Since 2003, Belize has received ten million US dollars in grant funding to address the HIV/AIDS situation from the Global Fund. Presently, the National Aids Commission, which serves as the Country Coordinating Mechanism for the Global Fund grant, is concluding a project that commenced in 2016. The project focuses on HIV/AIDS and Tuberculosis, a co-infection which is the leading cause of death of persons living with HIV/AIDS. The Global Fund is withdrawing a significant sum of funding to Belize. Enrique Romero, the Executive Director for the National Aids Commission explains that they have been bracing for the changes over the last few years.
Enrique Romero, the Executive Director for the National Aids Commission: In 2014 the global front developed what they call their New Funding Model, NFM and that funding model places the focus of countries with the highest disease burden and the least ability to pay. We all know that Africa has the highest burden of HIV/AIDS, TB and Malaria and so they are the ones that benefit from the highest percentage of funding. In 2016 the Global Fund develop what they call their sustainability transition and co financing policy and this policy focuses on countries with low disease burden and ability to pay and to move towards domestically owned and funded health systems. The formula for calculating the ability to pay is done through the World Bank classification and what they do they simply look at the gross national income GNI so according to world bank classification Belize is considered as an upper middle income country which means that then according to them we have the ability to pay so once we have that ability to pay it means then that our grants from the Global Fund would be reduced so that is exactly what is a happening now. In 2017 what the Global fund did they published a list of all the countries and what these countries, the type of funding that these countries are is eligible for and again this was based on the Gross National Income classification by the World Bank and as well as the disease burdening the country. For Belize the burden of HIV is still considered high therefore we are still eligible for funding in HIV. This decrease in funding is not something that is unique only to Belize. This decrease in funding has been signaled to all countries globally because as you know the countries that have contributed towards the fund; the European countries are no longer concerned more about HIV. They are concerned about the issue of migration, border security, terrorism and Climate Change so most of the monies are going into those areas. The few monies that is coming to the Global Fund they are focusing on countries with the highest disease burden like i mentioned and the least ability to pay in most cases the countries in Africa.
The National AIDS Commission has submitted a proposal for one point nine million US dollars for a project to span from 2019 to 2021 which has been approved. This will again focus on HIV and Tuberculosis. Romero says that this will be the last year that funds from the Global Fund will be used to address Tuberculosis. That is because the disease burden is now being looked at by the Global fund as moderate. While Belize continues to be eligible for further funding, the focus will be strictly on HIV after 2021. But is Belize able to cope? Romero says it is. He adds that the Government of Belize co-finances the work with HIV/AIDS in the Country and so the cut in funds is not expected to have a negative impact in Belize.
Enrique Romero, the Executive Director for the National Aids Commission: That expires in December 2018. Apart from the annual budget every year from the Ministry of Health; the government committed an additional $1.8 million in getting testing kits and Viral load medications and so forth and I just want to mention also we are in a better position than many other countries because the Government of Belize purchases all antiretroviral medications and are distributed free of cost to all patients. There are some countries in the world that rely on global fund grants in order to access ARVs so again the whole issue of sustainability and transition implies governments is killing up their investments and taking on greater ownership of the national response. When I say countries it does not only refer to the Ministry, it does not only refer to the Ministry of Health or the Ministry of Finance. It will involve a multi sectoral approach whereby roles have to be played by the private sector for example, by civil societies for example, community based organizations by faith based organizations so all these entities have to come together and ensure that the gaps that will be left by global fund leaving that these have to be filled by local entities and that is the direction that we have been taking for the past years for preparation for the eventual fading out of global from our country.
Patients will continue to receive the free medical care and services that have been available in Belize over many years.