Africa: Money for AIDS Update, 04/15/03

Africa: Money for AIDS Update, 04/15/03

AFRICA ACTION Africa Policy E-Journal April 15, 2003 (030415)

Africa: Money for AIDS Update (Reposted from sources cited below)

On April 14, Africa Action released the statement "Money for AIDS, Not for War" with endorsements to date from more than 70 organizations around the U.S. and around the world. For the press release, including the full list of signatories, see If your organization has not yet signed, please sign up at The list of signatories will be updated regularly.

Today, April 15, many groups around the U.S. are also participating in protests against the use of citizens' taxes for war instead of for urgent human needs such as fighting the HIV/AIDS pandemic. See

As noted in an earlier e-journal [], U.S. congressional action to increase funding for international action against AIDS is still stalled, with the Bush administration arguing against increased funding in 2003-2004 for the Global Fund to Fight AIDS, TB, and Malaria. At the multinational level, more than 40 non-governmental groups meeting in Paris at the end of March called for other rich countries as well as the U.S. to commit to "fund the fund" before the next meeting of the G-8 group of rich countries at Evian,France, on June 1-3 (see for a press statement and list of groups at the Paris meeting).

This e-journal posting contains a news update and excerpts from two recent reports documenting the wide gap between the consensus on the need for greater funding, and the failure in practice to provide that funding. First, a report from the IMF/World Bank released for the spring meetings, summarized by the Kaiser Daily HIV/AIDS Reports and excerpted briefly below, documents that "If current budgetary trends continue, donor support in 2003 will still be much less than the bare minimum required for basic prevention and care programs." Secondly, an article from the Global Fund Observer newsletter notes the failure of the Global Fund itself to develop a fundraising strategy.

Another posting today provides updates on the Treatment Action Campaign for AIDS treatment in South Africa.

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Global Commitments To Fight AIDS Fall Short of Goals, International Monetary Fund Says

Access this story and related links online:

Kaiser Daily HIV/AIDS Reports E-mail registration:

Global commitments to fight HIV/AIDS are falling short of the amount needed to meet the World Bank's goal of reversing the virus' spread by 2015, according to the International Monetary Fund, Reuters reports (Wilkinson, Reuters, 4/13). In 2001, U.N. Secretary-General Kofi Annan said that between $7 billion to $10 billion per year would be needed to fight HIV/AIDS and called on international donors to contribute to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Kaiser Daily HIV/AIDS Report, 5/1/01). However, the IMF and World Bank in a joint report issued yesterday said that "global commitments to date have not kept pace with rising demands," according to Reuters. The report says that there needs to be "significant changes" in the way HIV/AIDS is addressed in order to meet the Millenium Development Goal. In 2002, an estimated $3.2 billion was needed from international donors to battle the disease, but contributors missed that goal by about $2 billion, according to Reuters. Fighting HIV/AIDS will also require more than monetary donations, according to the IMF and World Bank report. Resources and stakeholders must be mobilized from "the village to the national level" to provide antiretroviral drugs and HIV/AIDS education. "Effective prevention and treatment of HIV/AIDS requires educating and promoting behavior change among population groups that are normally far beyond the reach of government and mainstream NGO (non-governmental organization) programs," the report states. The spread of the virus has harmed the economies of many developing countries, draining them of workers and depressing their agricultural and industrial sectors, as well as hurting education, according to the IMF. The disease, which is estimated to have killed 60 million people since the beginning of the epidemic more than 20 years ago, is spreading most rapidly in Eastern Europe and Central Asia, with the number of infected individuals in Russia "skyrocket[ing]" from 11,000 in 1998 to 200,000 in 2002, according to Reuters (Reuters, 4/13).


DEVELOPMENT COMMITTEE (Joint Ministerial Committee of the Boards of Governors of the Bank and the Fund On the Transfer of Real Resources to Developing Countries) DC2003-0004/Add.2

April 1, 2003

Progress Report and Critical next Steps in Scaling Up: Education for All, Health, HIV/AIDS, Water and Sanitation


Fighting HIV/AIDS: Progress, Prospects and Issues

Brief excerpts only [for full text search on World Bank site -]


A. INTRODUCTION. This addendum reviews the status of the global fight against HIV/AIDS, charting progress to date and prospects for achieving the Millennium Development Goal (MDG), which includes to "have halted by 2015 and begun to reverse the spread of HIV/AIDS". Following an overview of the state of the epidemic, the paper reviews the current financial commitments that international donors have made and actual spending for the fight against HIV/AIDS. These are then compared against the best available estimates of the resources required to scale up HIV/AIDS activities if enough funding were available to use existing infrastructure to its maximum potential. The addendum also discusses how best to remove impediments to progress, and accelerate implementation of HIV/AIDS programs. The overall conclusion is that without significant changes in the way the epidemic is addressed, there is little chance of halting and beginning to reverse the spread of HIV/AIDS by 2015. ...


