Africa: Global Health Fund Update,1/2, 1/30/02

UNIVERSITY OF PENNSYLVANIA - AFRICAN STUDIES CENTER

Africa: Global Health Fund Update, 1 Date distributed (ymd): 020130 Document reposted by Africa Action

Africa Policy Electronic Distribution List: an information service provided by AFRICA ACTION (incorporating the Africa Policy Information Center, The Africa Fund, and the American Committee on Africa). Find more information for action for Africa at http://www.africaaction.org

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Region: Continent-Wide Issue Areas: +economy/development+ +health+

SUMMARY CONTENTS:

The Global Fund to Fight AIDS, TB and Malaria held its first board meeting in Geneva on January 28-29, and announced funding criteria for grants to be decided in April. Simultaneously President Bush announced his budget proposal including a U.S contribution to the Fund for Fiscal Year 2003 (beginning October 2002) at the same low level of $200 million as for the current fiscal year. President Bush's State of the Union address contained no mention of AIDS, global health, poverty, or any other global or African issue except terrorism.

This posting contains a brief introductory note by Africa Action executive director Salih Booker, the press release from the Global Fund calling for funding proposals to be submitted, and a note from the selection committee on the NGO members chosen for the Global Fund board.

Another posting sent out today contains three action-related documents concerning the current status of the fund and related issues, from the Global Aids Alliance, the Treatment Action Campaign, and the Health Gap Coalition.

The British Medical Journal for January 26, 2002 (available on-line at http://bmj.com), has a special issue on HIV/AIDS, including an editorial calling for increased funding and effective quick action by the Global Fund. The UK Stop Aids Campaign has issued a similar call (http://www.stopaidscampaign.org.uk)

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Bush Disregards Africa & the Larger Struggle for Human Security

In May last year, when President Bush announced the initial pledge of only $200 million towards the $10 billion annual requirement of the Global Health Fund launched by UN Secretary-General Kofi Annan, he sent a clear signal to the millions of Africans and others around the world dying of AIDS: "Drop Dead!" Now, despite congressional resolutions calling for contributions as high as $750 million a year, the President has repeated his message.

The President has adamantly refused to consider any increase, while proposing over $40 billion in increased military spending and maintaining his tax cut for the richest Americans. The White House inaccurately described the $200 million pledge as a "doubling" of its previous cotribution.

Other developed and developing countries and even the World Bank argue that September 11 should be a signal for renewed global commitment to address the structural violence of poverty that creates conditions that foster insecurity and terrorism. The U.S., however, is lobbying against any commitments to global public investment. It is, for example, seeking to sabotage the global conference on Financing for Development, to be held in Monterrey, Mexico in March, by refusing to tolerate any language calling for a doubling of development assistance resources for poor countries.

Nevertheless, the Global Fund has been launched, and expects to receive some $700 million (of the total $1.7 million pledged thus far) for its first year of operation. The key test, as spelled out in several of the documents posted here, will be whether these limited funds quickly reach those on the front lines.

- Salih Booker

P.S. For our article in the Nation (January 10), "AIDS: Another World War, see http://www.africaaction.org/desk/nat0201.htm

For Africa Action's press release of May 11, 2001, see http://www.africaaction.org/desk/pres0105.htm

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PRESS RELEASE

GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA ISSUES CALL FOR FUNDING PROPOSALS

Funding Criteria Announced and Board of Directors Elected; First Round of Grants To Be Awarded in April

Contacts: Melanie Zipperer at +41 22 791 9456 or Leyla Alyanak at +41 22 791 9455.

Further information on the Global Fund can be found at
http://www.globalfundatm.org.

GENEVA, 29 January 2002 The Global Fund to fight AIDS, Tuberculosis and Malaria, set up to help combat these three diseases that kill a daunting six million people a year, has approved its first call for funding proposals from country partnerships hard hit by the epidemics. The initial round of grants, to be awarded in April, will be the first made from the Fund, which was initiated last year by an alliance of private donors, non-governmental organizations (NGOs), foundations, national governments and intergovernmental organizations.

