Activist anger over US ‘ambush’ of the Global Fund

1 July 2003. Related: Treatment access.

Graham McKerrow, HIV i-Base

The Group of Eight most industrialised nations (G8) and the Global Fund to fight HIV, TB and Malaria have announced new donations by rich countries to the fund – but there is widespread criticism that the donations are far too small, and one activist group says an American “ambush” will divert money to bilateral agreements between donor countries and developing countries and leave the fund impotent.

The G8 summit in the French Alpine town of Evian in early June was criticised for the limited pledges of new money for the fund. Amid much rhetoric, The European Union promised to consider, at its own summit in Salonika, Greece on 26 June, matching the $1 billion promised by the United States. This is part of a much larger sum, $15 billion over five years, that George Bush has said the US will give in bilateral aid directly to selected countries. The G8 and the Global Fund have also agreed to hold a conference, in Paris in July, to bring together governments and other organisations to plan a strategy for further fund raising for the Global Fund.

President Jacques Chirac told the G8 meeting that France would triple its donation to the Global Fund from 50m euros to 150m euros ($175 million) annually up to 2006. The week before the summit, Tony Blair announced that the UK’s contribution would be increased from $200 million to $280 million up to 2008.

Chirac said Bush was “totally right” to urge other countries to match the US contribution and thought Europe would “accept the challenge.” The French president also said he was in favour of a tax on the arms trade to help finance a global fund to feed the world’s hungry. Such a tax, suggested by Brazilian President Luiz Inacio Lula da Silva, “would not be at all unjustified,” Chirac told a press conference.

Jose-Maria Zuniga, president and CEO of the International Association of Physicians in AIDS Care, commented: “With President Bush’s recent commitment of his government’s resources to stepping up this battle, the onus was placed on the world’s other wealthy countries to show equal commitment and to demonstrate the need for the United States to live up to the authorisations approved by President Bush. This is a role and responsibility that, with the notable exceptions of France and the United Kingdom, other G8 nations are now failing to live up to. In fact, several other non-G8 nations continue to surpass these wealthier states in living up to their proportional responsibilities.”

European Commission president Romano Prodi questioned how much of President Bush’s $15 billion would actually materialise, pointing out the money still had to be approved by Congress. “The money’s not on the table,” Prodi told reporters. He also dampened speculation that the EU would give $1 billion to match the US donation to the Global Fund, saying European Union payments to the fund remained higher than Washington’s.

“It was really easy for me to match it, it’s certainly not a problem because we are giving more than that [already],” Prodi said.

At the end of May Richard Feacham, executive director of the Global Fund, told the French newspaper Le Monde that the fund needed $4 billion by the end of 2004. But by the time he reported to the fund’s board meeting in Geneva on 5 June the amount yet to be raised by the end of next year had fallen to $3 billion. Feacham reported that pledges to the fund had increased by $1.2 billion in one week: France promised 450 million euros, the European Commission promised 340 million euros, Italy 200 million euros and the UK an extra $80 million. However, these promises cover different periods going up to 2008 and only 23% of the fund’s needs up to the end of 2004 are met by these pledges.

Feacham said that because the US promise of $1 billion was conditional on twice that sum being raised from other sources, he hoped the EU would provide $1 billion and that public and private donors outside the US and Europe would provide another $1 billion.

A statement issued by the fund said: “The most urgent need for resources is the Global Fund’s third round of proposals [to be considered in October]. Over 200 proposals have been received from 85 countries, requesting $2 billion for two years. It is likely that at least half of these requests will be recommended to the board for approval in October, but the Fund has only $400 million in remaining pledges for 2003. Needs for 2004 include two more proposal rounds.”

A statement issued by the fund said: “The most urgent need for resources is the Global Fund’s third round of proposals [to be considered in October]. Over 200 proposals have been received from 85 countries, requesting $2 billion for two years. It is likely that at least half of these requests will be recommended to the board for approval in October, but the Fund has only $400 million in remaining pledges for 2003. Needs for 2004 include two more proposal rounds.”

