Donor countries and private corporations pledged a record US$11.7 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria at the end of a funding conference in New York on 5 October, allowing another two million people access to HIV treatment by 2015, but still falling short of the amounts organizers had hoped to raise.
The Global Fund is still expecting pledges from the UK and the Netherlands, which are together projected to contribute $900 million. That, with an expected pledge from Sweden, would bring contributions to $13 billion, the amount needed for programmes to be fully operational, and not just “running in place”, said Asia Russell, director of international policy for Health Gap, an advocacy group based in New York.
Organizers had sought $20 billion to continue and expand the fund's programmes in 145 countries over the next three years. The shortfall is likely to make some of the Millennium Development Goals (MDGs), including halting and beginning to reverse the spread of HIV/AIDS, unachievable by 2015.
The US led donors with a three-year pledge of $4 billion - a 38 percent increase over its previous contribution, but $2 billion short of what HIV/AIDS activists had been pushing the Obama administration to deliver.
UN Secretary-General Ban Ki-moon hailed the funding as a “concrete manifestation of global solidarity that moves us closer to achieving the Millennium Development Goals”. But Global Fund executive director Michel Kazatchkine, speaking alongside Ban at a press conference, noted that if this amount “were to be the last word from donors… it is not enough to reach the Millennium Development Goals”.
It will also not be enough to eliminate mother-to-child transmission of HIV. “Based on the resources we want to mobilize, we are not there,” Michel Sidibe, executive director of UNAIDS, told IRIN/PlusNews in a phone interview shortly before the conference outcome was publicized. “This means that [fewer] people will be on PMTCT [prevention of mother-to-child transmission] than need to be, and the reality is that it is very important for us to look for other ways of financing, other partnerships, to do things more effectively and efficiently.”
|Country||Confirmed pledges denoted in USD million||Pledge as percentage of 2009 Gross Domestic Product|
|Source: Global Fund / CIA World Factbook|
In contrast, two weeks earlier at the MDG summit in New York, Sidibe and other UN officials said the elimination of mother-to-child transmission by 2015 was achievable.
Nearly $3 billion from the Global Fund’s total three-year pool will be made available for new programming - not enough to meet the demand from countries seeking to scale up their national HIV, TB and malaria programmes. Governments will likely be faced with tough decisions.
“It’s a matter of priorities,” said Jon Lidén, the Global Fund’s communications chief. “There will be some things that countries won’t be able to tackle.”
The remaining $8.8 billion will fund existing programmes, which will not be cut or eliminated, but will “not be in a position to expand as fast as we would have hoped”, Kazatchkine said.
Civil society groups said the lack of scale-up would mean more than five million preventable deaths, affecting at least 3.1 million people needing HIV treatment and more than 2.9 million needing TB treatment.
“We have a limited amount to cover existing programmes, and the problem is we will not be able to expand that as fast as we need to,” said Karlo Boras, executive director of the Yugoslav Youth Association against AIDS, who serves as a member of the Developing Country NGO Delegation on the Global Fund Board. “Our opportunities are decreasing rapidly with the outcome of this replenishment.”
More than 40 countries contributed, with France pledging $1.48 billion, Germany $822.4 million, Japan $800 million and Canada $528.4 million.
The US’s $4 billion - for the first time spread over three years - is the largest investment any country has made to the Global Fund in its history. Eric Goosby, US Global AIDS Coordinator and head of the President’s Emergency Plan for AIDS Relief (PEPFAR), told reporters that the unprecedented funding “sends a signal to the world that even in these difficult times we are committed to fighting these diseases”.
The policy shift to a three-year pledge is a “smart change”, he told IRIN/PlusNews, adding that it will allow “funding lines to have the biggest impact”.
At its last replenishment session in 2007, the Global Fund fell $3 billion short of a $13 billion target to provide funding for 2008, 2009 and 2010.