"The Fund is an unprecedented cooperative effort to combat the world's deadliest epidemics," said Paul Ehmer, Team Leader of the Secretariat. "Today, we are taking a major step forward, moving rapidly to get these resources to the people that need them most. This is not just a matter of caring and compassion -- it is economically wise as well. The diseases we are addressing have a terrible impact both on human lives and on economic development." A report released recently by leading economists and health experts reaffirms that healthy people are essential to a nation's economic prosperity.

The Fund will finance plans developed through country partnerships in severely affected countries as well as in areas with growing epidemics. It will also support plans in countries that have demonstrated the highest level political commitment to eradicating these diseases. Its approach will be integrated and balanced, covering prevention, treatment, and care and support in dealing with the three diseases.

Proposals will be funded rapidly, with minimum red tape, but with enough safeguards to make sure funds are used responsibly and effectively. Also, the Fund will finance projects that are most likely to clearly demonstrate measurable success.

To date, industrialized and developing countries, corporations, foundations and individuals have pledged some US$ 1.9 billion to the Fund, including a US$ 200 million pledged by the US yesterday. Up to US$ 700 million are expected to be disbursed in 2002. While this is an important start, far more resources are needed. The Fund's aim is to attract significant additional resources that will increase the pool of money already available to fight AIDS, tuberculosis and malaria.

"To be able to responsibly spend millions of dollars in a way that will make a measurable difference takes time," said Mr Ehmer. "We must get it right."

The Purpose of the Global Fund

At a meeting concluded today in Geneva, the newly-elected Board of Directors approved a call for proposals and finalized a set of guidelines for their submission, which are designed to help potential recipient country partnerships apply for funding. The guidelines explain eligibility, application procedures, the types of project the Fund is prepared to support, and the criteria on which funding decisions will be based. The guidelines also explain the proposal review process, and provide details on how the projects will be monitored and evaluated.

"The Fund will support interventions based on best practice that have the potential to fight the three diseases effectively and with lasting results," said Paul Ehmer. "AIDS, tuberculosis and malaria have a devastating global impact. The objective of the Fund is to raise significant new resources to fight them, and to apply these resources in the most strategic and intelligent manner possible. The streamlined grant-making process we are announcing today is designed to minimize unnecessary delays, and maximize the support available for front-line efforts to control these epidemics."

The Global Fund is an independent, public-private partnership whose cornerstone objective is to help save lives by making an ongoing and significant contribution to reducing infections, illness and death. It was created to share resources and expertise across national boundaries and private and public sectors in order to make significant progress in fighting AIDS, TB and malaria. These three diseases have a devastating global impact and together are responsible for nearly six million deaths a year - 10% of the world's total - as well as unimaginable social and economic hardship. Together, the three diseases are responsible for more than one-third of all deaths in Africa. HIV/AIDS kills about half - three million deaths in 2001 - while malaria and TB share the rest of the burden.

How the Global Fund is Administered

A unique feature of the Global Fund is its composition. Non-governmental organizations (NGOs) sit on the Board with two voting seats, as does the private sector. The NGO seats, one from a developing country and one from an industrialized one, belong to the German Institute for Medical Mission and to Health Rights Action from Uganda. The private sector has two seats, one for foundations, held by the Gates Foundation, and the other for private companies, represented by Anglo-American PLC.

All members were chosen by their own constituencies - governments, NGOs and the private sector. Board members are appointed for two years, with equal representation - seven seats each - from donor and developing country governments.

Donor countries represented on the Board are France, Italy, Japan, Sweden, the UK, the US and the European Commission. Some of these seats have alternates and will rotate among countries. The seven developing countries on the Board include, China, Brazil, Nigeria, Pakistan, Thailand, Uganda, Ukraine.

