How the Global Fund
Spent its Money
by Erv Dyer
The two-year-old Global
Fund, an ambitious private-public partnership to battle HIV,
tuberculosis and malaria in developing countries, in its first
round of grant-making, was met with applause and criticism
at the International AIDS Conference. With nearly two billion
dollars in pledges from Industrial and Third World nations
and assistance from foundation support, the Fund awarded a
total of $378 million over two years to 40 programs in 31
countries.
The Board also agreed to
a fast-track process to approve an additional $238 million
for 18 proposals in 12 countries, plus three multi-country
proposals, provided certain conditions are met. This would
bring the total funding over two years to $616 million.
The approved grants were
selected from more than 300 proposals. In all, these proposals
requested more than $5 billion from the Global Fund over five
years. More than 60 percent of those dollars went to proposals
addressing HIV/AIDS. More than 55 percent of the funding was
targeted toward sub-Saharan Africa, an area hit hardest by
HIV infections. A second wave of funding is scheduled for
early 2003 and proposals must be submitted by late September.
Almost before the checks
were written, the announcement of the approved grants was
quickly caught up in a swirl of criticisms and politics. Many
wondered if developed nations were over-represented in funding
and whether enough funding was committed to nations battling
TB or malaria.
The most noise came from
activists who felt that not enough dollars went toward HIV
treatment. Too much was handed out to prevention rather than
treatment, they charged, and what treatment dollars there
were went towards the promotion of patented medicines and
generic brands.
Meanwhile, Richard Feachem,
incoming executive director of the Global Fund, defended its
grants. “We are committed to prevention and treatment funding,”
said Feachem, who was warmly received at an address in Barcelona.
Grants will be balanced across the diseases and geographical
regions, he pledged, saying, “HIV gets the lion’s share and
rightly so, but we will not turn our back on TB or malaria.”
According to officials, Global
Fund donations will make it possible over the next five years
for 220,000 people living with HIV/AIDS to receive anti-retroviral
treatments. It’s a first step, but still more must be done,
said Allison Dinsmore of Health GAP (Global Access Project),
a U.S. group that monitors barriers to care for people living
with HIV. After all, she said, that number represents only
10 percent of the people who have the virus in sub-Saharan
Africa alone.
According to Milly Katana,
a member of the Global Fund board representing non-governmental
organizations, and who works with the group People Living
with AIDS in Uganda, “it is just the beginning.” More can
be done, Katana argued, “to support people who have been fighting
this plague with unlimited courage while lacking any other
weapons. Billions more dollars are needed now for more prevention
and treatment measures.”
But activists remained skeptical.
“We’re not anti-Global Fund,” explained Dinsmore, with Health
GAP, “we’re just concerned that the Fund, which is supposed
to grow to $10 billion, isn’t being taken seriously by the
U.S. government.” The Bush administration has pledged $500
million to the Fund. Dinsmore thinks it should commit more.
“If we don’t give, other countries won’t be giving much either,”
she said. “Then the fund will be always bankrupt and will
not accomplish much.”
Members of ACT UP/Paris (AIDS
Coalition to Unleash Power), a vocal advocate for HIV/AIDS
issues known for its sometimes disruptive tactics, were wearing
stickers in Barcelona questioning the Global Fund’s bottom
line. A goal of $10 billion was set when United Nations Secretary
General Kofi Annan called for the creation of the fund. Annan
suggested $7 to $10 billion was needed to address HIV, TB
and malaria in the world’s developing nations.
By mid-May, $1.9 billion
had been pledged to the Global Fund—less than 20 percent of
the goal. The world’s richest countries must contribute more
to make a difference, said organizers with ACT UP/Paris. “To
refuse to do so means the industrialized G-8 countries are
responsible for the deaths of 10,000 persons every day,” scolded
Gaelle Krikorian, a member of ACT UP/Paris.
As officials with the Global
Fund held meetings in Barcelona to explain its first round
of funding, it asked participants to be patient with its growing
pains. “We have to learn from our mistakes,” said Christoph
Brenn, an NGO representative with the Global Fund. “This is
a new initiative, we have to make it work.”
Erv Dyer is a Pittsburgh
reporter who covers issues of race relations, spirituality
and black American health care. He can be reached at ellisdyer@aol.com.
Reprinted courtesy of www.BlackAIDS.org
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