Davis described the “ambush” thus: “The US has decided to put everything into its bilateral AIDS programme. Therefore, it is working hard to reduce all the countries’ obligations to pay into the Global Fund, and by manipulating the agenda through control of the Chair, Tommy Thompson [the US health secretary] arranged a new policy to reject any Global Fund application for round 3 beyond the $417 million now in the bank. Deviously, a policy was adopted that almost no one understood. That means that only $417 million of the $2 billion in grants [applications] that just came in will be funded, in spite of ample cash in the bank by the time that cheques would have to be written. The board may now only approve good applications up to the amount of pledges in 2003.

“What this means is that the $1-1.5 billion the Global Fund is fairly certain to have pledged by the October board meeting simply does not count, because most of those cheques will be written in 2004. So most of the applications are to be rejected. This policy reduces pressure on the donors, since they will not have unfunded but approved proposals laying around.”

To date, the Global Fund has considered two proposal rounds, approving US$ 1.5 billion to 93 countries over two years. (See table for details of pledges and contributions to the fund up to the end of May.)

The G8 meeting contained further disappointment in its six-point so-called Action Plan in which the G8 repeatedly use phrases like “we express our continued concern…” and “reiterate our commitment to fight AIDS, as well as TB and Malaria, as agreed in Okinawa…” A section on access to medicines welcomed and encouraged pharmaceutical companies’ decisions to supply free and discounted drugs to developing countries, but it made no mention of the important role the supply of generic medicines plays in cutting prices and increasing distribution of antiretrovirals. A very woolly paragraph instructed G8 ministers and officials to work with partners in the World Trade Organisation to “establish a multilateral solution in the WTO” to the problems faced when developing countries import from other developing countries medicines produced under compulsory licence for addressing public health crises.

Global Fund to Fight AIDS, TB & Malaria: Donors Total Pledges to date

Notes:

1. (a) For pledges made in currencies other than US dollars, the pledge amount in USD comprises the actual USD value realised from any contributions made plus the USD equivalent of the remainder of the pledge calculated using UN operational rates of exchange at 1 May 2003 (15 May 2003 for Euro pledges).
   (b) Where pledges have not been specified for individual years, the amount shown as pledged for a period is the sum of contributions received in that period.
2. Contributions in process comprise amounts remitted to holding accounts with the Trustee pending execution of contribution agreements and amounts expected to be received within one month pursuant to a signed contribution agreement.
3. Contributions from the Gates Foundation are received via the GFATM Trust account.
4. Payments in process for 2002: Kenya (8,273) and Zambia (25,000).

Before the summit, Medecins Sans Frontieres demanded that the G8 make existing essential medicines affordable to those who need them by supporting an equitable pricing system based on generic competition, and abandon reliance on voluntary, ad hoc efforts to increase access to medicines, “which do more to protect the interests of the pharmaceutical industry than the lives of people in developing countries”.

MSF also called on the G8 to ensure that public health needs were prioritised over commercial interests in international trade negotiations so that patents no longer constituted a barrier to access to medicines.

Links:

Global Fund to Fight AIDS, TB and Malaria
http://www.globalfundATM.org/

Fund the Fund
http://www.fundthefund.org/

Global Fund Observer
http://www.aidspan.org/gfo/

Letter from Kofi Annan to the G8
http://allafrica.com/stories/200305300078.html

Medecins Sans Frontieres
http://www.msf.org/

Health GAP (Global Access Project)
http://www.healthgap.org/

European Union
http://europa.eu.int/

European Commission
http://europa.eu.int/comm/

University of Toronto G8 Information Centre
http://www.g7.utoronto.ca/

International Association of Physicians in AIDS Care
http://www.iapac.org/

Global Fund requires ‘significant’ new money, and other reports from HTB 4-5 see under Treatment Access at
https://i-base.info/htb/date/2003/06