In addition to regular Board members, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), along with the World Bank, which handles the Global Fund's finances, hold ex-officio non-voting seats on the Board. The Board's composition includes a person living with or affected by HIV/AIDS, TB or malaria, also in a non-voting seat.

The Fund will not be business as usual. Nor will it be a large bureaucracy. A small Secretariat located in Geneva manages the Global Fund's work and recruitment of the permanent executive head and staff is beginning. Meantime, an interim Secretariat is being staffed by secondments from UN organizations and governments.

The Road to the Fund

The concept of a fund was initially raised 18 months ago at the G-8 summit in Okinawa. The notion was endorsed at the UN General Assembly Special Session on HIV/AIDS in June 2001 and again at the G-8 Summit in Genoa under the Italian presidency in July 2001. It was championed by UN Secretary-General Kofi Annan, whose calls for stronger action kept attention focused on the Fund. Shortly thereafter, a Transitional Working Group (TWG) was set up to establish a new Global Fund, broadened to include tuberculosis and malaria.

During its mandate, the TWG - made up of more than 40 representatives from developing and donor countries, NGOs, the private sector, foundations and associations of people living or affected by HIV/AIDS, TB or malaria -negotiated the design and operations of the Global Fund, including its legal status, management structure, financial systems and general eligibility criteria. This process involved three meetings of the TWG, regional consultations in Africa, Asia, Latin America and Eastern Europe, and thematic consultations with civil society, the private sector and academia. At its last meeting in December 2001, the TWG handed over its package of recommendations to the new Board and was dissolved.

Mobilizing additional public and private resources will be a key goal for the Fund. The Fund's second board meeting will take place towards the end of April in New York.

ENDS

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BTS (break-the-silence) Listserv, January 25, 2002

BTS discussion archives and subscription information are available at: http://www.hdnet.org

Dear Colleagues,

The Selection Committee would like to thank everyone who applied for an NGO position on the GFATM Board. We received strong applications, and hope that everyone will continue their interest in the GFATM. Having strong NGO involvement and representation in the country processes will help to see that the Fund addresses the needs of the communities we serve.

The following candidates and alternates have been selected as NGO representatives on the Board of the Global Fund to Fight AIDS, Tuberculosis & Malaria:

NGO Representative from a Developing Country:

Milly Katana is currently the Lobbying and Advocacy Officer for Health Rights Action Group in Uganda. Milly has worked with various UN agencies such as the United National Industrial Development Organization (UNIDO) and the United Nations Program Joint Program on HIV/AIDS (UNAIDS). She has recently concluded an assignment on Strengthening Programs for People Living with HIV/AIDS in Botswana, working with the Government of Botswana and the World Health Organization. Milly is a woman living with HIV/AIDS. She has extensive experience with various national and international networks, including the African Council of AIDS Service Organizations (AfriCASO), the Society of Women Against AIDS in Africa (SWAA) and the Network of African People Living with HIV/AIDS (NAP+) and the Global Network of People Living With HIV/AIDS (GNP+). Milly has a keen interest in issues affecting women with HIV and families affected.

Milly Katana Health Rights Action Group P.O. Box 40126, Kampala, Uganda Tel: +256- 41-223957 / +256-41-403836 Fax: +256-41-222201 / +256-41-343301 E-mail: katanam@infocom.co.ug

NGO Representative from a Developed Country

Christoph Benn is the Head of the Department for Health Policy and Studies with the German Institute for Medical Mission. As a medical doctor in tropical medicine and public health he has experience in the treatment and prevention of AIDS, TB and malaria. Since 1992, he has spent several months per year particularly in Africa and Asia to work with communities and NGOs in the planning, implementation and evaluation of health care programs. As the current secretary of the German working group on international health, he coordinates more than 50 organizations from all sectors. Christoph works with many national and international organizations including the World Council of Churches, the Ecumenical Advocacy Alliance and is cofounder of the German network Covenant for Action Against AIDS.

