Global Fund Making Progress But Lacking Resources, GAO Report Says
The Global Fund to Fight AIDS, Tuberculosis and Malaria has made "noteworthy progress" since its inception but could face difficulty approving and subsidizing grants due to a lack of resources, according to a General Accounting Office draft report being circulated for comment, the Boston Globe reports. The 51-page report, requested by Rep. Jim Kolbe (R-Ariz.), found that the fund's "most glaring problem" was a lack of resources (Donnelly, Boston Globe, 5/7). The Global Fund has about $250 million in pledges available to apply toward round three grants this year, leaving an estimated 2003 shortfall of $1.4 billion, and although another $500 million in pledges is available next year for rounds four and five, the fund estimates a 2004 shortfall of $3.3 billion (Global Fund Questions & Answers, 5/7). The report states, "Pledges made for this year are insufficient to cover more than a small number of additional grants" and "without significant new pledges" the Global Fund -- which so far has awarded grants to 160 projects in 92 countries -- would not be able to complete projects it has already begun. Thus far, the United States has pledged $1.65 billion of the total $3.4 billion pledged to the fund through 2008 (Phillips, Wall Street Journal, 5/7).
President Bush's original plan for an international AIDS initiative announced during his State of the Union address in January proposed a total of $1 billion to go to the fund over a five-year period (Boston Globe, 5/7). However, last week, the House approved 375-41 an international AIDS bill (HR 1298), sponsored by Rep. Henry Hyde (R-Ill.), that would authorize $3 billion a year for five years to go to HIV/AIDS programs in Africa and the Caribbean, with up to $1 billion in fiscal year 2004 going to the Global Fund (Kaiser Daily HIV/AIDS Report, 5/5). The bill is still up for debate in the Senate, and then must go through the appropriations process, the Journal reports. Some observers are projecting that the fund could receive approximately $350 million from the United States for FY 2004. Global Fund Chair and HHS Secretary Tommy Thompson is expected to visit several European countries to urge officials there to increase their contributions to the fund. In addition, officials from some "wealthy" countries could use the G8 summit in June -- or a donors' meeting scheduled for July -- to lobby for more pledges, the Journal reports (Wall Street Journal, 5/7).
Global Fund Executive Director Richard Feachem said that the GAO report's findings are "constructive" and that they reflect the "growing pains" of any new organization. In a seven-page written statement, Feachem said that raising money is the Global Fund's "single most important challenge," adding, "To date, the United States has led the way in giving, acting as a beacon for others" (Boston Globe, 5/7). He said, "We can't afford to squabble when there are six million people a year dying from the three diseases we're working on" (Wall Street Journal Europe, 5/7). Paul Zeitz, executive director of Global AIDS Alliance, said that Bush's proposal for $1 billion over five years for the Global Fund would "doom the fund just as it starts showing potential," according to the Globe. Zeitz, who recently returned from a trip to Zambia and Kenya, added, "Our feedback from groups in Africa is that this is working; it is creating new momentum. It is not business as usual on the ground in Africa. That is exciting. But the Global Fund's ability to continue the effort, and refine on these initial phases, is compromised by the lack of support from President Bush" (Boston Globe, 5/7).
The House Appropriations Subcommittee on Foreign Operations is scheduled to hold a hearing today on global AIDS, at which Thompson, Feachem and Dr. David Gootnick, director of international affairs and trade at the GAO, are scheduled to testify. A kaisernetwork.org HealthCast of the hearing will be available online by noon ET tomorrow.