UNIVERSITY OF PENNSYLVANIA - AFRICAN STUDIES CENTER
Africa: Global Fund Update Date distributed (ymd): 020722 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
Region: Continent-Wide Issue Areas: +economy/development+ +health+
This posting contains a speech by Dr. Richard Feachem, who took up his post as the new Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria on July 15, as well as a related article by Bernard Rivers of Aidspan from the on-line magazine of the Barcelona AIDS conference.
Particularly significant at the conference were the wide consensus that (1) there is an urgent need for treatment as well as prevention, worldwide, and (2) in practice rich countries still lack the political will to mobilize sufficient resources to meet these needs.
Other related material can be found at the web sites below.
Break the Silence Discussion http://www.hdnet.org
Barcelona Conference http://www.aids2002.com.
Global Fund http://www.globalfundatm.org
For more background documents and links see the archive
of recent postings by Africa Action at
http://www.africaaction.org/docs02/chr02.htm and Africa Action's Africa's Right to Health campaign page at http://www.africaaction.org/action/campaign.htm
Note that the Global Fund site has guidelines and application information for the second round of proposal submissions.
Dr. Richard Feachem Executive Director Global Fund to Fight AIDS, Tuberculosis and Malaria
At the XIV International AIDS Conference, Barcelona Senior Lecture, 9 July 2002
I am Richard Feachem and I'm really really glad to be here. (Applause)
I was in Durban and many of you were in Durban also. In Durban we had no global fund. Now we have a global fund.
The Global Fund as you know has already committed 1.6 billion dollars to 40 programs in 31 countries. And over 60 percent of these monies are going to HIV/AIDS. These commitments will double the current number of people receiving HAART in the developing world and in Africa HAART recipients will increase six fold as a result of these commitments. This is nothing like enough. (Applause)
But it is a start and we commit to do much much more. (Audience: So do we!) Good! The second round of proposals was launched on July the second, less than six months after the birth of the Global Fund. The Global Fund is committed and I am committed and you are committed to raising many billions of dollars of additional resources, and getting these funds to those on the frontlines who are really making a difference.
Now I want to put credit where credit is due and I want to thank everyone in this room. I want to thank everyone in Barcelona but not in this room with us now. And I want to thank the thousands of people who are working around the world fighting HIV/AIDS who have not been able to come to Barcelona. The Global Fund is your achievement. You have lobbied. You have fought. You have advocated. You have analyzed. And you have shaken the world into recognizing the magnitude of this crisis. Out of that, together with the leadership of Kofi Annan and the backing of the G8 you have made it happen and you have made the difference. I want to recognize that very clearly here today. (Applause)
Let me make it absolutely clear that the Global Fund needs a massive increase in resources, and it needs it quickly. (Applause) I am well aware of the calculations that have been made concerning the magnitude of the resources that we require. Estimates come from the Commission on Macroeconomics and Health and I was a member of that commission. Estimates have come from Schwartlaender and Bertozzi and other experts. I am familiar with those individuals and those estimates. Kofi Annan on the basis of sound advice, has called for a scaling up of the level of investments in HIV/ AIDS to the 8 to 10 billion dollars per year mark. The Global Fund also has to invest in tuberculosis and malaria. (Applause)
Following the October meeting of the board of the Global Fund, that will be our third board meeting, we will be publishing and widely disseminating the Global Fund's financial projection estimates of resources needed and rates of expenditure over the next several years. We will invite your critique and comments on those when they are published later in October. I feel sure that you will not be bashful in expressing your opinions to us, on those numbers. We will also be calling on you to ensure that the resources are indeed made available and that the expenditures are put to good use quickly.
Let me now turn to the subject of prevention and treatment. The Global Fund is committed to prevention and treatment. The board of the Global Fund is committed to prevention and treatment. And I am committed to prevention and treatment. Our financing decisions so far confirm this commitment.