Christoph Benn German Institute for Medical Mission Paul-Lechler-Str. 24, D-72076 Tuebingen, Germany Tel: +7071-206520 E-mail: benn@difam.de

Representative of PWA/Malaria/TB Communities

Philippa Lawson is the International HIV/AIDS Team Leader/ Senior Program Manager for the Academy for Educational Development. She has worked in numerous countries in Asia, Africa, Europe, the Caribbean and Latin America. Philippa is a woman living with HIV/AIDS and has extensive linkages to key local, national and international networks including the International Community of Women Living with HIV/AIDS (ICW). Philippa has worked with numerous marginalized communities, and her emphasis over the years has always been to ensure that the needs of women and children are always considered. She has extensive experience working with advocacy and on review and technical bodies.

Philippa Lawson Academy for Educational Development 1825 Connecticut Avenue, NW, Washington, DC 20009, USA Tel: (202) 884-8586; Fax: (202) 884-85474 E-mail: Plawson@aed.org

Alternate NGO representative from a developing country:

Fidon R. Mwombeki is the General Secretary of the Northwestern Diocese Evangelical Lutheran Church in Tanzania (ELCT). He lives in a community that has been severely affected by AIDS, malaria and TB and is committed to fighting all three diseases. Fidon has been involved in the fight against AIDS since 1986 when his diocese first intervened to provide support and care for orphans. He has extensive experience working at community, national and international levels. He has worked with ELCT's Primary Health Care Program, the Building Eastern Africa Community Network, the Tanzania Coalition on Debt and Development, the Jubilee 2000 campaign and the Ecumenical Advocacy Alliance.

Fidon R. Mwombeki, Evangelical Lutheran Church in Tanzania, Northwestern Diocese P.O. Box 98, Bukoba, Tanzania Tel: (+255-28) 222-1313; Fax: (+255-28) 222-0954 E-mail: elct-nwd@twiga.com

Alternate NGO representative from a developed country:

Peter Poore is a Health Adviser with extensive experience with Save the Children. As a medical doctor Peter has 28 years of experience in health care delivery and the development and management of health care systems in developing countries. He has been involved in policy work on HIV since the mid 1980s; his experience working with malaria and TB extends back to the 1970s. He has extensive international experience and has worked with the Department for International Development (DFID) UK, The World Health Organization, UNICEF, the World Bank and the Global Alliance for Vaccines and Immunisation.

Peter Poore Reading Green Farmhouse, Denham, Eye, Suffolk, United Kingdom Tel: (+44-137) 966-8134 E-mail: pdpoore@aol.com

Alternate representative of PWA/Malaria/TB communities:

Charles Roy is the Executive Director of the AIDS Committee of Toronto (ACT), the largest AIDS service organization in Canada. Charles is a man living with HIV/AIDS and has been a leader in the Canadian HIV/AIDS field for the past decade, working with community, professional and academic organizations to advocate for the rights of people living with HIV/AIDS. His interest in promoting the dignity and well-being of people living with HIV/AIDS expands beyond non-governmental work and has also been demonstrated through his lecturing and writing. Charles' interest in promoting the dignity and well-being of people living with HIV/AIDS expands beyond non-governmental work and has also been demonstrated through his lecturing and writing. His docteral dissertation, "Living and Serving: Persons with HIV in the Canadian AIDS Movement", explores the challenges and opportunities that consumer involvement brings to a health movement.

Charles Roy, AIDS Committee of Toronto 399 Church Street, Toronto, Ontario, Canada M5B 2J6 Tel: (+1-416) 340-8484 ext. 271; Fax: (+1-416) 340-8224 E-mail: croy@actoronto.org

We wish them success in moving our issues and priorities forward. Information on the specific roles of the Alternates will be circulated as it is available.

