlighted by the Global Fund through meetings between Peter Sands and the Health Minister of India but also from the grassroots level upwards by the collective efforts of IWG and communities. India has always been a donor and recipient of the Global Fund grants and the support that we get from the Global Fund is approximately 1% of the total of India’s current health budget. While this may appear to be a small amount, for the communities and people on ground this is a huge amount of resources and is perhaps something that communities still need for the interventions to be uninterrupted across the three diseases.
Since 2003, the Global Fund has signed over USD 3 billion worth of grants for HIV, TB/HIV, TB and malaria programmes in India, and in 2021 its COVID-19 Response Mechanism contributed USD 112.9 million for mitigating COVID-19 impacts on the three diseases and reinforcing national COVID-19 responses of which USD 75 million was to support India to purchase oxygen concentrators and Pressure Swing Absorption (PSA) oxygen plants.
Joining the launch of the India Investment Case Dr Shobini Rajan congratulated the IWG for the launch of the India Investment Case and reiterated the importance of synergies between the government, Global Fund and communities, and emphasised the need for a successful Seventh Replenishment of the Global Fund to achieve the 2030 targets.
The India Investment Case highlights that active and enhanced community leadership and involvement of the Global Fund is critical to combat COVID-19 and defeat interconnected epidemics of HIV, TB, and malaria, and to ensure a resilient and sustainable system for health (RSSH). It emphasises that sustained domestic investment and support from the Global Fund must continue as India requires exceptional support amidst the unprecedented crisis of multiple reinforcing epidemics.
In this context, the India Investment Case 2021 calls for:
- Increased focus on disease prevention of the four interconnected diseases;
- Investment in enhanced community leadership and ownership through community systems strengthening;
- Doubling of domestic investment of India in health from 1.2% of GDP to 2.5%;
- Increased investment in the Global Fund; and
- Continued investment of the Global Fund in India beyond 2025.