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Africa: Money for AIDS Update
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
http://www.africaaction.org/desk/pr0304a.htm
If your organization has not yet signed, please sign up at
http://php.africaaction.org/action/moneyaids.php 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
http://www.unitedforpeace.org.
As noted in an earlier e-journal
[
http://www.africafocus.org/docs03ej/hiv0304a.php>], 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
http://www.fundthefund.org 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.
+++++++++++++++++end summary/introduction+++++++++++++++++++++++
Global Commitments To Fight AIDS Fall Short of Goals, International
Monetary Fund Says
Access this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17153
Kaiser Daily HIV/AIDS Reports
E-mail registration:
http://www.kaisernetwork.org/email
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
Addendum
Fighting HIV/AIDS: Progress, Prospects and Issues
Brief excerpts only [for full text search on World Bank site -
http://www.worldbank.org]
I. THE HIV/AIDS CHALLENGE
I. 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. ...
II. THE RESPONSE TO THE GLOBAL HIV/AIDS CRISIS
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. ...
GLOBAL FUND OBSERVER (GFO) NEWSLETTER
A service of Aidspan.
Issue 8 - Monday 24 March 2003.
Note: For a formatted web version of this issue, see
http://www.aidspan.org/gfo/archives/newsletter/issue8.htm
Reproduced from the Global Fund Observer Newsletter
[http://www.aidspan.org/gfo], 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
http://www.aidspan.org/gfo/archives/newsletter/issue2.htm)
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 the 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 Funds
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 (rivers@aidspan.org) 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 - http://www.iaen.org),
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
http://www.aidspan.org/gfo/docs/gfo55.pdf.]
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.
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Date distributed (ymd): 030415
Region: Continent-Wide
Issue Areas: +political/rights+ +health+
The Africa Action E-Journal is a free information service
provided by Africa Action, including both original
commentary and reposted documents. Africa Action provides this
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of
human rights.
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