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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.81 n.7 Genebra Jan. 2003

http://dx.doi.org/10.1590/S0042-96862003000700016 

NEWS

 

Mixed reaction to US pledge of US$ 15 billion to fight AIDS

 

 

Jacqui Wise

Cape Town

 

 

AIDS campaigners are ambivalent about the five-year US$ 15 billion package promised by US President George W. Bush to fight AIDS in sub-Saharan Africa and the Caribbean.

While welcoming the increased commitment to spending on AIDS in Africa, activists are upset that Bush has set aside only US$ 200 million a year for the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund was set up two years ago to coordinate and deliver resources to projects around the world quickly and with a minimum of bureaucratic red tape. Next year the Fund faces a US$ 4 billion shortfall.

Sharon Ekambaram, spokesperson for the AIDS Consortium, a South African-based advocacy and lobbying organization, told the Bulletin: "What is the US agenda in setting up a separate funding mechanism instead of using existing structures like the Global Fund? The US obviously wants its own funding which it can control."

Nathan Geffen, spokesperson for the Treatment Action Campaign, agreed: "The Global Fund has requested $2.5 billion this year from the Bush administration and $3.5 billion in 2004. We call on this commitment to be made to the Global Fund, which has the independence and integrity to ensure that the money is properly allocated and accounted for."

The US$ 15 billion programme was first announced in the President's State of the Union address on 28 January. President Bush described it then as "a work of mercy", in which the United States "can lead the world in sparing innocent people from a plague of nature". The response at that time of Stephen Lewis, the United Nations special envoy for HIV/AIDS in Africa, was: "It opens the floodgates of hope."

The programme of funding was signed into law at the end of May. It will more than double US contributions to the worldwide fight against AIDS. The United States this year is spending about US$ 1.2 billion on international AIDS efforts.

Ms Ekambaram said: "It is an important gesture but in many ways seems to be a public relations act. It seems to be a lot of money but not when you look at it in the context of how much money has already been spent on SARS in a short time, or on the Iraq war."

She added: "There are a number of questions over whether the money comes with strings attached, for example over the use of generic drugs. At the end of the day it is the US deciding how the money gets spent without caring about the priorities of developing countries."

The US House of Representatives passed the US$ 15 billion bill only after the President's conservative allies insisted that abstinence from sexual activity should get a prominent role in the AIDS effort. The House approved, by 220 votes to 197, an amendment requiring that one-third of funds spent on prevention go to abstinence programmes. The new package recommends that 55% of direct aid should go to treatment programmes, 20% to prevention, 15% to care for those dying of AIDS, and 10% to children orphaned by the disease.

Nathan Geffen told the Bulletin: "We are worried that there are moves afoot to ensure that this money is going to go to organizations with a pro-life agenda which promote abstinence at the expense of condoms. This may result in the money being put to detrimental use and it is important that this issue gets rectified and clarified."

At the G8 Summit in Evian (1–3 June) European countries agreed to try and match the US funding. However, activists are disappointed that the leaders of the world's richest countries failed to make progress on new trade rules to allow poor countries to buy cheap, generic versions of new medicines, including antiretrovirals.