Tuesday 17 Jul 2018 | 16:15 | SYDNEY
Tuesday 17 Jul 2018 | 16:15 | SYDNEY

Three scenarios for three diseases


Bill Bowtell

13 April 2010 15:15

This year, the Global Fund to Fight AIDS, Tuberculosis and Malaria comes to the end of its three-year funding cycle. On 4-5 October, the UN Secretary-General, as Chair of the Third Global Fund Replenishment, will convene in New York a meeting of present and potential Global Fund donors to the Fund for 2011-2013.

In 2007, the Second Global Fund Replenishment took place at the height of the global boom. Donors then pledged some US$10 billion that has since enabled countries supported by the Fund to place 2.5 million people on anti-retroviral treatment for HIV/AIDS, detect and treat 6 million new cases of infectious tuberculosis and distribute 104 million insecticide-treated bed-nets to prevent malarial infection.

This year, however, the Fund and its major donors are meeting in far less propitious economic circumstances.

On 24-25 March, I joined the Fund's senior management, its major governmental and private sector donors and civil society advocates at a meeting in The Hague that marked the formal start of six months of haggling and negotiation that will culminate in the October meeting in New York, at which time new pledges will be made.

At The Hague, the Fund's Executive Director, Michel Kazatchkine, compellingly presented the Fund's record of achievement since it was founded in 2002. He made the case for donors to devote substantial new resources to the Fund over the coming triennium.

In two key documents, 'Resource Scenarios 2011-13' and 'The Global Fund 2010: Innovation and Impact' (both available here), the Fund put three funding scenarios — of US$13 billion, US$17 billion and US$20 billion — and outlined the impacts on the three diseases that would occur under each. Put simply, the more money donors (including Australia) provide to the Fund, the more lives will be saved, the more people will be restored to good health, and the more the avoidable toll of these three killer diseases will be contained.

The US$19 billion already disbursed by the Fund since 2002 has brought us to the threshold of achieving great public health goals. For example, if the Fund is replenished at the higher range of the scenarios — that is, up to US$20 billion — there is the real possibility that by 2015 we might virtually eliminate mother-to-child transmission of HIV, and end deaths from malaria.

The Hague meeting was notable for furrowed brows and pursed lips of the representatives of the world's richest countries, conveying the gravity of the 'global financial crisis' and the consequent difficulty their governments would have in meeting even the $US13 billion scenario.

This tawdry kabuki is, of course, a standard feature of all international negotiations that bring together worthy causes and parsimonious treasuries.

The difference between US$13 billion and US$20 billion is the derisorily small sum of US$7billion or just over US$2 billion per year. It takes a hard heart to argue that the economies of the richest countries in the world are so stricken that they have to haggle over $US7billion.

No-one who attended The Hague meeting, and weighed up the costs and benefits of the Fund's activities to world's sickest and neediest people, could come away other than totally convinced of the need to fund the Global Fund at least at the level of US$US20 billion for next triennium.

The great challenge of the next six months will be to translate this conviction into action by convincing global public opinion, and donor governments, of the merits of the $US20 billion target.

Photo by Flickr user Gustavo (lu7frb), used under a Creative Commons license.