The members of the Selection Committee were:

Alex Coutinho - TASO, former TWG member; Joseph Scheich - Aids Fonds, former TWG member; Paula Fujiwara - International Union Against Tuberculosis and Lung Disease (IUATLD), former TWG member; Richard Burzynski - ICASO, former TWG member; Linda Hartke - World Council of Churches, Ecumenical Advocacy Alliance; Leslie Wright "C CONGO; Bai Bagasao - UNAIDS (advisor, no vote)

[submitted by: tanyaj@icaso.org on behalf of the committee]

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Africa: Global Heath Fund Update, 2 Date distributed (ymd): 020130 Document reposted by Africa Action

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Region: Continent-Wide Issue Areas: +economy/development+ +health+

SUMMARY CONTENTS:

The Global Fund to Fight AIDS, TB and Malaria held its first board meeting in Geneva on January 28-29, and announced funding criteria for grants to be decided in April. Simultaneously President Bush announced his budget proposal including a U.S. contribution to the Fund for Fiscal Year 2003 (beginning October 2002) at the same low level of $200 million as for this fiscal year. President Bush's State of the Union address contained no mention of AIDS, global health, poverty, or any other global or African issue except terrorism.

This posting contains three action-related documents concerning the current status of the fund.: (1) an organizational sign-on letter addressed to President Bush and Congress (open to organizational sign-ons by both U.S. and non-U.S. groups), (2) a press release from Treatment Action Campaign in South Africa concerning their initiative importing antiretrovirals from Brazil (a good example of what the Global Fund should be funding), and (3) a memorandum by Health Gap Coalition on critical issues in the first months of the Global Fund's operation.

A related posting also sent out today includes a brief introductory note by Africa Action executive director Salih Booker, the press release from the Global Fund calling for funding proposals to be submitted, and a note from the selection committee on the NGO members chosen for the Global Fund board.

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Stop Global AIDS Campaign

Updated Sign-On - Jan 28, 2002

100 Organizations Signed On: More Needed

Call for Urgent Action by President George W. Bush and Congress to Fully Fund the Fight Against AIDS

1. Read the Statement below to see if your organizational can sign-on. If yes, please an email to pzeitz@globalaidsalliance.org; Please provide the name of your organization and its location (state and country);

2. Please pass this email on to your listserve, consider posting on your website, and encourage as many organizations as possible to sign on to this statement;

3. This statement will be used by advocacy groups who are meeting members of Congress in their Districts and in Washington Offices. It will also be sent to the President and all key Administration officials. The statement is designed to demonstrate the broad-based coalition that is supporting increased US government funding to stop global AIDS;

4. Updated versions of this organizational "Call for Action" will be posted at http://www.globalaidsalliance.org

FOR MORE INFORMATION:

Dr. Paul Zeitz, Executive Director, Global AIDS Alliance Box 820, Bethesda MD 20827-0820 tel: 301-765-2046, cell: 267-254-5857, fax: 301-765-6091 pzeitz@globalaidsalliance.org

http://www.globalaidsalliance.org http://www.yahoogroups.com/group/global-aids-alliance

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CALL FOR URGENT ACTION TO STOP GLOBAL AIDS

(Update as of 28 January 2002)

Our organizations are humanitarian, religious, and other groups committed to a full-scale effort to stop the global AIDS pandemic and its related causes, particularly in the impoverished regions of the world, which have been the hardest hit by the AIDS crisis. Because of the unprecedented impact of the crisis, we call on President George W. Bush and the US Congress to provide $2.5 billion in FY 2003 resources to the Global Fund to Fight AIDS, TB, and Malaria and to bilateral AIDS programs.

Without bold investment now, projections are that 100 million people will become infected by 2007. The AIDS pandemic and its related causes in Africa, Asia and elsewhere threaten to destabilize nations and undermine global security. We believe taking immediate action to ensure adequate resources to combat AIDS, TB, and Malaria is one of the best ways the US can exert leadership in a troubled world.

