Risk of global emergency for AIDS funding

A call to action by the Treatment Action Campaign

The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Fund) is less than 10 years old. The third Voluntary Replenishment Pledging Conference will be held in New York on 4-5 October 2010. This conference, chaired by UN Secretary General Ban Ki-Moon, is an opportunity for government and private donors to pledge funds that will finance the Fund’€™s work over the next 3 years.

The pledging Conference will be held 2 weeks after the UN MDG (Millennium Development Goals) Summit, and it is expected that several governments will announce their pledges to the Fund at that Summit, which starts on 20 September.

Secure financing has saved five million lives ‘€“ now is not the time to stop!

Since it was created in 2002 the Fund has grown dramatically; it is now the major source of external financial support for programmes tackling AIDS, TB and malaria. The Fund has been able to demonstrate remarkable results by funding programmes in 144 countries; these have already saved more than 5.7 million lives, and it is estimated that every day 4,000 deaths are prevented.

The Fund has achieved these unprecedented results by funding programmes that have scaled up services which include:

‘€¢ providing anti-retroviral therapy (ART) for 2.5 million people,
‘€¢ detecting and treating 6 million people with active TB,
‘€¢ distributing 104 million insecticide-treated bed nets and treating 108 million cases of malaria.
‘€¢ In 2009 alone, 345,000 pregnant women in low- and middle-income countries received treatment to prevent mother-to-child transmission of HIV (PMTCT).

The Fund has calculated 3 scenarios for the resources it needs to raise at the Replenishment Conference: $13 billion, $17 billion, $20 billion. Globally activists and health experts agree that the ambition must be to meet the highest scenario: $20 billion. This will enable the Fund to continue the level of programming already underway, and to support more programmes that would set the world on track to meet the MDGs. It has been calculated that a full replenishment would support programmes over the next 3 years that would:

‘€¢ Put 7.5million people on ART
‘€¢ Deliver TB treatment to 6.8m people annually
‘€¢ Get close to eradicating mother to child HIV transmission by 2015
‘€¢ Hit the malaria MDG target (to halt and reverse the spread of malaria by 2015) ahead of schedule
‘€¢ Contribute to improvements in health system strengthening and maternal and child health

At the current time there are no indications that the Fund will receive the full $20billion. In fact there are serious concerns that the Replenishment may not even hit the lowest scenario – $13 billion. This would mean that the budget would be flat-lined and the Fund would have to cap future funding Rounds. This would mean a new tsunami of HIV-related deaths across the world in the years ahead ‘€“ just at the time when we have begun to make inroads against HIV.

What can we do?

Through demonstrations, meeting elected officials, policy makers and other influential people, writing letters and emails, and other tactics, TAC members and supporters can seek to change the decisions that rich donor governments are making about their contributions to the Fund, and to ensure that all donors contribute their fair share. Unfortunately, the global recession is being used as an excuse for donor governments to step back from their previous promises. But these excuses simply don’€™t make sense. Most donor governments have agreed to increase spending on overseas aid so that they contribute 0.7% of their country’€™s Gross National Income. This means that they should have ring-fenced their budgets for development. And the argument that massive cuts in development budgets are necessary simply doesn’€™t make sense when rich countries were able to find $700 billion to bail out the banks when markets collapsed and continue to find billions of dollars to pr osecute the war on terror.

Naming the key countries

Partnership is fundamental to the fight against AIDS, TB and malaria. We insist that low and middle-income countries need to do much more to fund the health of their own citizens, as well as putting in place the right policies and laws, and stopping corruption and misuse of funds. But even whilst we say this, there is a moral duty on the richest countries of the world to fill the gap’€”the investments of all partners must increase.

At this point, the most important countries for TAC members and supporters to focus on are:

The USA: As the richest donor country the USA is the largest contributor to the Fund, and also supports important AIDS programmes through its own bilateral programme PEPFAR (the President’€™s Emergency Plan for AIDS Relief). It would be a very important signal of support for the USA to make a multi-year pledge for the first time. This would mean that the Fund can make firmer long-term plans ‘€“ especially if other donors follow this approach. 101 members of the US Congress (led by Congresswoman Barbara Lee) have called on their government to do this. It is essential that the US does not take money out of PEPFAR to fund the Fund. Both PEPFAR and the Fund have played a central role in supporting AIDS programmes in South Africa and beyond.

