A/67/302 because they disproportionately impact the poor, who rely more heavily on the availability of public health facilities, goods, and services than other groups. Pooling international funds for health 30. International funding for health is inconsistent and insecure. Donor interventions are often fragmented and poorly coordinated. The insecurity of international funding has been highlighted by the recent global financial crisis, which led, in part, to the cancellation of Round 11 of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Inconsistent international funding for health places States that rely heavily on international assistance at risk of severe funding shortfalls during global economic downturns. Fragmentation of donor interventions is illustrated by the situation in one State, where 50 donors operate, 19 of which directly provide assistance to the Government through budget support and 31 of which provide aid through isolated individual mechanisms or agreements 27. Poorly coordinated donor interventions lead to redundant spending, inefficient allocation of health funds and resources, and the failure of initiatives to address domestic health needs effectively. 31. In order to cooperate towards ensuring the availability of sustainable international funding for health as required by the right to health, States should pool funds for health internationally. International cooperation in the form of a single global pool or multiple coordinated pools would facilitate the cross-subsidization of health systems in developing States and allow for the coordination of donor activities in recipient States. International cooperation in the form of global pooling of funds for health is critically needed at this time in order to meet the global disease burden and promote the development of sustainable domestic health systems. 32. The Global Fund and the International Drug Purchase Facility (UNITAID) represent two successful examples of global pooling that have had significant positive impacts in the fight against HIV/AIDS, tuberculosis and malaria globally. Both the Global Fund and UNITAID have collected and pooled significant resources from donor States and through innovative financing mechanisms and allocated funds and resources based on need. 28 Under programmes funded by the Global Fund, 3.3 million people living with HIV received antiretroviral treatments in 2011 alone 29 and 9.3 million smear-positive cases of tuberculosis were detected and treated between 2010 and 2012. 30 UNITAID has provided child-friendly treatment to 400,000 children living with HIV and delivered 46 million artemisinin-based combination therapies to first-line purchasers of malaria medications. 31 Moreover, in contrast to bilateral aid and assistance from international financial institutions, the Global Fund and UNITAID have removed conditionalities and increased levels of transparency and __________________ 27 28 29 30 31 12 Karen McColl, “Europe Told to Deliver More Aid for Health”, The Lancet, vol. 371, No. 9630 (2008), p. 2073. See United Nations, Innovative Financing for Development, The I-8 Group Leading Innovative Financing for Equity (New York, 2009). The Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Fund Results Fact Sheet End-2011 (2011), p. 1. The Global Fund to Fight AIDS, Tuberculosis and Malaria, News Release: Global Fund Results Show Broad Gains against HIV, 23 July 2012, available from: www.theglobalfund.org/en/ mediacenter/newsreleases. UNITAID, Annual Report 2011 (WHO, December 2011), available from: www.unitaid.eu/ images/Annual_Report_2011/UNITAID_AR2011_EN.pdf. 12-46101

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