Mail & Guardian (Johannesburg) - October 18, 2002
Nawaal Deane

The Global Fund for Aids, Tuberculosis and Malaria will not have enough money to cover proposals for next year if pledges made by countries are not paid.

At its third annual meeting in Geneva last week the board of the Global Fund announced that it needs about $8-billion from rich countries and the private sector over the next two years to keep up with the demand from poor countries to fight these epidemics.

The Global Fund has collected $2,1-billion, over five years, in pledges by governments and corporations, but thus far only a quarter of the pledged amount has been paid.

The fund was established in April last year when United Nations Secretary General Kofi Annan called on donors to provide at least $10-billion in additional funds yearly to fight the three big diseases of poverty.

The board found that most countries have not honoured their pledges, placing the fund under financial strain. Of the 31 countries that have pledged support, only Ireland has made a full payment. Seven other countries have made partial payments.

Whether the Global Fund succeeds will ultimately depend on the donor governments that created it.

Anil Soni, adviser to the executive director, says the board is expecting money to come through and the financial situation is not dire, but the board has set up a resource mobilisation committee to get more pledges and come up with innovative ways for countries to mobilise money internally.

Executive director Richard Feachem said: "The Global Fund was created to help take the world's response to a higher financial and operational level. The three epidemics can be driven back where there is top-level political commitment, where the public sector and private sectors work together and where there is accountability for achieving results."

He says a substantial front-loaded capital investment to scale up existing efforts is required.

"The programmes are ready. Any delay now will be measured by millions of lives lost and billions of dollars of additional cost to later respond to the expanded epidemics."

South Africa has one of the highest rates of HIV/Aids but, unlike other African countries, it has not pledged money to the fund even though it represents the Southern African Development Community in the fund and has had two proposals approved.

In South Africa there is an impression that the fund has copious amounts of money waiting to be handed out to countries worst hit by the epidemic. Soni says this is wrong: the fund is merely a financial channel that needs the global support of countries to implement good treatment programmes.

He says South Africa can support the fund by ensuring that the country coordinating mechanism (in this case the South African National Aids Council) meets the high standards set out by the fund, to strive to be a model in implementing treatment and health programmes.

South Africa is still in a stand-off with the fund over a $72-million grant approved for KwaZulu-Natal. Sources close to the Aids council says there is an impression in government circles that the only reason the fund approved the KwaZulu-Natal proposals was because of the connections of certain KwaZulu-Natal academics to the fund, thereby undermining the merits of the proposal.

The government has still not gone ahead with pooling its $93-million with the KwaZulu-Natal grant in order to redistribute the funds.

The Global Fund's board did not discuss the KwaZulu-Natal proposal but the fund remains firm on its decision, taken in April, to stick to its obligations.

"We look forward to disbursing money to fund this grant as soon as possible," says Soni. He says the fund will defer to national processes to ensure that the implementation is coordinated, through a mechanism that relies on partnerships.

"We are currently waiting for the Aids council to specify the primary recipients for both South African proposals approved in the first round. Any deviation from this path would require a specific board decision," says Soni.

Whether South Africa joins Zimbabwe, Uganda, Zambia and Nigeria in pledging to the fund remains to be seen.

In a statement earlier this month the Aids council said it should prepare for the third round of applications and endorse the second round of submissions to the fund. But the fund may not have sufficient finances for these proposals.

"We have sufficient pledges for round one and two [proposals] but not for the third round. We must raise more contributions and pledges for next fall," says Soni.

The Global Aids Alliance, a NGO, has called for more funds from countries like the United States. "The fund faces de facto bankruptcy in just four months, when new requests for funds will pour in," said Dr Paul Zeitz, executive director of the alliance.

"It is high time the US and other donors end their squabbling over who should be donating to the fund and at what level."

The alliance has drawn up a report calling on G7 nations to contribute about 74% of the total donations required, with the rest provided by 40 smaller but still wealthy nations.

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