Third World health: Video -- Universal access by 20-when? Global leaders renege on promised aid

Tuesday, October 5, 2010 (New York City, USA)-- The Treatment Action Campaign (TAC) today said the funding shortfall from donors to the Global Fund to Fight AIDS, Tuberculosis, and Malaria at this week´s Replenishment meeting taking place in New York means lives will be lost in countries like South Africa and has pledged to scale up its Resources for Health campaign. TAC’s campaign is calling on all countries – rich and poor – to devote the necessary political attention and financial resources to health, and holds governments accountable for the promises they have made.

There were important new pledges of close to $12 billion from donor countries and foundations at the meeting, held this week in New York,, and chaired by UN Secretary General Ban Ki-Moon. But still the pledges fell far short of the US$20 billion needed to maximize the impact of the Fund over the next three years and to put the world on track to achieve the health Millennium Development Goals in 2015.

“In South Africa many people have been saved by the HIV and TB treatment programmes which the Global Fund has supported”, said Nkhensani Mavasa, TAC’s Community Health Advocacy Coordinator who is attending the meeting in New York. “But now I’m afraid, afraid of what this will mean for South Africa, for the lives that we are now going to lose, the children who will be born with HIV who don’t need to be, and for our National Strategic Plan which will be starved of the resources needed to reach Universal Access. “

TAC is concerned about the impact of the low outcome of the Global Fund replenishment on all countries not just South Africa. Just as countries are beginning to build the infrastructure and systems to deliver services, and science is delivering new and more effective responses to HIV, the funding appears to be drying up. There are hundreds of programmes that will now not be able to access finance, and millions of lives that will be lost as a consequence. Based on estimates prepared by the Global Fund secretariat, the shortfall of more than US$8 billion will deprive at least 3.1 million people of access to life saving anti-retroviral treatment, 490,000 women will not be reached by PMTCT services to prevent HIV transmission to their babies and more than 2.9 million people will not get treatment for TB will be deprived of it.

The Global Fund Replenishment process demonstrated that there has been huge progress in the fight against the three diseases. Countries have made such strong progress through their own leadership and with support from many eternal partners, and in particular the Global Fund. The Fund provides two thirds of all external funding for TB and malaria programmes, as well as 20 per cent of all international funding for HIV/AIDS programmes. It has saved nearly six million lives already, and continues to save nearly 4,000 lives every day.

South Africa pledged some 15 million Rand (approx $US 2.2 million) at the meeting. Not all donors pledged their contributions at the Replenishment meeting today, and many important donors pledged well below their fair share of the $20 billion needed.

“Taking into account South Africa´s enormous HIV and TB burden, the country´s population size together with its pressing social needs, this pledge can be considered a significant act of global solidarity. It is far more generous than countries like China who between 2002-2010 gave a total of $US16 million to the Global Fund and at this meeting have come up with a dismally disappointing $US14 million despite receiving some of the largest grants ever from the Fund,” said Vuyiseka Dubula General Secretary of TAC.

“Where is the accountability?” said Dubula. “Rich countries found hundreds of billions of dollars to bail out our banks, but couldn’t pull together the extra $US8 [or 9] billion to keep the Global Fund on track to save the lives of poor children, women and men. TAC urges all of the Global Fund donors to dig deeper. Those that have not yet pledged must step forward with bold new contributions to make sure that the Fund can truly support countries to meet their ambitions.”

Further information:

Vuyiseka Dubula, General Secretary, (TAC), Cape Town
+27 82 763 005 or +27 83 532 4511

Mark Heywood, TAC Secretariat (Johannesburg) +27 836 348806

Nkhensani Mavasa, TAC Community Advocacy Coordinator (in New York on 5 Oct) c/o +1-202-640-3478

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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.