Respectfully,

[The list of more than 100 signatory organizations, including Africa Action, will be provided on-line at http://www.globalaidsalliance.org]

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Treatment Action Campaign, Medecins Sans Frontieres, and Oxfam

29 January 2002

TAC AND MSF IMPORT GENERIC ANTIRETROVIRALS FROM BRAZIL IN DEFIANCE OF PATENT ABUSE

Joint Press Release

* Zackie Achmat: (27) 83 467 1152 or (27) (21) 788 5058 * Mark Heywood: (27) (11) 717 8634

Additional background information is available on the websites of MSF and TAC: http://www.tac.org.za and http://www.accessmed-msf.org

Generic AIDS Drugs Offer New Lease on Life to South Africans Importation of generics cuts price in half

29 January 2002, Johannesburg - Yesterday, three members of the Treatment Action Campaign, (TAC) returned to South Africa from Brazil carrying generic drugs manufactured for use in an AIDS treatment program in Khayelitsha. At a press conference today, TAC and MSF explained that the drugs carried from Brazil were the second shipment of Brazilian drugs and that as of today more than 50 people are already taking the Brazilian medicines in Khayelitsha.

To guarantee the quality of these drugs, an authorisation from the Medicines Control Council (MCC), the South African drug regulatory authority, was obtained prior to their use.

"Last week in Brazil we saw what happens when a government decides to tackle HIV/AIDS. The Brazilians' decision to offer universal access to antiretroviral therapy even in the poorest areas of the country is keeping tens of thousands of people alive," said Zackie Achmat of the Treatment Action Campaign. "Central to the success of Brazil's AIDS programme is their willingness to do anything necessary to source the lowest cost quality ARVS. The South African government should pursue compulsory licensing to ensure that generic antiretrovirals can be produced and/or imported in South Africa."

At a press conference today, the NGOs said that the court victory of the South African government against multinational pharmaceutical companies had opened the door to improved access to affordable medicines. "The South African government may need international financial help to provide treatment, but these needs will be dramatically reduced if the government takes steps to use the most affordable drugs available on the worldwide market, as the multinational pharmaceutical companies are still charging exorbitant prices for these drugs," said Dan Mullins of Oxfam.

Despite the national government's refusal to provide antiretroviral treatment, three clinics run by MTdecins Sans FrontiFres (MSF) within the government primary health care centres offer a comprehensive package of services to people living with HIV/AIDS, including antiretroviral therapy. This project is part of an agreement between MSF and the government of the Western Cape, signed two years ago with the express intent to test the feasibility of generic antiretroviral therapy. These clinics, located in Khayelitsha, a sprawling township of 500,000 people outside Cape Town, were opened in April 2000 and have provided treatment for opportunistic infections for over 2,300 people living with HIV/AIDS.

In May 2001, combination antiretroviral therapy was introduced for a group of people in advanced stages of AIDS. To date, 85 people have received antiretroviral therapy and 50 of these are receiving Brazilian medicines. Using generic antiretrovirals offers the possibility of treating twice the number of people with the same amount of money.

"I have personally benefited from the MSF antiretroviral programme, and I have gone to Brazil to bring back generics so that more people like me can have access to these medicines," said Matthew Damane, a person living with AIDS who is receiving antiretroviral therapy as part of the MSF programme in Khayelitsha. "The government should publicly accept the effectiveness of these medicines and make them available to people with AIDS in South Africa."

"Our project shows that antiretroviral therapy is feasible in a resource-poor setting, contrary to those who insist that poor Africans are not able to successfully take these drugs. Patients who were critically ill are now returning to their normal lives," said Dr. Eric Goemaere of MSF South Africa. "We have seen firsthand that these drugs can be used safely and effectively here in South Africa. As medical professionals, it is our duty to offer these benefits to as many patients as possible."

Similar initiatives are springing up elsewhere around the country as medical staff become increasingly frustrated by the lack of action from the national government. Nonetheless, the price of medicines continues to be a critical problem.

