The precarity of the global 99%

What The Global Fund's decision to cancel next year's funding round means for victims of Aids, TB an

In Europe and the US there is a lot of talk of austerity these days. But elsewhere in the world, the financial realities of our age of insecurity are leading not to belt-tightening but to malnutrition and disease. And things look set to get a lot worse yet.

This week's unprecedented announcement by The Global Fund to Fight Aids, TB and Malaria to cancel its next funding round is a case in point. It reveals just how precarious daily life has become for the global 99 per cent: those whose very health, as much as their job security, is pegged to the rise and fall of the money markets.

The Global Fund has for years been one of the most important fronts in the battle to beat back HIV/Aids. It has helped put 3.2 million people on anti-retroviral therapy (ARVs). But it has been running on empty for a year now, since securing just $10 billion -- half of what it hoped for -- during a major funding replenishment a year ago. Some countries also recently cut their pledges owing to concerns about the way the Global Fund is operated.

Ten billion dollars sounds like peanuts in comparison to the bank bailouts we have gotten used to in recent years -- it's about the same amount that Goldman Sachs has cheerfully set aside in bonuses again this year.

But it was the minimum figure that the Global Fund required from rich countries to sustain the many medical programmes it supports around the world. And with those countries failing to meet even downsized pledges in October, the Global Fund concluded this week, after a heated and difficult board meeting in Accra, Ghana, that it had no choice but cut the funding lifeline.

Instead, it has put in place an emergency '"transition mechanism" to safeguard the most needy, but this is no more than a tin roof over the heads of some in a rapidly worsening storm. The fact is that sooner or later people are going to be kicked off existing treatment programmes: this is already happening in Swaziland, which recently decided to forego Global Fund support and, as a result, has simply run out of drugs.

The Global Fund's apparent demise could hardly come at a more crucial time. The last couple of years had seen greater optimism in the battle against Aids. Thanks to internationally funded programmes, the number of people on ARVs had increased by 20 per cent since 2009, and many had begun looking forward to a generation free of HIV. "We have an historical opportunity now with treatment as prevention to push back against HIV," Marius Trosied, a doctor with Médecins Sans Frontières told me just a few weeks ago. But such claims require solid revenue streams to back them up. It is now far from clear how even the 7.7 million people the Global Fund claims to have already "saved" will fare in the years to come.

South Africa and Kenya have already been told they are ineligible to apply for funds this year, despite both only having treatment coverage rates of around 50 per cent.

And in Malawi, which had ambitious plans to scale up treatment provision, the question now is all about how best to manage a treatment scale-down. That is global health speak for a process of triage to determine who lives and who dies.

The root problem is not just the banking and financial crisis, says David McCoy, a public health specialist at UCL: "What is happening to the Global Fund ought to concentrate the minds and efforts of public health workers all across the world on the need to change the broader social and economic institutions within which our fragile health programmes are located."

McCoy is right: the precarity of individuals is ultimately a function of the precarity of the institutions that sustain them. That is as true in Europe and the US -- where we are seeing jobs lost, services cut, and shops boarded up along our highstreets because our institutions and systems of government do not protect us equally from the vicissitudes of the market -- as it is in global health. But of course the two are related, and some individuals are more vulnerable than others.

So when life-saving organizations like South Africa's Treatment Action Campaign declare that, because rich countries now feel they can afford to give less, they too may be forced to shutter up the premises next year, then we have to recognise that the politics of austerity we are going through has not even begun to be properly costed. This is the real lesson of the Global Fund's demise and it will require much more than simply getting wealthy donors back on board to address it.

Simon Reid-Henry is a lecturer at Queen Mary, University of London

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Theresa May’s stage-managed election campaign keeps the public at bay

Jeremy Corbyn’s approach may be chaotic, but at least it’s more authentic.

The worst part about running an election campaign for a politician? Having to meet the general public. Those ordinary folk can be a tricky lot, with their lack of regard for being on-message, and their pesky real-life concerns.

But it looks like Theresa May has decided to avoid this inconvenience altogether during this snap general election campaign, as it turns out her visit to Leeds last night was so stage-managed that she barely had to face the public.

Accusations have been whizzing around online that at a campaign event at the Shine building in Leeds, the Prime Minister spoke to a room full of guests invited by the party, rather than local people or people who work in the building’s office space.

The Telegraph’s Chris Hope tweeted a picture of the room in which May was addressing her audience yesterday evening a little before 7pm. He pointed out that, being in Leeds, she was in “Labour territory”:

But a few locals who spied this picture online claimed that the audience did not look like who you’d expect to see congregated at Shine – a grade II-listed Victorian school that has been renovated into a community project housing office space and meeting rooms.

“Ask why she didn’t meet any of the people at the business who work in that beautiful building. Everyone there was an invite-only Tory,” tweeted Rik Kendell, a Leeds-based developer and designer who says he works in the Shine building. “She didn’t arrive until we’d all left for the day. Everyone in the building past 6pm was invite-only . . . They seemed to seek out the most clinical corner for their PR photos. Such a beautiful building to work in.”

Other tweeters also found the snapshot jarring:

Shine’s founders have pointed out that they didn’t host or invite Theresa May – rather the party hired out the space for a private event: “All visitors pay for meeting space in Shine and we do not seek out, bid for, or otherwise host any political parties,” wrote managing director Dawn O'Keefe. The guestlist was not down to Shine, but to the Tory party.

The audience consisted of journalists and around 150 Tory activists, according to the Guardian. This was instead of employees from the 16 offices housed in the building. I have asked the Conservative Party for clarification of who was in the audience and whether it was invite-only and am awaiting its response.

Jeremy Corbyn accused May of “hiding from the public”, and local Labour MP Richard Burgon commented that, “like a medieval monarch, she simply briefly relocated her travelling court of admirers to town and then moved on without so much as a nod to the people she considers to be her lowly subjects”.

But it doesn’t look like the Tories’ painstaking stage-management is a fool-proof plan. Having uniform audiences of the party faithful on the campaign trail seems to be confusing the Prime Minister somewhat. During a visit to a (rather sparsely populated) factory in Clay Cross, Derbyshire, yesterday, she appeared to forget where exactly on the campaign trail she was:

The management of Corbyn’s campaign has also resulted in gaffes – but for opposite reasons. A slightly more chaotic approach has led to him facing the wrong way, with his back to the cameras.

Corbyn’s blunder is born out of his instinct to address the crowd rather than the cameras – May’s problem is the other way round. Both, however, seem far more comfortable talking to the party faithful, even if they are venturing out of safe seat territory.

Anoosh Chakelian is senior writer at the New Statesman.

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