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  • Volume 377 1719 (2011)
  • May 21, 2011

Safeguarding the right to health amidst Côte d’Ivoire’s crisis: a challenge to the Global Fund

Today’s TLS blog entry is by Mariam O. Fofana, studying at Johns Hopkins School of Medicine. Mariam’s blog entry addresses the ongoing political unrest in Côte d’Ivoire, the emergence of a human rights crisis and the decision to freeze funding in the country

Since the November 28 elections that were meant to put an end to a decade-long political and military crisis, the fate of Côte d’Ivoire seems more uncertain than ever [1]. With the incumbent Laurent Gbagbo and the opposition candidate Alassane Ouattara both claiming to be president, the country is mired in a crisis that is taking an increasingly devastating toll on the civilian population, with mounting human rights violations. As of mid-January, the UN Operations in Côte d’Ivoire reported 247 deaths and 61 disappearances, in addition to an estimated 25,000 refugees in Liberia and 16,000 internally displaced persons along the border [2,3].

The European Union, the UN and the United States have all declared sanctions against the government of Gbagbo, who is widely regarded by the international community as having usurped power [4,5,6]. Joining the fray, the Global Fund to fight AIDS, Tuberculosis and Malaria has announced that it is withholding a portion of funds and supplies in Côte d’Ivoire, most of which were earmarked for malaria control efforts [7]. Although “life-saving” medications will still be disbursed, according to Global Fund spokesperson Veronique Taveau [7], the decision is troubling in that, unlike the freezing of bank assets or travel bans, its effects will likely be felt disproportionately by needy populations rather than by Gbagbo’s government. In fact, the harm of withholding aid can be exacerbated in a time of crisis and conflict, when government facilities and services are weakened.

It is also questionable whether the Global Fund should take a political stand in such situations. Funding has been withheld in countries where they were found to be misappropriated [8], but in the case of Côte d’Ivoire the funding freeze has clearly political aims. Is this decision justified when it threatens the fulfillment of the right to health? Reaching a peaceful resolution in Côte d’Ivoire should absolutely be a priority for the international community, and it will undeniably help civilian populations who, for years, have suffered from deteriorating economic and social conditions [6]. But at what cost? Who is truly being punished by the Global Fund’s decision? Is withholding bednets more likely to oust a president than it is to deprive children of protection from malaria?

The Global Fund’s decision is worrisome because it puts needy civilians’ health on the betting table of politics, potentially setting a precedent for future political crises.  With the mounting humanitarian toll in Côte d’Ivoire, the Global Fund has a chance to stand by those who need its help. In times of crisis the Global Fund should not further deprive those whose civil and political rights are endangered, but rather protect more fervently than ever their right to the “highest attainable standard of physical and mental health” [9]. With what will likely be a long road to a resolution in Côte d’Ivoire, the Global Fund has a chance to reset its course and reaffirm its commitment to the health of those in “greatest need” [10].

[1] Airault, P. Compte-rendu des six jours qui ébranlèrent Abidjan. Jeune Afrique 2010 Dec 10. Available from:
[2] ONUCI-Opération des Nations Unies en Côte d’Ivoire. L’ONUCI réitère son appel au calme face aux violences croissantes [press release]. Abidjan: ONUCI 2011 Jan 13. Available from:
[3] Number of Ivorian refugees in Liberia tops 25,000 – UN Agency. UN News Centre 2011 Jan 11. Available from:
[4] Côte d’Ivoire: Financial Sanctions [press release]. Washington, DC: US Department of State 2011 Jan 6. Available from:
[5] Côte d’Ivoire: EP backs EU sanctions and calls on Gbagbo to step down [press release]. Strasbourg: European Parliament 2010 Dec 16. Available from:
[6] Côte d’Ivoire: The economic squeeze [briefing]. Dakar: Integrated Regional Information Networks (IRIN) 011 Jan 7. Availabe from:
[7] Doherty, D. Ivory Coast sees some aid frozen by Global Fund to Fight AIDS. Bloomberg 2011 Jan 11. Available from:
[8] Global Fund suspends two malaria grants, terminates TB grant to Mali [press release]. The Global Fund to Fight AIDS, Tuberculosis and Malaria 2010 Dec 7. Available from:
[9] International Covenant on Economic, Social and Cultural Rights. United Nations General Assembly resolution 2200A (XXI). Available from:
[10] The Global Fund to Fight AIDS, Tuberculosis and Malaria [Internet]. [cited 2011 Jan 15]. Available from:

Mariam O. Fofana

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