The USA needs to contribute at least $6 billion to the Fund over the next 3 years.

Germany is the third biggest donor, having pledged $1.2 billion since 2002. But now the German government’€˜s support for effective, multilateral aid in the fight against the three diseases appears to be weakening. At an early Global Fund Replenishment meeting they stated that they had strong support for the Fund and would increase their contribution. Less than a year later, they are breaking that promise, threatening to cut their current contribution level, rather than increasing to reach their fair share’€”and Germany is threatening only to pledge funds for one year.

Germany should pledge what civil society calculates as a fair share: $1.9 billion for the next 3 years.

Italy’€™s actions as a donor to the Global Fund are bizarre ‘€”they are the only donor not to have converted outstanding pledges to the Global Fund into actual contributions in cash’€”both for 2009 and 2010. They have not even budgeted for these pledges. This is outrageous. In addition, Italy is refusing to commit to a new pledge. They also haven’€™t bothered to respond to UN Secretary General, Ban Ki Moon, who wrote to ask President Berlusconi what had happened to the money.

Italy should immediately pay what it owes: $340 million, and pledge an additional $731million for the next 3 years.

Japan is the ‘€œfounding father’€ of the Global Fund, yet its contribution is a lower proportion of its GNI than many other donors with smaller economies. Japan said it will make its commitment at the MDG summit and seemed likely to announce $800 million over 3 years.

Japan should at least double its contribution – and pledge what civil society calculates as a fair share: $1.8billion

The United Kingdom (UK) is the seventh biggest donor and has an existing pledge: £1billion ($1.6 billion) over 7 years (to 2015). It was the first donor to make a major multi-year pledge, which gave the Fund a secure future basis for planning. The UK elected a new government recently. While they say that development spending is safe, there is a Multilateral Aid Review (MAR) to decide which multilateral agencies will get more (or less) money. The MAR will report in early 2011 so the UK says it cannot make a pledge on October.

The UK should reiterate its support for the Fund, and make a new pledge in early 2011 (after the MAR reports) of at least an extra £840million for the next 3 years.

Other countries matter too’€”Belgium, The Netherlands and Australia have in the past been strong supporters of the Fund and should be called on to renew and strengthen their commitments. In addition, new economic power houses such as China should accept their responsibility for global health.

Millions of lives are at stake. Concrete gains in reducing sickness and death are at risk. Time is short. TAC appeals to you to raise this issue in every way possible. Write to these government’€™s ambassadors in South Africa. Issue press statements. Sign on to this global petition: www.globalfundreplenishment.org/sign-on-letter/. Organise demonstrations. Send copies of your letters to us.

His Excellency Ambassador Donald Gips
US Embassy
PO Box 9536,
Pretoria 0001South Africa

Fax: 012 342-2299

<gipsd@state.gov>

His Excellency Ambassador Dieter W. Haller
Embassy of the Federal Republic of Germany
P.O. Box 2023,
Pretoria, 0001
South Africa

Fax: 012 343 3606 or 012 343 9401

His Excellency Ambassador Mr. Elio Menzione
Embassy of Italy in South Africa
796, George Avenue,
Arcadia 0083
Pretoria

Fax: 012 430 5547

His Excellency Ambassador Mr. Toshiro Ozawa
Embassy of Japan in South Africa
Private Bag X999,
Pretoria 0001
South Africa

Fax: 012 460 3800

Her Excellency High Commissioner Dr Nicola Brewer
British High Commission
255 Hill Street,
Arcadia 0002,
Pretoria,
South Africa

Fax: 012 421 7555

Her Excellency High Commissioner Ann Harrap
Australian High Commissioner to South Africa
292 Orient Street, Arcadia, Pretoria
Fax: 012 342 8442

His Excellency Ambassador Mr R G De Vos
Netherlands Ambassador to South Africa
P.O. Box 117
0001 Pretoria
South Africa
Fax: 012 425 4511

We will keep you informed of further activities and plans.

Stand up for our Lives – Millions of people Depend on it!

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  • Health-e News

    Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews

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