Global Fund Should Delay New Round of Funding Until Next Spring, U.S., British Officials Say
The Bush administration and the British government at a meeting of the board of the Global Fund to Fight AIDS, Tuberculosis and Malaria this week in Chiang Mai, Thailand, have said that the fund should slow down its spending by delaying a fourth round of grants until next spring, the Boston Globe reports (Donnelly, Boston Globe, 10/15). In its first two rounds of grants, the Global Fund has committed $1.5 billion in funding to support 154 programs in 93 countries worldwide. The fund in June said that it would need at least $700 million to fund projects that are up for approval in 2003. The $700 million is the gap between the total amount requested in project proposals set to gain approval this year and the $300 million the fund has left to spend this year (Kaiser Daily HIV/AIDS Report, 10/15). The fund has borrowed $101 million from donor contributions for 2004 in order to finance grants for 2003, the Globe reports. Therefore, U.S. officials say that the fund should delay the fourth round of grant awards until it has a "more accurate accounting of its bank account," according to the Globe. However, officials at the Global Fund and the World Health Organization want to start the new round of funding in December, arguing that the fund has always given out money based on future pledges from wealthy countries (Boston Globe, 10/15). Global Fund Director Richard Feachem at the opening of the meeting on Wednesday said, "[O]ur task is to look boldly to the horizon and keep up the pace. We did that in 2003 by turning the gears of our mechanism to disburse money to many recipients in many countries. To do so in 2004, we must recognize and preempt today the challenges that will face us tomorrow" (Feachem speech text, 10/15).
HHS Secretary Tommy Thompson, who chairs the board of the Global Fund, said that the Bush administration will not publicly debate its position on the start date of the next round of grants. However, the Bush administration has said that funding for AIDS initiatives should increase gradually over the next few years because many developing countries lack sufficient infrastructure to absorb large amounts of money (Boston Globe, 10/15). For example, although the measure (HR 1298) supporting the United States' five-year, $15 billion global AIDS initiative authorizes $3 billion for the first year of the program, the Bush administration has requested that Congress appropriate $2 billion. During a July press conference, President Bush said, "We sent up something less than $3 billion because we didn't think the program could ramp up fast enough to absorb that amount of money early" (Kaiser Daily HIV/AIDS Report, 9/17). Of the total $2 billion requested for fiscal year 2004, the Bush administration has requested that $200 million go to the Global Fund; however, AIDS advocates have called for a $1 billion donation to the fund. The Senate and House are currently working on legislation that would add another $200 million to $300 million to the FY 2004 amount earmarked for the Global Fund, according to the Globe. A senior U.S. health official, who asked not to be named, said that White House officials have "become angry over the attention given to the Global Fund and WHO" and believe that the U.S. initiative will "be the centerpiece of the AIDS fight and should receive the bulk of the credit," according to the Globe.
Jim Yong Kim, a senior adviser to WHO Director-General Dr. Jong-Wook Lee, said that "many millions" of dollars could be spent now to develop infrastructure so that health systems will be better equipped to handle AIDS, according to the Globe. "Any effort at this point to slow things down would be disastrous," he said, adding, "Round four has to be right away. There's enough money to start." AIDS advocacy organizations this week began pushing for the fourth round of funding to begin in December (Boston Globe, 10/15). The board is scheduled to announce the date of fourth round grants and third-round grant recipients on Friday (Global Fund Web site, 10/16).
An audio version of Feachem's opening address is available online.