MSF has signed agreements with the Brazilian Ministry of Health (MoH) and Fiocruz, a public research body funded by the Brazilian government. The former established a cooperative agreement involving technical collaboration on the response to HIV/AIDS, so that MSF and the Brazilian MoH can collaborate to improve the delivery of treatment in resource-poor settings. The agreement with Fiocruz allows MSF to purchase antiretroviral drugs produced by FarManguinhos, the Brazilian national pharmaceutical producer, which is part of Fiocruz.

An innovative aspect of this arrangement is that the money MSF pays will go directly into research and development for AIDS and neglected diseases such as sleeping sickness, Chagas Disease and malaria (all diseases for which current treatment options are inadequate). MSF is currently using the antiretroviral drugs AZT, 3TC, co-formulated AZT/3TC, and nevirapine produced by FarManguinhos. By using these drugs the price per patient per day falls from US$3.20 to US$1.55.

In 1996, in response to pressure from civil society, the Brazilian government began providing free access to antiretroviral therapy to people with HIV/AIDS. This policy has allowed more than 100,000 people to receive antiretroviral therapy and reduced AIDS-related mortality by more than 50%. Between 1997 and 2000, antiretroviral treatment has saved the Brazilian government $677 million on hospitalisations averted and treatment for opportunistic infections averted.

South Africa could launch a similar programme. To do so, the government needs to have access to the lowest cost medicines, whether they come from multinational pharmaceutical companies or from generic producers. This means both taking advantage of offers from multinational companies and being willing to seek compulsory licenses. These licenses can be used to produce these drugs locally or import them and are an important way to stimulate competition, which is a powerful tool to reduce prices.

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COSATU Statement on the Importation of Generic Antiretrovirals from Brazil

The Congress of South African Trade Unions (COSATU) and the Treatment Action Campaign (TAC) have returned from a visit to Brazil. The delegation included Joyce Pekane, Second Deputy President of COSATU, Zackie Achmat, Chairperson of TAC, Nomandla Yako, and Matthew Demane, a person who is living with AIDS and currently being treated with anti-retroviral therapy.

The delegates, hosted by Medecins sans FrontiFres (MSF), looked at Brazilian HIV/AIDS treatment programmes, visited factories which manufacture generic anti-retroviral medicines and met government officials and people living with AIDS. The Brazilian government has formally offered the South African government help in fighting HIV/AIDS.

On their return the delegates brought back a batch of generic anti-retroviral medicines for use by MSF in a treatment programme in Khayelitsha. The Medicines Control Council (MCC), having studied the safety of these medicines, has given a Section 21 exemption which allows for them to be imported and used by MSF.

The equivalent drugs are in fact available in South Africa, produced by GlaxoSmithKlein (GSK) and Boehringer Ingelheim. But they cost approximately R1000 per month compared to the cost of R450 for the medicines being brought from Brazil.

The importation of these drugs for use under strict conditions by MSF has been approved by the MCC. We are aware that it may infringe patent rights. However, we believe that faced by an emergency caused by AIDS, and in face of overwhelming support for the government's view that patent rights should not be used to deny people access to life-saving medicines that this importation is in line with government and international policy.

COSATU, TAC and MSF stand by their belief that the government and society as a whole must get anti-retroviral medicines to the people who need then as quickly and cheaply as possible and must not let the vested interests of multi- national pharmaceutical manufacturers to prevent this.

This is why these medicines are being brought in. The MSF programme in Khayelitsha is already improving the lives of over 80 people. With affordable medicines many more people could be reached, not only in the Western Cape but throughout SA.

