[Ip-health] New York Times: Global Fight Against AIDS Falters as Pledges Fail to Reach Goal of $13 Billion

Thiru Balasubramaniam thiru at keionline.org
Tue Oct 5 23:03:37 PDT 2010


October 5, 2010
Global Fight Against AIDS Falters as Pledges Fail to Reach Goal of $13  
Billion
By DONALD G. McNEIL Jr.
In another signal that the global battle against AIDS is falling apart  
for lack of money, the Global Fund to Fight AIDS, Tuberculosis and  
Malaria failed on Tuesday to reach even its lowest “austerity level”  
fund-raising target of $13 billion — the amount it had said it needed  
just to keep putting patients on treatment at current rates.

Three-year pledges from 40 countries attending a two-day conference  
held in Manhattan amounted to $11.7 billion. The pledges were  
announced at the United Nations. The fund had hoped to raise $20  
billion to catch up with the growing epidemic.

No one now on treatment will be cut off, said Dr. Michel Kazatchkine,  
the fund’s executive director, but the targets for the next few years  
must be lowered.

He said that he “deeply appreciates” the amount raised, but that “we  
need to recognize that it’s not enough to meet expected demand and  
will lead to difficult decisions in the next three years.”

He could not, he said, estimate exactly how many deaths would result.

The fund pays for AIDS drugs for almost three million patients now,  
and still might be able to reach four million by 2013. It had hoped to  
reach five million or more.

It supports about half of the world’s poor who are getting treatment.  
The President’s Emergency Plan for AIDS Relief, or Pepfar, started  
under the administration of President George W. Bush, pays for the  
other half.

An estimated 33 million people are infected worldwide, a number that  
grows by a million people a year after adding new infections and  
subtracting deaths.

Of that number, about 14 million are already so sick that, under World  
Health Organization guidelines, they should be on drugs. It looks  
increasingly likely that that number will outpace the number getting  
drugs.

The United States pledged $4 billion, which is a nearly 40 percent  
increase over its previous contribution. It is by far the most  
generous donor, and most countries raised their contributions by less.

France, Canada and Norway went up by 20 percent, Japan by 28 percent.  
Britain, Sweden and the Netherlands could not commit because of budget  
cycles, but were expected to be in that ballpark; Italy and Spain gave  
nothing. South Africa, which has the world’s worst AIDS epidemic, made  
a token contribution of $2 million. Russia and China gave $60 million  
and $14 million respectively, far less than fund officials had hoped.  
To reach the fund’s $20 billion goal, all countries would have had to  
roughly double their giving.

AIDS activists vented open frustration, both with the overall result  
and the American contribution.

“This is a modest course correction, not what we were hoping for in  
terms of U.S. leadership,” said Dr. Paul Zeitz, executive director of  
the Global AIDS Alliance, an advocacy group that had lobbied the  
administration for a $6 billion contribution. “This took the other  
donors off the hook. Everyone could aim low.”

By not reaching a decision earlier, he complained, the United States  
dithered away its leverage over other countries.

Under American law, the United States can contribute only one-third of  
the fund. If it had told other donors privately weeks ago that it  
intended a 40 percent increase, they would have been under pressure to  
match that, both to avoid sounding cheap, and because the United  
States cannot pay unless its donation is matched 2 to 1.

Dr. Eric Goosby, the global AIDS coordinator, said the intra- 
administration debate about how much to pledge was “robust” and went  
on right up until Tuesday morning.

“We’re proud of the pledge,” Dr. Goosby said in a telephone interview.  
Getting the United States, which has a one-year budget cycle, to  
commit to a three-year pledge was “swimming upstream,” especially in  
such a weak economy.

The battles against malaria and tuberculosis will also suffer, but the  
effect on AIDS is easier to measure. Malaria waxes and wanes with hot  
weather and local spraying. The TB epidemic echoes the AIDS epidemic  
because so many people have both, but TB can be cured in six months,  
which shrinks case counts rapidly.


Neil MacFarquhar contributed reporting from the United Nations.


------------------------------------------------------------


Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
thiru at keionline.org


Tel: +41 22 791 6727
Mobile: +41 76 508 0997








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