Global AIDS Fund Facing Lag as Nations, Organizations Hesitate to Donate, Fight Over Control
The global AIDS fund is "making little headway" as wealthy countries are failing to provide the necessary funds and international groups are "politicking over control" of the plan, proposed four weeks ago by U.N. Secretary-General Kofi Annan, the Boston Globe reports. U.N. officials "predict" that only $1 billion will be donated by the end of the year, substantially less than the $7 billion to $10 billion called for by Annan, as "wary" governments and organizations "balk at putting millions of dollars into a fund based on what remains a jumble of ideas." Global health officials said that skepticism was so great earlier this month that the collapse of the fund seemed imminent. Gordon Perkin, executive director of the global health program at the Bill and Melinda Gates Foundation, said, "The fate of the fund hung in the balance a little while. There was concern about a big fund that governments wouldn't control themselves. But now I think the problems are being worked out." However, he noted that even the Gates Foundation is "not convinced throwing money into the pot is the best use of our dollars." Thus far, the United States has provided the only government contribution to the fund, a $200 million pledge considered by many AIDS activists to be too small. U.N. Development Program administrator Mark Malloch Brown said, "The $200 million from the United States probably means up to $1 billion in the total new resources this year, figuring that other countries will give about $600 million and private donors another $200 million." Slow donor response may be explained by the fact that "they probably want to know a little more about how this fund will function before making firm commitments for money," U.N. Deputy Secretary-General Louise Frechette said. Laura Efros, who was senior adviser for international health at the National Economic Council under the Clinton administration, said that "an order of magnitude more is needed to fight AIDS," but she added, "[I]t might be a poor idea now to put much money into a fund that does not yet exist." Others expressed confidence that the fund would grow eventually. Global Health Council head Nils Daulaire said, "One billion dollars is not the end point; this is a starting point of a long process."
Fight for Control
In addition, "turf battles" have erupted among U.N. organizations and the World Bank for directing roles in how the money should be spent, and the fight for control has "raised questions about the future role of UNAIDS," the Globe reports. According to one health official, "UNAIDS is a question mark right now. It was formed because the WHO used to be such a disaster. With WHO back on the rails, it's a different dynamic." But Frechette said that "the need for UNAIDS will continue with or without a fund. It is a source of advice and support for governments." Annan's plan for the global AIDS fund is to create a public-private board in which developing nations "set the agenda by proposing initiatives for consideration." Although "hundreds of details remain unresolved," Annan has said he hopes to announce the fund's framework and several sizable donations at next month's U.N. special session on AIDS (Donnelly, Boston Globe, 5/24).