I have been asked repeatedly at this conference about cost effectiveness and the implications of recently published cost-effectiveness analyses. Cost-effectiveness analyses can be well used and it can be stupidly used. Let me tell you a fairy tale. I was driving across Uganda with an economist, as one does. (Laughter) We came upon a horrendous traffic accident. A school bus had collided with a truck. Children were lying all over the road. Some were dead. Some were dying. Others were seriously injured. I said "hurry hurry let us call for ambulances and get these children to hospital quickly. Many of them maybe saved." The economist said, "No! Let us drive on to Kampala, to discuss seatbelt legislation with the government. It's more cost effective." The Global Fund will not be calling on that economist. (Applause)
Before Durban, there was genuine economic and clinical uncertainty about ARV therapy and its widespread application. Now we have the tools and the tools are affordable. We have achieved an intellectual consensus. The Global Fund working with WHO, with UNAIDS and many other partners including many organizations represented in this room today, has the task of translating this intellectual consensus into a practical reality. A practical reality bringing hope and life to millions of people throughout the world.
Let me turn now to NGOs. There is no country with which I am familiar where the public infrastructure alone can mount an adequate response to HIV/AIDS, tuberculosis or malaria. It just cannot be done. In all countries we need to mobilize and empower the non-government actors alongside the government actors, alongside the public infrastructure. These non-government actors come in many different colors and flavors. Many different shapes and sizes. They include international NGOs, local NGOs, faith-based organizations, and the private sector ranging from large corporates who can do so much more to show leadership by providing effective services to their workforces and the families of their workforces. Right through to small traders and little shops as you find in every village in every community who sell drugs, who sell condoms, who sell bednets, who sell other products relevant to the task that we collectively face. All these actors must be mobilized and the Global Fund expects to invest across the whole spectrum of significant frontline actors.
I was at this point going to show some slides to provide some more factual detail about the Global Fund so far and the Global Fund over the next few months. In deference to my friend and colleague Dr. Gro Harlem Brundtland, and the fact that we are running a bit late, in this session, I won't show those slides but I would invite you all to come to the symposium at 4.30 where I and others are speaking and where those slides will be shown and where we can have more of an interaction about the work of the Global Fund.
I want to conclude by making a number of commitments which you should hold me to, and also seeking your help and assistance:
I commit to maximizing resources that flow into the Global Fund.
I commit to ensuring that the expenditures to the Global Fund go quickly to those on the frontlines who can use them and make a real difference in people's lives.
I commit to accountability. The resources with which we are entrusted must not be lost, diverted, stolen or in any way misspent.
I commit to results. We will measure with your help process indicators. We will measure outcome indicators. And we will allocate resources where they can do the most for the most number of people.
I commit to balance across the three diseases with which we are mandated. No doubt HIV/AIDS will continue to take the lions share, and rightly so. But we will also invest in malaria and tuberculosis, and we will not turn our backs on the communities that suffer terribly from these diseases, also. (Applause)
I commit to geographical balance. We will invest in those parts of the world already devastated by HIV and we will also invest in countries which have high vulnerability but where it is not too late to prevent a disaster from unfolding.
I commit to balance in the interventions that we support. We will fund prevention. Lots and lots of prevention. We will fund treatment. Lots and lots of treatment. (Applause) Treatment for malaria. Treatment for tuberculosis. And treatment for HIV/AIDS. (Applause)
And finally I call on your help. The Global Fund is a financing mechanism. I anticipate that the total number of people that it employs will rise to no more than 50. In a short period of time we expect to be disbursing several billions of dollars per year. This will be a world record in bureaucratic efficiency and the lightness of the bureaucratic touch. (Laughter) I think the Guinness book of records will have to invent some new category to capture this. This is only possible if our partners work with us on every aspect of what we are all trying to achieve. We need our partners to ensure that funds flow into the Global Fund. We need our partners to ensure that the best possible applications are received from countries and communities in greatest need. We need our partners to ensure that funds are well spent and have the maximum impact on people's lives. We need our partners to conduct the operational research which will improve subsequent investments. And we need our partners to independently and robustly measure the impacts and the outcomes in order that we may know what we are achieving and allocate our funds accordingly.
As the Global Fund goes forward, together with all of you here, we tread into the unknown and into the darkness. No one has gone where we are going. The only light is the light of our imaginations. The only vehicle is the vehicle of our commitment and our vision. And the only trail is the trail that we will break. Together we will do this. Together we will make a difference. Together we will change the world.
Thank you very much.
New Goals for Global Fund (10 July 2002)
Wealthy nations must give at least $9 billion for AIDS, tuberculosis and malaria in 2003, according to a panel yesterday of four leading global health policymakers.
