Wall Street Journal - April 25, 2001
Michael M. Phillips and Rachel Zimmerman, Staff Reporters

United Nations Secretary-General Kofi Annan is expected to unveil Thursday a comprehensive plan financed by rich nations to fight AIDS and other infectious diseases in poor countries, according to people familiar with the proposal.

At a speech before African leaders meeting in Abuja, Nigeria, Mr. Annan plans to outline his vision for a single fund -- likely to be run by the World Bank -- that would unite disease-prevention efforts and the provision of advanced life-extending drugs, now that pharmaceutical companies are cutting their prices.

"Having brought the price point down, we now have to demonstrate there's a fighting fund of resources to bring treatment to the poor," said Mark Malloch Brown, administrator of the U.N. Development Program.

Details of the plan are still sketchy. But Mr. Annan, who has made fighting AIDS a top priority, hopes to polish his strategy in time for the June United Nations General Assembly focused on HIV/AIDS.

Already, officials from the U.N., World Bank and wealthy donor countries are edging toward agreement on how to manage such a sweeping attack on the disease.

At a meeting in London on Monday, representatives from the U.N., World Bank, U.S., Britain, Italy, Canada, the Netherlands and Sweden, as well as the Bill & Melinda Gates Foundation, agreed to consolidate various proposals that have been floating around international policymaking circles for months. The participants left the meeting with an understanding that the World Bank would probably handle the mechanics of running the fund.

While officials are making progress in designing the fund, they still have far to go in filling it up. Researchers estimate that it could cost $7 billion to $10 billion a year more than is being spent now to fight AIDS, including prevention and the provision of costly drugs. The U.N. estimates that less than $1 billion a year is currently being spent for treatment and prevention in the developing world.

So far, officials haven't specified how much money they aim to collect from donor governments and private philanthropists. And the Bush administration, a key potential source of money, hasn't yet signaled whether it would help finance such an effort.

Yet international pressure is mounting on the U.S. and other donors. President Bush's senior advisers met Tuesday in the White House situation room to hammer out a U.S. position on an AIDS fund, including perhaps a first stab at the tough question of how much the U.S. would be willing to contribute, those familiar with the meeting said.

Drug companies have recently agreed to cut the prices of their antiretroviral treatments, and Italy, which plays host to the July summit of the Group of Seven major industrialized nations, wants the leaders there to announce a major health initiative for poor countries.

Among the decisions facing the Bush team was whether to endorse the idea that the fund should address tuberculosis and malaria, in addition to AIDS. Those at the meeting included Secretary of State Colin Powell, Treasury Secretary Paul O'Neill, Health and Human Services Secretary Tommy Thompson, and White House AIDS adviser Scott Evertz.

The Gates Foundation, which last year committed more than $1 billion for global health initiatives, is among the private donors considering a contribution to a global fund. "We are encouraged that there seems to be consensus building around one plan," said a foundation spokesman.

The Annan plan, said some meeting participants, might include:

• Strengthening HIV education and prevention among young people.
  
  
• Increasing distribution of condoms and stepping up counseling targeting people with sexually transmitted diseases and IV drug users.
  
  
• Determining the best methods for providing drug therapies to HIV-positive women to prevent them from transmitting the virus during pregnancy.
  
  
• Determining how AIDS medicines should be administered and delivered to decrease the likelihood of resistance.
  
  
• Improving treatment for opportunistic infections and speeding up the search for an AIDS vaccine.
  
  
• Increasing care and education for AIDS orphans.
  

Write to Michael M. Phillips at michael.phillips@wsj.com and Rachel Zimmerman at rachel.zimmerman@wsj.com

010425
WJ010410

Copyright © 2001 - The Wall Street Journal. Reproduction of this article (other than one copy for personal reference) must be cleared through the WSJ Permissions Desk.

ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2001. This material is designed to support, not replace, the relationship that exists between you and your doctor.

ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1990, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS and the Sisters of Saint. Elizabeth of Hungary, or the party credited as the provider of the content.