Annan Calls on Foundations to Support Global Fund Against AIDS, World Bank Endorses Plan
Speaking yesterday before the annual meeting of the Council of Foundations, an "umbrella group" of 1,800 charitable foundations and corporations, U.N. Secretary-General Kofi Annan called on the philanthropic institutions to "put their financial might behind a new global fund designed to orchestrate a new coordinated attack on the AIDS pandemic," Reuters/Contra Costa Times reports. If the foundations "make the fight against AIDS a top priority," Annan said he would "wager that governments and the general public will not be far behind." Annan proposed the fund Friday at the largest-ever African AIDS conference in Abuja, Nigeria, stating that on top of the $1 billion already spent annually on HIV/AIDS in developing nations, an additional $7 billion to $10 billion a year is needed to launch an effective "global assault" on HIV/AIDS, malaria and tuberculosis. Yesterday, he asked the foundations to increase their monetary contributions and to "act as levers and advocates" to "stimulat[e] others to emulate your generosity." The foundations "have the flexibility to provide funds quickly, and use them to plug gaps, where other institutions may be held back by political considerations, or by the terms of their mandates," he told the conference (Morgan, Reuters/Contra Costa Times, 4/30). Annan stressed that the "heavy lifting" must come from wealthy industrial nations, which currently spend "100 times" the amount he is seeking for HIV/AIDS on their military budgets. Although details of the fund have not been solidified, Annan said he hopes to have commitments from donors and an action plan ready when the United Nations convenes a special session on HIV/AIDS at the end of June (Collins, Philadelphia Inquirer, 5/1).
A Five Point Plan
In his speech, Annan outlined five "key action areas" for the campaign against HIV/AIDS, including:
- Containing the epidemic: The campaign must prevent further spread of HIV "especially by giving young people the knowledge and power to protect themselves," Annan said. "Large-scale" awareness and prevention campaigns are needed, as well as additional counseling and testing and condom distribution programs.
- Reducing vertical transmission: Annan called mother-to-child HIV transmission the "cruellest, most unjust infections of all" and advocated HIV testing for all pregnant women, as well as the administration of "short-term" antiretroviral drugs to HIV-positive pregnant women and their newborns to reduce vertical transmission rates.
- Accessible treatment: Based on his recent meeting with pharmaceutical industry leaders, Annan said that the industry is prepared to supply anti-AIDS medications to the developing world at "greatly reduced prices." These discounts will help increase drug access, but drugs are only part of the "comprehensive HIV care package" that is needed. Counseling and testing, home- and community-based care and "simple" treatment of opportunistic infections is also needed.
- Advances in science: The creation of an effective HIV/AIDS vaccine and a cure for the disease must be given "higher priority" in scientific budgets, Annan said.
- Orphans: Those made "most vulnerable" by HIV/AIDS must be "protect[ed]," Annan said, adding that the world's 13 million AIDS orphans, most of whom reside in Africa, must be given greater attention (U.N. release, 4/30).
World Bank Gives Its Endorsement
At the close of the IMF/World Bank meeting in Washington, D.C., the World Bank's governing committee yesterday officially gave its endorsement to the idea of a global AIDS trust fund and said it will administer the fund with the United Nations, the Washington Post reports. The endorsement follows similar actions Sunday by the IMF and the G7 nations. World Bank President James Wolfensohn said he had the "distinct impression that industrialized countries are prepared to ante up the funds" for the trust and predicted that "proof" of that commitment will appear in the "next month or two." The bank estimated that a "well-funded effort" could reduce HIV transmission by a quarter, despite Africa's lack of adequate health infrastructure. The bank also said that such an effort could prevent nearly 7.5 million deaths annually from infectious diseases such as malaria and TB. Treating those already infected with HIV would require the "full goal" of $7 to $10 billion Annan announced, Chris Lovelace, the bank's health director, said (Pearlstein/DeYoung, Washington Post, 5/1).
Doing the Grunt Work
The United Nations, the World Bank and the World Health Organization have not yet addressed how a new global fund would be divided between treatment and preventive measures. They also have not determined which agency will take the lead in the initiative. Although the United States and other Group of Seven nations have expressed support for the fund, exact contribution figures have not been determined, nor has the length of the commitment been discussed. In addition, details about whether the fund will address HIV/AIDS in developing countries outside of Africa and what, if any, other diseases will be targeted have not been worked out. Annan "side-stepped" these issues in an interview with the Philadelphia Inquirer yesterday, the paper reports. He also declined to comment on the role generic drugs would play in any treatment plans. Many activists credit generic drug competition with helping to lower the cost of brand-name AIDS medications and are "concerned" that if generic drugs are not a "strong part" of any global AIDS program, the major pharmaceutical companies will lack any further incentive to reduce their prices. Annan said he is planning to meet with the heads of several generic drug manufacturers soon (Philadelphia Inquirer, 5/1).
Annan's request for global AIDS funds was greeted with an "enthusiastic response" from Council of Foundation members, Reuters/Contra Costa Times reports. "It was an eye-opening speech," Paul Di Dinato, head of a consortium of AIDS-related foundations, said. He predicted that HIV/AIDS-related charitable giving could "easily rise" to $200 million within three years. U.S. foundations donated an estimated $27.6 billion last year, of which less than $100 million went toward AIDS-related projects (Reuters/Contra Costa Times, 4/30). Susan Berres Ford, president of the Ford Foundation, said that the council "heard" Annan's message. She predicted such a global effort would "promote collaborations between foundations and governments" and act as a "safeguard against duplication" (Carr, Atlanta Journal-Constitution, 5/1).
The 'Lion's Share'
Annan added that he hoped the foundations' positive reactions would be well received by the Bush administration, and encouraged the White House to increase its funding of the global AIDS effort. "It would be presumptuous of me to say how much the U.S. should pay. I hope, considering the size of the government, that it would be substantial," he said (Cappello, Associated Press, 5/1). Administration officials said yesterday that they support the "idea of a multilateral attack" on HIV/AIDS, but it remained unclear how much the government is willing to put toward the effort (Philadelphia Inquirer, 5/1). British Finance Minister Gordon Brown, who heads the International Monetary Fund's policymaking team, said that the United States could be "pressed" into lending greater support "by the enthusiasm of others." According to Brown, Great Britain and Italy have been "working behind the scenes" to promote a trust fund since February. "I want us to treat this issue with the same urgency that we treat the debt issue. We cannot stand by and allow lives to be lost when there are potentially drugs and vaccines that can stop this needless loss of life," Brown added (Willard, Reuters/Contra Costa Times, 4/30). Brown will address the United Nations today to offer the G7's support of the fund. The "precise amount" of money to be provided by the nations -- including the United States, the United Kingdom, Canada, Germany, France and Italy -- will be decided later this year, but total contributions could be as high as seven billion British pounds. "The scale of this would have to be very big indeed. Governments will pledge what they can afford and we expect the biggest countries are in a position to do the most," Brown said, adding that the United States, as the world's wealthiest nation, will be expected to contribute the "lion's share" (Thornton, London Independent, 5/1).