Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
San Francisco Chronicle - Sunday, December 1, 2002
Sabin Russell, Chronicle Medical Writer
The 1-year-old Global Fund to Fight AIDS, Tuberculosis and Malaria, which Feachem heads, was about to sign its first check -- part of a $12 million contract to promote the use of bedroom mosquito nets, impregnated with insecticide, to fight malaria among newborns and their mothers.
But at the eleventh hour on Nov. 20, the Tanzanian Finance Ministry insisted that it, rather than the nation's malarial control program, would handle the funds.
Feachem, who left a post in San Francisco as director of the Institute for Global Health to become executive director of the fund, based in Geneva, promptly pulled the plug.
"The Global Fund is disappointed to announce that it will not be able to proceed with the planned signing of its first grant agreement with Tanzania," he informed his board.
In San Francisco Friday, the globe-trotting Feachem likened the uncompromising stand of his new young agency to "tough love."
The task facing the Global Fund, he said, breaks down to six words: "Raise it. Spend it. Prove it."
Without proving its integrity, he added, the Global Fund will not be able to raise, or spend, the billions needed to turn the tide on the three most dangerous diseases on earth.
"We have to take a principled stand on a variety of issues," he said.
In fact, the Global Fund is also holding up a two-year, $36 million grant to Uganda, after reports surfaced that the finance minister there planned to subtract an equal amount from the nation's annual health budget. That would violate Feachem's "no substitution" principle.
"The use of our money to save somebody else's -- that's completely not allowed," he said.
With the opportunity for ceremony lost in Tanzania, the Global Fund promptly signed a pair of agreements with Ghana: $4.2 million for a variety of AIDS prevention programs and $2.3 million to pay for TB treatments. Before the Global Fund's Jan. 27 board meeting, Feachem hopes to have signed agreements in 40 countries that will distribute $615 million in the next two years.
With $700 million in the bank, Feachem will have to act quickly to keep the money flowing. The Global Fund has $2.2 billion in pledges from the international community, including $500 million from the United States. But the Global Fund needs an additional $7 billion in pledges through 2004 to keep on track.
"Our message to Washington, D.C., is: 'Thank you, but we need a lot more,' " Feachem said.
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