15. Global commitments. Commitments made by developing countries, UN agencies, the donor community, multilateral development banks, and other partners in development have increased to begin to match the challenge posed by the pandemic. Most notably, resources have been mobilized to respond to the crisis through commitments from the G8 and other donors, both in the public and private sector, agreements made at Monterrey and coordinated actions by partners in UNAIDS. concluded with a Declaration of Commitment for an intensified effort to mobilize national and international resources for combating HIV/AIDS.

16. The UNGASS Declaration of Commitment pledged UN agencies, partners and governments to a series of broad-ranging goals related to HIV (some of which are summarized below) which, if met, will certainly contribute towards reaching the MDGs. However, without significant changes in the way the epidemic is addressed, there is little chance of meeting the MDG goal which encompasses halting and beginning to reverse the spread of HIV/AIDS by 2015. Further, even interim MDG goals, such as those for education, will not be realized, given the huge toll that HIV/AIDS exacts on teachers and educational systems in some countries (particularly in Sub- Saharan Africa). Simply put, progress toward a number of the other MDGs will be hindered or even reversed in the seriously HIV-affected countries unless business as usual changes. Substantial changes are needed to redress existing blockages to implementation.

17. Resources. With regard to financial requirements, UNGASS calls for resources for the global response to HIV/AIDS that are "substantial, sustained, and achieve results." By 2005, UNGASS cites an overall annual target of between USD 7 billion and USD 10 billion to be spent on HIV/AIDS for low- and middle-income countries and countries with, or at risk of, high rates of HIV infection. It also calls for national governments to do their part in allocating domestic resources. As part of the call for additional resources, an explicit call was made for the international community to provide assistance for HIV/AIDS to developing countries on a grant basis.

18. While the international donor community has begun to respond to this call for a massive effort, global commitments to date have not kept pace with the rising demands. A review of global HIV/AIDS related spending, (from all sources, including out of pocket expenditures and based on current and projected disbursement levels from multi-and bilateral sources) estimated that at least USD 3.2 billion was needed in 2002 for the fight against HIV/AIDS in developing countries. Yet far less was available, with an estimated gap of nearly 1.5 to 2 billion US dollars in 2002. UNAIDS projections are that the total funding required for all key interventions will increase to USD 10.5 billion in 2005, and USD 15 billion in 2007.17 Available funding and pledged funding will not match the need, as discussed in section III, under the heading "Resource Gap." ...

Resource Gap

31. UNAIDS recently completed a major effort to assess gaps in the availability of resources for HIV/AIDS. The report reflects estimates of the cost of HIV/AIDS prevention, care and support for 135 low- and middle-income countries from 2001 to 2007. The total funding required for all key interventions increases from USD 3.2 billion in 2001 to USD 10.5 billion in 2005, and USD 15 billion in 2007.

32. Global HIV/AIDS related spending reached approximately USD 2.8 billion in 2002. While this is encouraging, UNAIDS notes the estimate does not reflect the costs above the service delivery level (e.g. of setting up and operating a national HIV/AIDS organization, or the costs of mobilizing and managing the flow of resources incurred by donor agencies). Overall, UNAIDS estimates a gap between available and needed resources on the order of USD 1 billion, and expects this gap to grow to USD 3.5 billion by the end of calendar year 2003, and to USD 5 billion for 2004. If current budgetary trends continue, donor support in 2003 will still be much less than the bare minimum required for basic prevention and care programs. ...



Issue 8 - Monday 24 March 2003.

Note: For a formatted web version of this issue, see

Reproduced from the Global Fund Observer Newsletter [], a service of Aidspan.

COMMENTARY: Funding the Fund (by Bernard Rivers)

Nearly three months ago, Global Fund Observer asked "How can we expect $11 million to be raised every day under the leadership of a [Resource Mobilization] committee made up primarily of [board members] who would rather be somewhere else? How can we expect the Fund to meet its mission, or indeed to survive, if it pays so little attention to fundraising?" (See

The situation has grown even worse since then:

* The Global Fund predicts that it will need to receive $1,600 million by the end of the year in order to pay for the Round 3 grants that are anticipated to be approved in September. So far, only $229 million of that amount has been raised.

* The Global Fund board's Resource Mobilization Committee has only held one meeting, in late January. (Other board committees have been vastly more active.) The minutes of that meeting have still not been written. Dr. Feachem, Executive Director, attended the meeting for only 20 minutes, partly because all the board committees met on the same day.

* The Resource Mobilization Committee has no chair, because the full board's Chair (Tommy Thompson of the US) and Vice Chair (Dr. Suwit Wibulpolprasert of Thailand) cannot or will not agree on whom to appoint.

* The Secretariat has no Director of Resource Mobilization. Last November, someone was hired to play that role, and also to supervise all communications activity, but he was gone within two months.

