We have actually a very interesting and important phenomenon worldwide. Most people suffering from HIV and tuberculosis are living in middle-income countries. Actually most poor people nowadays live in middle-income countries. It's a phenomenon. Therefore, yes we need to address the fragile states, the low-income states, and we do so. We focus most of our resources on low-income and fragile states; there's no question about that.
It's also important to say, without addressing those affected by these three diseases in middle-income countries, that we will not end those diseases either. Some fragile states are actually formally middle-income states. Look at Nigeria, for example. Because of the oil wells, Nigeria is a middle-income country, but at the same time, it's not only one of the most fragile, but it is also home, for example, to 25% of the global malaria burden. Therefore, you cannot be too rigid, if you like, in your approach and say that we will finance only the low-income.... We would miss many of the populations affected by these diseases.
However, we differentiate, of course. Proportionately low-income fragile states receive more resources from the Global Fund than middle-income countries do. We have a very progressive co-investment policy, by the way. The higher the per capita income of the country, the more we expect that they will co-finance. Actually, we encourage all countries to increase their domestic budgets to co-finance with the Global Fund, but if you're a middle-income country, the expectation is much higher.
Not only do we provide this international funding but we hold them accountable also for increasing their own health budget. Only in that way can we make the program sustainable.