The Global Fund to Fight Aids, Tuberculosis and Malaria on Wednesday began a drive to raise $14 billion to fight the global epidemics, but faces an uphill battle in the face of donor fatigue.

French President Emmanuel Macron was to chair the final day of a two-day meeting in Lyon on Thursday and meet African heads of state.

The Global Fund has asked for $14 billion, an amount it says would help save 16 million lives, avert “234 million infections” and place the world back on track to meet the UN objective of ending epidemics of HIV/Aids, tuberculosis and malaria within 10 years.

‘A collective signal‘

“I count on every one of you to bring together the financing necessary to give the Global Fund the means necessary to support the worst affected countries,” said French health minister Agnes Buzyn as the meeting opened.

“We are here to send a strong signal – a collective, universal and ambitious signal,” she said.

The UN World Health Organisation (WHO) says 770,000 people died of HIV-related causes last year. Tuberculosis, a high risk for HIV-positive people, claimed some 1.7 million lives in 2017 and malaria more than 430,000.

‘People can’t access meds’

The meeting is the sixth to replenish the Global Fund since it was set up in 2002, with prominent supporters including Microsoft founder Bill Gates and U2 lead singer Bono in attendance.

But officials said ahead of the meeting that collecting such a large sum could prove challenging, especially as global attention moves from Aids towards fighting climate change.

Anything more than the $13 billion pledged at the Global Fund’s last meeting three years ago in Montreal “will be considered a success”, said an Elysee official.

Macron, however, made it clear at the UN General Assembly in September that he expected no less than $14 billion, saying “no one any longer can understand” that people are unable to access medicine for the three deadly diseases.

NGOs insist even more is needed – as much as $18 billion.

Some countries have announced their contributions. The US is the number one donor, with a $4.68 billion contribution voted by Congress.

The UK is set to pledge $1.7 billion and Germany $1.1 billion. It remains to be seen what France will contribute, although Macron has vowed it will be worthy of the country’s historical status as the Global Fund’s number two donor.

France also wants the private sector to play a bigger role, with the Global Fund seeking $1 billion of the total from the business world.

“No amount less than $14 billion will be acceptable,” the NGOs Aides and Coalition Plus said, urging France to ramp up its contribution by 25 per cent.

‘Bargaining with lives‘

“We are here to remember that behind this financial bargaining there are human lives,” said the president of Aides, Aurelien Beaucamp.

Aides said that as things now stand, the meeting risks falling $200-$500 million short of its target.

Macron will meet leaders including Niger President Mahamadou Issoufou and Cameroonian President Paul Biya, while Rwandan President Paul Kagame is also set to be in attendance.

The Global Fund groups states, NGOs and private firms to support public health programmes around the world, investing around $4 billion every year.

It says it has helped save 32 million lives and provided prevention, treatment and care services to hundreds of millions of people, while the number of deaths caused by Aids, TB and malaria each year has been reduced by 40 per cent since 2002 in countries where the Global Fund invests.