AFRO-NETS> GFATM v. Bush Emergency AIDS Bill

[John Kiwanuka Ssemakula <jssemakula@medilinks.org>]

GFATM v. Bush Emergency AIDS Bill
---------------------------------
 
 
By Jean Su Anchun, June 11, 2003
http://medilinks.org/Features/Articles/june2003/gfatmvsbushbill.asp
 
Although world leaders unanimously endorsed the Global Fund against 
AIDS, Tuberculosis, and Malaria in June 2001 during a UN special Gen-
eral Assembly meeting on HIV/AIDS, how their support is being trans-
lated into GF grant dollars remains the crux of the issue. The GF 
Board estimated that US $7-10 billion is needed annually to effec-
tively combat the surging epidemics. Board members hoped that wealthy 
nations would foot most of the bill, each government contributing an 
amount proportional to its place in the world economy. 
 
The U.S. was thus expected to contribute US $3-5 billion to the Fund 
by 2004. In contrast, the G8, a conglomeration of the world?s richest 
nations, pledged a total of US $1.3 billion over five years in 2002. 
As a result, the Fund collected a total of US $2 billion in the first 
two rounds, falling greatly short of the Fund?s original goals. De-
spite its dearth of funding, what GF has gained is international 
clout by espousing a multilateral approach that involves governments, 
private and public organizations, and individuals. 
 
 
U.S. President George W. Bush?s recent US $15 billion pledge to fight 
AIDS/HIV marked a watershed in international political concern for 
the epidemic. But rather than give full-fledged support to the Global 
Fund, the Bush Administration is determined to address the HIV/AIDS 
threat on its own terms. One billion will go to the Global Fund, 
while the remaining US $14 billion will go to research and the imple-
mentation of a four-tiered network program for treatment and preven-
tion of HIV/AIDS already employed (with promising results) in Uganda. 
 
Announced during Bush?s 2003 State-of-the-Union address, Bush?s Emer-
gency AIDS Bill targets fourteen countries: the African nations of 
Botswana, Cote d?Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nige-
ria, Rwanda, South Africa, Tanzania, Uganda, and Zambia, and Guyana 
and Haiti in the Caribbean. While criticisms of the Bush Bill insist 
that gravely affected nations have been left off the U.S. aid list, 
the countries chosen house 20 million HIV-infected persons and make 
up 70% of the total number of infected individuals in Africa and the 
Caribbean. Another key factor in choosing the countries that receive 
U.S. aid is the level of healthcare infrastructure already developed 
in each nation. Bush?s plan for AIDS relief depends on existing hos-
pitals as well as established NGOs, private and public clinics set up 
by faith-based groups, and mobile rural satellites to distribute 
medication. Therefore, the U.S. selected countries based not only on 
the severity of national infection rates but also the level of the 
national healthcare infrastructure in order to successfully implement 
the proposed model. 
 
It is logical that almost all of the fourteen nations targeted by the 
U.S. have also been granted GF funds, which are awarded based on re-
sults of already implemented programs. 
 
In April 2002, GF announced its first round of grants­US $616 million 
awarded to 37 countries over two years, 42% of the funds going to Af-
rican nations. Over the last month, second round grants of US $866 
million have been allotted to 60 countries over two years. The Board 
bases its decisions on the quality of the proposal and the evidence-
based efficacy of the programs, most developed by partnerships among 
governments, public and private organizations, and victims of the 
diseases. In the first two rounds, the Fund allocated 65% of its col-
lected money to programs fighting HIV/AIDS and 61% to sub-Saharan Af-
rican nations. The GF money for HIV/AIDS programs is used to increase 
people?s access to antiretrovirals (ARVs), to fund prevention pro-
grams and campaigns, and to care for orphans with the virus. 
 
A number of countries are receiving significant aid from both the 
U.S. and GF. In Africa, GF provides Ethiopia with the greatest sup-
port to date­US $93.3 million over two years for programs combating 
AIDS and malaria. Like Ethiopia which received GF funding for both 
the first and second rounds and now U.S. aid, Zambia, Uganda, Kenya, 
South Africa, and Nigeria face the highest infection rates in the 
world, and monetary aid from the world superpowers is sorely needed. 
Other nations slotted to receive lump sums from the U.S. and GF are 
Mozambique, awarded US $54 million from GF, and Namibia, which will 
use its GF grant of US $26.1 million to support AIDS orphans. All of 
the nations on the U.S. aid list have been granted some amount of GF 
money except for Guyana.
 
The U.S. alone has committed US $15 billion to combat AIDS in the in-
ternational sphere; if the aid money is disbursed evenly, more than 
US $1 billion will be invested in each nation on the U.S. list, far 
surpassing the millions that GF can spare for each country. The 
Global Fund has disbursed US $1.5 billion to 153 programs in 92 coun-
tries thus far. In order to finance applications in rounds 3, 4 and 
5, GF will need a total of at least US $6.3 billion over 2003-2004. 
The G8 recently increased its pledge by US $1.2 billion, raising the 
funding to US $4.6 billion through 2008. Nonetheless, this sum only 
fulfills 23% of the Fund?s needs through 2004. How effective the U.S. 
network model will be, in comparison to programs supported by the 
Global Fund, will test how best to use international monetary re-
sources to combat HIV/AIDS. 
 
Of course, the strength of the Global Fund lies in the autonomy it 
gives nations to deal with internal problems and the increased role 
it espouses NGOs and other organizations to play in the development 
of the world?s poorest nations. The role of the U.S. in the nations 
it aids is still unknown. But in the spirit of the United Nations, 
the Fund believes that a multilateral approach can be taken to ad-
dress issues of concern in the international community while still 
upholding the right to sovereignty of nations. Fighting the HIV/AIDS 
epidemic through the Global Fund is a groundbreaking opportunity for 
nations to depend on the expertise of other international actors to 
address a world threat ­- one that states cannot deal with alone. 
 
--
Jean Su Anchun is a contributing writer currently studying at Prince-
ton University, Princeton, NJ A.B. degree in the Woodrow Wilson 
School of Public and International Affairs.
 
--
Comments are welcome
 
John Kiwanuka Ssemakula
mailto:medilinks@medilinks.org
--
To send a message to AFRO-NETS, write to: afro-nets@healthnet.org
To subscribe or unsubscribe, write to: majordomo@healthnet.org
in the body of the message type: subscribe afro-nets OR unsubscribe afro-nets
To contact a person, send a message to: afro-nets-help@healthnet.org
Information and archives: http://www.afronets.org