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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I believe only Yvette Cooper has the breadth of support to beat Jeremy Corbyn

All the recent polling suggests Andy Burnham is losing more votes than anyone else to Jeremy Corbyn, says Diana Johnson MP.

Tom Blenkinsop MP on the New Statesman website today says he is giving his second preference to Andy Burnham as he thinks that Andy has the best chance of beating Jeremy.

This is on the basis that if Yvette goes out first all her second preferences will swing behind Andy, whereas if Andy goes out first then his second preferences, due to the broad alliance he has created behind his campaign, will all or largely switch to the other male candidate, Jeremy.

Let's take a deep breath and try and think through what will be the effect of preferential voting in the Labour leadership.

First of all, it is very difficult to know how second preferences will switch. From my telephone canvassing there is some rather interesting voting going on, but I don't accept that Tom’s analysis is correct. I have certainly picked up growing support for Yvette in recent weeks.

In fact you can argue the reverse of Tom’s analysis is true – Andy has moved further away from the centre and, as a result, his pitch to those like Tom who are supporting Liz first is now narrower. As a result, Yvette is more likely to pick up those second preferences.

Stats from the Yvette For Labour team show Yvette picking up the majority of second preferences from all candidates – from the Progress wing supporting Liz to the softer left fans of Jeremy – and Andy's supporters too. Their figures show many undecideds opting for Yvette as their first preference, as well as others choosing to switch their first preference to Yvette from one of the other candidates. It's for this reason I still believe only Yvette has the breadth of support to beat Jeremy and then to go on to win in 2020.

It's interesting that Andy has not been willing to make it clear that second preferences should go to Yvette or Liz. Yvette has been very clear that she would encourage second preferences to be for Andy or Liz.

Having watched Andy on Sky's Murnaghan show this morning, he categorically states that Labour will not get beyond first base with the electorate at a general election if we are not economically credible and that fundamentally Jeremy's economic plans do not add up. So, I am unsure why Andy is so unwilling to be clear on second preferences.

All the recent polling suggests Andy is losing more votes than anyone else to Jeremy. He trails fourth in London – where a huge proportion of our electorate is based.

So I would urge Tom to reflect more widely on who is best placed to provide the strongest opposition to the Tories, appeal to the widest group of voters and reach out to the communities we need to win back. I believe that this has to be Yvette.

The Newsnight focus group a few days ago showed that Yvette is best placed to win back those former Labour voters we will need in 2020.

Labour will pay a massive price if we ignore this.

Diana Johnson is the Labour MP for Hull North.