* The Fund has no written resource mobilization strategy.

* No country other than the US has made a significant new pledge to the Fund in many months.

* The US is of the opinion that it is time for other countries to make the next pledges to the Fund, because the US, which has pledged all the way to 2008, has pledged half of all the pledges made thus far. On the other hand, regarding 2003-2004, which is the period that the current funding crisis relates to, the US has actually pledged less, relative to GDP, than have Canada, France, Italy, Netherlands, Spain, Sweden, and the UK.

* Dr. Feachem is working hard to make a case in G7 capitals for further funding. But he has multiple other responsibilities, many of which appear to interest him more and to make better use of his talents, and he has assigned almost no staff to help him with resource mobilization.

* The nations from whom Dr. Feachem hopes to raise the bulk of the Fund's needs also have seats on the Global Fund's board. That board hired Dr. Feachem, and can fire him. So it is unrealistic to expect Dr. Feachem to push those nations hard to contribute to the Fund.

This situation is a recipe for disaster. Everyone is waiting for someone else to solve the problem.

Dr. Feachem cannot raise the money alone, with or without the help of hard-working aides. Western governments will not give substantial money just because Dr. Feachem jets in, meets a few key people, and jets out again.

The plain fact is that the Fund has not really *raised* any money at all. It was *given* about $2 billion in startup money, based on an initial vision developed and promoted by Kofi Annan and others. The Fund faces a crisis now because the startup funding is running out and no clear strategy has been developed regarding what to do next.

The board and the Secretariat must acknowledge that the Fund's resource mobilization crisis is severe, and that it cannot be overcome unless an entirely new approach is devised. (This new approach might require scrapping or reconstituting the Resource Mobilization Committee.)

Both the board and the Secretariat must make resource mobilization their top priority, and must work jointly and harmoniously on developing and then implementing a forceful and viable strategy. The strategy must include a precise workplan, time- based targets, effective use of external allies, and built-in monitoring and evaluation.

The resource mobilization strategy must separately address the short-term needs (i.e. obtaining voluntary governmental pledges this year and next), and the long-term needs (i.e. gaining eventual approval of a dues-based "appropriate minimum contribution" framework that leads to more predictable outflows from the donors and inflows to the Fund, and that also taps potential support from corporations, foundations, and individuals). The short-term component must be launched by the end of April.

The June board meeting must make resource mobilization its primary focus. And if, at that meeting, the Resource Mobilization Committee and the Secretariat cannot show that the new strategy is well under way and is worthy of board endorsement, approval of Round 3 grants (scheduled for September) should be put on hold.

[Bernard Rivers ( is Executive Director of Aidspan and Editor of its GFO Newsletter.]


On March 14, Richard Feachem, Executive Director of the Global Fund, was interviewed by Bernard Rivers of GFO and Jim Cashel of IAEN (International AIDS Economics Network -, for publication in both newsletters. Question: What is the Secretariat doing, and what is the Board doing, to raise the money that the Fund needs by October?

Feachem: A lot. We regard the upcoming G-8 summit in Evian, France, as an extremely important event. There will be a report back to the G-8 leaders in Evian on the progress and challenges of the Global Fund, including the financing of the Global Fund. France, who is the president of the G-8 this year, is hosting the Evian meeting, and will also be hosting a Global Fund donors' conference in Paris in the middle of July& The details of those discussions are, of course, somewhat different in each of the G-7 capitals because they each have their own appropriations cycles and parliamentary procedures, but the overall news is cautiously positive& In the case of both the U.S. and other G-7 nations, there's a need to front-load [their] pledges because the immediate refinancing needs for the Global Fund are this year, right now, and not in three or four years' time.


[Aidspan, the organization that publishes GFO, has conducted a detailed analysis on "How Much Money Does the Global Fund Need? How Much Does it Have?". The paper, based on data published by the Global Fund through 21 March 2003, is available at .]

As can be seen [from the analysis cited], the US share of the global economy is 33%. As a result, its Equitable Contribution for 2003+2004 is $2,069 m., of which it has currently pledged $650 m. (when one includes $100 m. from its 2002 pledge that was not used that year so was rolled into the 2003 disbursement). The US has so far only pledged 31% of its Equitable Contribution, though legislation is being proposed to increase this figure. Of the G7 nations, Canada, France, Italy and the UK have pledged higher portions of their Equitable Contributions than the US; Germany and Japan have pledged much lower portions. Not shown in the table are Netherlands and Sweden, which are the two countries that have already pledged in excess of their Equitable Contributions.

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Date distributed (ymd): 030415 Region: Continent-Wide Issue Areas: +political/rights+ +health+


Message-Id: <> From: "Africa Action" <> Date: Tue, 15 Apr 2003 15:41:53 -0500 Subject: Africa: Money for AIDS Update

Editor: Ali B. Ali-Dinar

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