Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Newsday - September 22, 2003
Laurie Garrett, Staff Writer
Currently, according to UN Secretary-General Kofi Annan, fewer than 300,000 people living in poor countries have access to the sorts of anti-HIV medicines that have reduced AIDS death rates in the United States and Europe. An estimated 42 million people are living with HIV infection in the world, and Annan said funding and treatment goals established more than two years ago are far from being realized.
Earlier this year, WHO declared a health emergency for the first time, targeting the SARS epidemic. Monday's announcement, by WHO's new director general, Dr. Lee Jong-wook, was also a first. The plan aims to provide anti-HIV treatment to 3 million people in poor countries by 2005.
It calls for a series of meetings to map out a simplified mode of anti-HIV treatment, aiming for a strategy announcement on Dec. 1. The strategy would be implemented country-by-country swiftly, in an atmosphere of trial and error. WHO would work closely with other UN agencies and nongovernmental organizations, such as Doctors Without Borders, WHO's Dr. Jim Kim said.
AIDS activists generally praised the announcement and urged the Bush administration to put billions of dollars into the effort.
Kim described his agency as the leader of the effort, with the UNAIDS Programme providing statistical support and the Global Fund acting as a financial conduit to poor countries.
Dr. Nils Daulaire, executive director of the Global Health Initiative, an organization independent of UNAIDS and WHO, said in an interview he hopes the plan yields "a joint effort, joint leadership, rather than a jockeying for position and supremacy. We don't care who is Number One, as long as the job gets done.
"This is certainly doable if the three organizations and the United States and local governments choose to work together collaboratively."
Global Fund spokesman Anil Soni said he thinks the three organizations can work out any differences they may have.
In June 2001, Annan and the UN leadership united around the Global Fund, saying the nations of the world ought to put $10 billion a year into the Fund to pay for HIV, malaria and tuberculosis treatment in poor countries -- the bulk coming from the eight wealthiest nations. Monday Annan told the General Assembly that none of the targets has been met or is on track for achievment by 2005. HIV infection rates continue to climb in much of the world -- now topping a third of young adults in some African countries.
About $1.5 billion has been committed to the Global Fund, but only about $700 million has been deposited in Fund accounts, according to UNAIDS. The fund has sent $130 million to poor countries, but it has recently approved another $1.5 billion worth of grants, Anil Soni said Monday.
"We cannot accept that 'something else came up' that forced us to place AIDS on the back burner," Annan said of the impact of the Sept. 11, 2001, attacks on the World Trade Center and the Pentagon. "Something else will always come up."
Although the Bush administration has commited $15 billion over the next five years to tackling HIV in poor countries, the spending will go from the United States directly to 14 selected nations, rather than to the Global Fund.
In his speech to the UN Monday, French President Jacques Chirac said the United States should donate $1 billion to the interational effort, matching the population-percentage ratio of $150 million France has given to the Global Fund.
"My country continues to be the largest donor to UNAIDS," Secretary of State Colin Powell said. "And we will be issuing another grant for $100 million" to the Global Fund.
Adding to the complexity of funding issues was Trevor Rowe, spokesman for the World Food Programme. AIDS "is not just a medical crisis," he said. "It is a food crisis. It's unrealistic to talk of a medical solution right now -- these people can't afford medicine. And even if they can get medicine, the treatment does no good without food."
Rowe said about 40 million Africans are now on the edge of starvation, many unable to farm because they are weakened by AIDS.
"We thought this was a medical crisis," Rowe said. "It's not. It's a global humanitarian crisis."
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