Included in the recently passed 2009 Omnibus Spending bill is a contribution of $900 million dollars for the Global Fund to Fight AIDS, Tuberculosis and Malaria, the highest contribution ever made by the U.S. to the Global Fund since its inception in 2002 and an increase of $60 million over the U.S. contribution for 2008. This year's appropriation brings total US contributions over the last 7 years to more than $4.4 billion, 28 percent of all funds recieved by the Fund through 2009. It also signals, along with renewed commitments to the United Nations Population Fund, a return to proactive engagement by the U.S. in multilateral partnerships often undercut during the previous Administration.
Michel Kazatchkin, Executive Director of the Fund, welcomed the increased U.S. contribution, stating:
“The United States is a leader in the fight against infectious diseases. It sends a strong signal of the importance of this fight that the U.S. Congress continues to increase funding for global health at a time of economic crisis. It underscores the need to maintain the progress and continue to invest in people’s health globally.”
Some advocates simultaneously praised the increased funding level and cautioned that it remains well below what they consider to be the U.S. fair share for the Fund. According to Kaytee Riek, Grassroots Organizer at Health Global Access Project (Health GAP):
"The Global Fund is facing a $5 billion funding gap over the next several rounds of funding. This is due to the fact that the Board voted two years ago to triple the size of the Fund, and countries came forward in the last round with bigger, better, and bolder grants that were three times the size of the previous round. When all these grants are funded, no money will be left for future rounds, and donor countries need to come forward with more money to fill the gap."
Given this scenario, asserts Riek,
"The US contribution is short between $700 million and $1 billion for 2009, and the US's fair share for 2010 is $2.7 billion (1/3 of the total need for the next two rounds of funding, which is $8 billion). If new money isn't contributed to the Fund, then the Fund will be forced to cut existing and future grants by 25 percent and take other cost-cutting measures."
The Global Fund is considered a unique public/private partnership:
"dedicated to attracting and disbursing additional resources to prevent and treat HIV/AIDS, tuberculosis and malaria. This partnership between governments, civil society, the private sector and affected communities represents a new approach to international health financing. The Global Fund works in close collaboration with other bilateral and multilateral organizations to supplement existing efforts dealing with the three diseases."
At the end of 2008, Global Fund-supported programs (according to the Fund) are estimated to have averted more than 3.5 million deaths by providing AIDS treatment for two million people, provided anti-tuberculosis treatment for 4.6 million people, and distributed 70 million insecticide-treated bed nets for the prevention of malaria worldwide. The Global Fund has so far approved funding of $15 billion in 140 countries.
The Fund is also unique in the degree to which it has incorporated and welcomed civil society participation at all levels of decision-making. Because of the strong role played by advocates, the Fund provided a welcome foil to and a far higher level of transparency than the President's Emergency Plan for AIDS Relief (PEPFAR) under the Bush Administration. Advocates succeeded in establishing a strong platform on prevention of sexual transmission, the single most important factor in the spread of HIV worldwide and the cause of 80 percent of new infections. As a result, the Fund recognizes HIV transmission as a fundamental aspect of sexual and reproductive health and rights, and of the indivisible nature of sexual and reproductive health to HIV prevention, treatment, and care. In turn, the Fund provides support to programs that take integrated approaches to HIV prevention, pregnancy, and maternal health, to addressing gender-based violence, and to ending stigma and discrimination against gay, lesbian and transgender persons as well as against women and girls and HIV positive persons more generally.
Fifty donor countries have contributed to the Global Fund to date, in addition to a number of private foundations, corporations and individuals. The United States is the Global Fund’s largest single donor, although European Union member states together contribute more than half of the Global Fund’s resources, with France being the second largest donor overall after the U.S.
These additional funds come as the Global Fund prepares for its Mid-Term Review Meeting starting March 31st, during which there will be a performance review and an assessment of future needs.
