October 26, 2006

We write to congratulate you on your candidacy for the position of Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. In a few short years, the Global Fund has grown to become one of the world's most important sources of funding to tackle killer diseases and help the world reach the Millennium Development Goals (MDGs). The Global Fund is critical to the global fight against tuberculosis, a disease that afflicts 9 million people and kills 1.6 million people annually. Since its inception, the Global Fund has approved nearly 100 TB grants in 80 countries, and now provides a full two-thirds of external resources for TB control.

The Global Fund's Executive Director is looked upon to provide leadership in the fight against TB, both internationally and at the country-level. As members of TB civil society, we would like to raise several issues we believe are crucial for any new Executive Director to champion:

Raising the Profile of TB and Ensuring a Bold TB Response: The new Executive Director has the opportunity to serve as a high-profile advocate for not only HIV/AIDS, but for TB and malaria as well. To reverse the TB epidemic and ensure universal access to treatment, TB's profile must be raised on the political and development agendas of world leaders. This requires ensuring strong, proportionate representation from the TB community on the Global Fund Board and within Country Coordinating Mechanisms (CCMs).

Resource Mobilization: The new Executive Director should leverage his/her position to mobilize strong, sustainable support from both donor governments and the private sector to ensure future rounds are fully funded, and demonstrate bold commitment to reaching the MDGs through endorsement of a US$10 billion by 2010 Global Fund size, which has been estimated by the Fund Secretariat as its appropriate share for achieving the MDGs.

Supporting the new Stop TB Strategy and the Global Plan to Stop TB 2006-2015: The WHO's new Stop TB Strategy and the Stop TB Partnership's Global Plan to Stop TB 2006-2015 articulate the vision and direction for fighting TB for the global community. Building on recent achievements and best practices, the Global Plan is a business plan for reversing the TB pandemic over the next decade. It specifies funding needs and gaps, and it is the primary guide for countries to follow in working toward the MDGs and the Partnership's TB targets. The new Executive Director should be a strong advocate for both the new Strategy and the Global Plan, including the uptake of new TB tools as they become available, and encourage countries to develop their national TB plans according to the Global Plan's recommendations, maximizing mobilization of external and internal resources.

Linking with Effective Drug Procurement Mechanisms: The Stop TB Partnership Global TB Drug Facility (GDF) has delivered over 4.5 million TB treatments in more than 70 countries since 2001. It is a proven mechanism for delivering high quality anti-TB drugs at best world prices, providing the necessary technical assistance to preserve such drugs, and playing a central role in DOTS expansion efforts. In addition, the Green Light Committee (GLC) is a critical innovative mechanism for supporting multidrug-resistant tuberculosis (MDR-TB) treatment in countries. The Global Fund should be more proactive in ensuring maximum usage of the GDF by recipient countries and provide expanded support for the GLC. In addition, the Global Fund should continue its collaboration with UNITAID via the GDF and GLC to address resource gaps in drug procurement for second-line and pediatric anti-TB drugs.

TB/HIV Collaboration: There is an urgent need to improve coordination between TB and HIV policies and service delivery. This will ensure maximum impact in reducing deaths and increasing access to critical services. The WHO's Interim Policy on Collaborative TB/HIV Activities and the Stop TB Partnership's Two Diseases, One Patient: TB/HIV Control Strategy Toward 2015 lay out a path for these efforts. The Executive Director should direct the Global Fund to work with TB and HIV/AIDS stakeholders to ensure strategies are in place within grants for improving TB/HIV collaboration.

XDR-TB and MDR-TB: The emergency of extensively drug resistant (XDR) TB underscores the need for ensuring adequate treatment for TB and MDR-TB and preventing the further rise of drug resistance through the adoption of new WHO guidelines for the management of drug-resistant tuberculosis and the broader Stop TB Strategy. While the Global Fund has played a critical role in increasing the number of patients being treated for MDR-TB, over 98% of people with MDR-TB still lack access to proper treatment. The Global Fund must scale up its response to effectively diagnose, treat and prevent drug resistance.

Patient/Community and Private-Sector Involvement: To ensure a comprehensive, effective approach to TB prevention and treatment that involves all stakeholders and promotes equity and sustainability of programs and health systems, the Global Fund and national CCMs must ensure the participation of patients and affected communities, local implementing partners, healthcare workers, as well as other relevant actors from the private sector. The Global Fund should also proactively promote the implementation of the International Standards for Tuberculosis Care and the Patients' Charter for Tuberculosis Care to help ensure quality TB services in all sectors and the involvement and empowerment of patients in all aspects of TB care.

We again would like to congratulate your candidacy for Global Fund Executive Director. We trust you will consider the issues we have raised above when moving forward with your candidacy.

Sincerely,