In an open letter to the Global Fund to Fight AIDS, Malaria and TB (the Global Fund), NCD Alliance and a group of leading global health experts call for the full funding of noncommunicable disease (NCD) prevention and care services in the organisation's programming. 

The letter, addressed to the Global Fund Executive Director, Peter Sands, the Global Fund Board and Members of The Global Fund Strategy Committee, notes the next 2023-2028 strategy as a unique opportunity for the inclusion of integrated and people-centred care approaches that includes NCDs and co-morbidities. 

Due to the bidirectional relationship between NCDs, and HIV, tuberculosis (TB), and malaria, the incorporation of NCD programing could lead to improved quality of life and treatment outcomes, and to reduced premature mortality. Action now would build on the recommendations of the Global Fund Board’s approval of the framework for financing co-infections and co-morbidities of HIV/AIDS, TB and malaria, as set forth in GF/B33/11, on 1 April 2015.

Given the growing focus on universal health coverage (UHC), health system strengthening and the clear evidence of NCD comorbidities with HIV/AIDS, TB, and malaria, a bold approach to health services integration is needed to both protect the hard-earned gains for the three diseases over the last few decades and to ensure a better quality of life for people with these diseases.

The 60 signatories call for the Global Fund to:

• Prioritise the inclusion of NCD interventions into the work program of the 2023-2028 Global Fund strategy to ensure the promotion of integrated, people centered, quality care services for the Global Fund target groups who are currently strongly affected and dying from NCDs.
• Create financial and technical support to for activities relating to HIV and NCD prevention and care integration as a path towards UHC.
• Ensure meaningful engagement of people living with and affected by Global Fund target diseases who also live with other chronic conditions, such as NCDs, in Global Fund’s strategic decision-making and accountability processes at global and country level, including in Global Fund’s country funding proposal development and implementation. So, to understand their full health care needs to improve quality of life and physical and financial barriers to access, including in accountability for progress towards UHC.
• Provide financial and technical support for integrated services in PHC to develop more resilient and sustainable health systems. Support could include the mandatory consideration of NCD prevention and care within PHC-level Global Fund supported programmes and funding proposals, and supporting communities to conduct community-led monitoring of the quality of integrated services at PHC level.
• Provide financial and technical support for data collection, monitoring, and evaluation of access to care and quality of life for people living with Global Fund target diseases and NCDs to advance the evidence base on: Current gaps in secondary and tertiary health care for these patient groups. Equitable, impactful, cost-effective, gender-sensitive and age-responsive integration strategies at secondary or tertiary level.

Now is the time for the Global Fund to act on the growing impact of NCDs on the physical and mental health and wellbeing of people living with and at risk of HIV, TB, and malaria, and on the sustainability and resilience of health systems.  The price on action to address the comorbidities of HIV, TB, and malaria with NCDs is far outweighed by the human cost of inaction.

Read the full open letter and list of signatories