Forceful Pro-Fund Speech by Stephen Lewis

Author:

Bernard Rivers

Article Type:

Article Number: 8

ABSTRACT "it's time for the world to embrace the Fund... No one pretends the Fund is perfect, including its own Secretariat. But it is emerging as one of the most inspired multilateral financial instruments that the world has latterly fashioned... In my respectful submission the Global Fund has been abysmally resourced."

The following is an excerpt from the keynote lecture by Stephen Lewis, UN Special Envoy for HIV/AIDS in Africa, at the 11th Conference on Retroviruses and Opportunistic Infections, February 8, 2004 in San Francisco:

it’s time for the world to embrace the [Global] Fund, without all the carping to which it has been – often mindlessly – subject. No one pretends the Fund is perfect, including its own Secretariat. But it is emerging as one of the most inspired multilateral financial instruments that the world has latterly fashioned. And I, for one, am nonplussed by the refusal to fund the Fund at levels which would save and prolong millions of lives. There’s something nuts about holding out a begging bowl for an organization dedicated to confronting and subduing the AIDS pandemic. I am reminded of the 1980s, when members of the international community were reduced to groveling on behalf of financing the United Nations, in order for the world body to function in the interests of humankind. Where would we be without it today – you’ll note that there seem to be countries who suddenly need it – if its capacity for intervention had been eroded by the Scrooges of the planet?

The Global Fund is largely past the inevitable hiccups associated with launching a new and complex international mechanism. It has sophisticated and useful processes in place. The innovations of the so-called CCM – the country coordinating mechanism – and the Technical Review Panels are working pretty effectively at country level and at the centre. The Board, with its unique representative nature, is functioning well, and the Fund is now disbursing money rather more quickly than certain other international financial institutions that have been around forever.

This isn’t some blanket apologia. I myself have occasionally been critical of the Global Fund and have raised with them some of the frustrations felt by recipient countries. But let’s keep perspective here. In barely more than two years, we have an entirely new international construct up and running, admirably serving the interests for which it was intended, and getting money to the grass-roots of AIDS-plagued countries where it is so desperately needed. Tht’s one of the most admirable things about the Fund: because the proposals come from the bottom, the money can get to the bottom.

The Fund was the brain-child of the Secretary-General of the United Nations. It was an excellent cerebral birth. It can become the kind of international coordinating body which we must have to defeat the three communicable diseases that constitute its mandate. I have nothing but regard for the work of the Clinton Foundation in the four countries where it is most in evidence: Tanzania, Rwanda, Mozambique and South Africa. And I’m delighted by the prospect of President Bush’s enterprise bringing hefty resources into twelve of the countries of Africa. But what of the countries that are left out of those initiatives? What of Swaziland and Lesotho and Zimbabwe and Malawi, whose collective prevalence rates range from fifteen to nearly forty per cent? it’s the Global Fund that stands ready to be called upon. With 3 by 5, the presence of a coherent and rational funding body, for all regions of the world, is surely vital.

it’s been a heavy blow, then, to see how inadequately-funded the Global Fund has been. In fact, I think I should stop pulling my words: in my respectful submission the Global Fund has been abysmally resourced. You might think that the industrial nations would compensate for a decade of financial abstinence by embracing the Global Fund as the obvious vehicle for resource-constrained countries. But that hasn’t been the case. At this moment in time, the Fund is several hundred million dollars short for this year, and almost three billion short for next. Nor are the omens auspicious. The administration of the United States has asked for only $200 million for the Fund for 2005, some $350 million less than 2004, and a billion short of what many active observers feel would be an equitable contribution. The rule of thumb, based on gross world product, is one-third from the United States, one-third from Europe and one-third from everyone else – everyone else comprising vast powers like Japan to sweetly diminutive states like Canada. In 2005, the Fund will need a minimum of $3.6 billion – hence $1.2 billion from the United States. This is not higher calculus: the arithmetic is clear. And let me add a footnote: of the $3.6 billion required for 2005, $1.6 billion represents money needed to extend existing programmes – that is, those that were approved in years one and two. If that money is not forthcoming, the programmes cannot be extended, and people who have been put on treatment with that money will have their regimen severed, posing serious mortal risk.

On the other hand, it must be said that no country, my own included [Canada], is paying an adequate share based on any reasonable formula. And that, quite simply, is shocking. Worse, it deters developing countries from asking for what they truly need because they don’t believe they can get it. People are dying at a rate of three million a year, and we have the capacity to keep them alive, and we can’t summon sufficient resources. Overall, some $4.7 billion was spent in the global response to AIDS in 2003. UNAIDS says a minimum of $10.5 billion is required by 2005, and $15.5 billion by 2007. Where will the dollars come from?