Peter Piot of UNAIDS, Richard Feachem of the Global Fund, Jeffrey Sachs of Columbia University, and Stephen Lewis, the UN Secretary-General's Special Envoy on AIDS, addressed the Conference together as the first step towards a possible global consensus on essential health spending.
According to Jeffrey Sachs, Chairman of the WHO's Commission on Macroeconomics and Health, $5.5 billion of the required sum should go to the Global Fund to Fight AIDS, Tuberculosis and Malaria - nearly three times the sum that was pledged to the Fund during 2002.
The United States should provide about $3.5 billion of the total - $2.5 billion for the Global Fund and $1 billion in bilateral aid, he said. These sums do not include the amounts that will be spent by the governments and people of affected countries.
During the meeting, it was also proposed that three plans should be developed over the next few months. The Global Fund will develop over the next 90 days a plan for how much it needs to raise and spend each year. UNAIDS and WHO should simultaneously develop a related but separate plan, showing total needs from all sources, not just from the Global Fund. And the U.S. government should develop a plan, based in part on the other two, spelling out how much and in what ways the U.S. would contribute.
Earlier in the day, Dr. Richard Feachem, in his first speech as the newly-appointed head of the Global Fund, announced the development of the Global Fund's financial plan. It will be drafted over the next three months, for review and approved by the board at its October meeting. As a result, the Fund would for the first time have public goals regarding its fundraising for the coming years.
Speaking to an appreciative audience, Feachem said "The Global Fund is committed and I am committed and you are committed to raising many billions of dollars of additional resources, and getting these funds to those on the frontlines who are really making a difference. The Global Fund needs a massive increase in resources, and it needs it quickly."
Discussing accountability, he said "The resources with which we are entrusted must not be lost, diverted, stolen or in any way misspent."
Feachem extended a friendly arm to the audience, saying "Together we will do this. Together we will make a difference. Together we will change the world." He also acknowledged the importance of NGOs, saying that he couldn't think of a single country where the government alone could mount an adequate response to the three diseases. "It just cannot be done. In all countries, we need to mobilize and empower the non-government actors alongside the government actors."
Discussing recent studies in which the cost effectiveness of various forms of intervention are compared, he told a "fairy tale" of driving in Uganda with an economist and coming upon a horrendous road accident involving a school bus. "I said 'Hurry, hurry, let us call for ambulances and get these children to hospital quickly!' The economist said, 'No! Let us drive on to Kampala, to discuss seatbelt legislation with the government. It's more cost effective.'" To chuckles, Dr. Feachem added "The Global Fund will not be calling on that economist."
In an interview with AIDS 2002 Today, Dr. Feachem said "whether our fundraising goal is $5 billion, $6 billion, or $7 billion, we know we haven't got anything close to that right now, so we need a lot more money."
He said that the funds will be sought not only from governments, but also from corporations, adding that when the Fund was started, corporate contributions had been promised, but "they haven't been forthcoming." Foundations will be encouraged to act in ways that are synergistic to what the Fund is doing - for instance, by supporting the provision of technical assistance to groups that are seeking Global Fund grants.
Dr. Feachem confirmed that 45% of the funds approved by the Fund in its first round of grants are for products and commodities, including essential medicines such as antiretrovirals. When asked whether the Fund would create - or develop links with - a bulk procurement facility, he said that that is one of several options being studied by a Procurement Working Group, for report to the October board meeting. He added that it's "certainly not, to me, beyond the pale" for a bulk procurement facility, if created, also to operate on behalf of others who have access to non-Global Fund money.
Concluding the interview, he said "What is most exciting about the Global Fund is that it is, unquestionably, the most important initiative in global health in my professional lifetime. It is an entirely new structure to transfer resources from those who have them to those who need them. The future of investment in global health rides on its success. And I think to a considerable degree, future attitudes towards official development assistance, and towards ways of transferring resources from the North to the South, rest on its success."
Message-Id: <200207230054.UAA20493@server.africapolicy.org> From: "Africa Action" <email@example.com> Date: Mon, 22 Jul 2002 21:45:13 -0500 Subject: Africa: Global Fund Update
Editor: Ali B. Ali-Dinar
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