Patrick Craven and Moloto Mothapo Acting COSATU Spokespersons 011 339 4911 0r 082 821 7456 siphiwe@cosatu.org.za 082-821-7456; 339-4911

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Critical Issues For The Launch Of The Global Fund

Health Gap Coalition Issues Brief, 24 Jan 2002

(Contact +1 215.833.4102, pdavis@critpath.org)

Health GAP Coalition: P.O. Box 22439 Philadelphia PA, 19143, USA * +1 215.474.6886 tel * +1 215.474.4793 fax

http://www.globaltreatmentaccess.org

Global Fund to Fight AIDS, Tuberculosis, and Malaria

The Global Fund to fight AIDS, TB and Malaria has a limited amount of time to succeed or fizzle. To inspire the invest-ments needed to mount a meaningful response to the global AIDS disaster, the GFATM must produce dramatic results in its first year. Saturating a measurable population sector with effectively delivered ARV treatment can drop mortality 25-40% in a single year, with roughly correlated decreases in rates of new infection. Yet most of the GFATM negotiators place little priority on treatment for the 8000 people who die each day without access to AIDS medicines.

Key issues:

1. Demand that Board spend money quickly and fully.

Some TWG [Technical Working Group] members are reluctant to spend all of the money contributed to the global fund, in order to extend the window of the fund. Such a limited vision both accepts the current small levels of funding, and assumes that the fund will not ever grow to meet the $9.3 billion need. The fund must prove itself by quickly spending every penny available, leveraging dramatic results for greater contributions.

2. Work with board, TRP [technical review panels] and applicant countries to ensure treatment for people living with AIDS.

Many of the TWG and board members see treatment for PWAs as not 'cost effective'. The political momentum the created the fund has been driven largely by a demand to provide treatment for people in impoverished nations. To refuse medicine for the 8000 people a day dying without access is immoral, and dooms the fund to a slow fizzle. At the December ICASA conference in Burkina Faso, NGOs representing hundreds of thousands of people with AIDS issued the "Ouagadougou Appeal", which calls for a minimum of 30% of the global fund's resources to be spent on AIDS treatment in the first year.

3. Work with recipient countries and TRP panels to work to ensure maximum market entry for generic drug manufacturers.

Treatment access advocates have always seen the global fund partly as a tool to jumpstart market entry of affordable generics into developing countries. The availability of affordable medicine within reach creates social demand for medicine, which can change the domestic priorities of nations. The economic mechanism of generic competition exerts a constant downward pressure on prices. Economies of scale in the raw materials market and in manufacturing can bring costs down substantially lower than has already been seen. Once launched on a meaningful scale, this economic process is difficult to reverse, irrespective of the future existence of the global fund.

4. Work with board members to revitalize the Quickstart proposal:

A "Quickstart" to the global fund has been negotiated and re-negotiated until, unfortunately, almost everything 'quick' or innovative has been removed from the current language. The Board should immediately issue an RFP [request for proposals] open to any qualified provider demonstrably able to deliver treatment services to people with AIDS, TB, or malaria. Recipients would then join the country coordinating mechanism (CCM), broadening and strengthening these bodies at the launch. This proposal addresses opposition to treatment, and puts immediately puts resources into the hands of NGOs and private sector workplace clinics. By building strong CCMs from the start, results can be delivered faster than if the eventual country proposal comes only from CCM members hand selected by government.

5. Place strong advocates for treatment on the TRP: Submit via any contacts on the TWG or board available. Access advocates should share their candidates information, to enable support for a 'slate'.

ACTIONS:

1. Push former TWGs & board members to spend all the resources in the fund, with at least 30% of grant resources spent for AIDS treatment, delivered largely to 'Quickstart' recipients in the first year.

2. Work with applicant countries to submit proposals that prioritize treatment for PWAs and include affordable generics wherever possible.

3. Lobby governments and donors for money for Global Fund.

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Message-Id: <200201310055.TAA20676@server.africapolicy.org> From: "Africa Action" <apic@igc.org> Date: Wed, 30 Jan 2002 20:35:25 -0500 Subject: Africa: Global Health Fund Update,1/ 2

Editor: Ali B. Ali-Dinar

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