We are now at the crossroads.

In the 15 years of the Millennium Development Goals (MDGs), the world made a significant progress in fighting HIV/AIDS, tuberculosis and malaria, with the leadership of the G7 countries. Our programmes have come so far that, depending on how we endeavor on the next step, we can “end” the big three infectious diseases as a threat to the world’s public health. In fact, the Sustainable Development Goals (SDGs) adopted at the UN in September 2015 stipulates to “end” the epidemics of HIV/AIDS, TB and malaria.

Meanwhile, the three infectious diseases remain the world’s greatest threat that claims lives of too many. Every year, the numbers deceased from AIDS, TB and malaria count as many as 1.2 million (2014), 1.5 million (2014), and 440,000 (2015) respectively. Moreoever, drug resistance is intensifying the problem. The crossroad we now stand determines if the human race is liberated from the threats of AIDS, TB and malaria, or continues to be exposed to the threats even more dire. Whether we can embark on the road to “liberty” depends on the leadership of the G7 countries.

An utmost necessity to ending the three infectious diseases is to replenish the programmes’ funding. Without adequate investment, both the new contractions of HIV and the deaths from AIDS shall increase by 2030. However, by fulfilling the financial needs and accelerating programmes, we can decrease by 2030 the new HIV infections down to 200,000 people, or roughly 1/10 of the present statistics. Likewise in TB, we will have to wait until the 22nd Century before the newly contracted cases decrease to the tenth of the present, if we retain the current funding size—while we can achieve the same by 2035, if we build up on the fund and measures. 

The most effective means to invest in the three infectious diseases programmes is to fully fund the resource needs of the Global Fund to Fight AIDS, Tuberculosis and Malaria, now in its fifth replenishment period. This in turn vitalises the programmess on HIV/AIDS, TB and malaria, and also creates incentives for the implementing countries to mobilise domestic resources for the big three. Furthermore, the Global Fund in its 2017-2022 New Strategic Framework maintains to reinforce its commitment to building resilient and sustainable health systems. By fully funding the Global Fund, we can scale up the infectious diseases programmes to comprehensive health system strengthening. Now is the time for the G7 to take the initiative.

In scaling up the investments in the HIV/AIDS, TB and malaria programmes and reinforcing its measures, we need to take into account the following.

First is to align ourselves with the SDGs principle to “leave no one behind,” and to focus the support for and realise the rights of the key populations who particularly face the threats of the three infectious disease, including MSM (men who have sex with men), sex workers, drug users, migrant workers, refugees, and ethnic minorities.

Second, we must strengthen support for the middle-income and other countries in their transition processes—changing from financial resources by the international organisations and binary assistance to domestic mobilisation—so that they can accomplish step-by-step transitions that “leave no one behind,” according to appropriate plans. We should note that in some countries of the Eastern Europe, the Southeast Asia, and the Lain America and Caribbean, the local communities and NGOS that have implemented programmes for the key populations had their financial resources depleted, as a result of indiscreet transition out.

Lastly, especially in the fields of HIV/AIDS, we must establish the right balance between the biomedical approach that is gaining momentum, and the social approach that focuses on community empowerment and promotion of preventive measures. 

Noting the aforesaid, we request the following statements on HIV/AIDS, tuberculosis and malaria be stipulated in the G7 Ise Shima Summit Declaration, as well as in the action plans on global health introduced by the health experts group.