Wall Street Journal - April 30, 2001
Michael M. Phillips, Staff Reporter

WASHINGTON -- Facing mounting international pressure, the Bush administration has decided the U.S. will contribute to a global fund aimed at combating AIDS, tuberculosis and malaria in the developing world.

While the exact size of the U.S. commitment is yet to be determined, administration officials have signed on to a multilateral statement to be released Monday calling on wealthy nations to pledge contributions to the fund around the time of a United Nations special AIDS meeting in June.

An advanced draft of the statement cites "the need for a substantial increase in global resources, including through a possible health and HIV/AIDS multilateral trust fund, for HIV-related analysis, research and action programs." The communiqu goes on to call for governments participating in the UN meeting "to make concrete commitments to produce a rapid intensification of global action on HIV/AIDS."

Officials from France, Japan, Britain, Saudi Arabia and other nations also approved the statement, which will be issued at Monday's conclusion of the semiannual meeting of the World Bank. The bank, which plans to double its pledge of $500 million toward new AIDS projects, would likely administer the global fund on behalf of its 182 member nations. The AIDS issue was a focus of this weekend's gathering here of top economic officials from the Group of Seven major industrialized nations, in which they issued a relatively upbeat assessment of the prospects for an early recovery from the global economic slowdown. They also vowed to work on a developing world health initiative in the lead-up to the G-7 summit in Genoa, Italy, this July.

Last week, UN Secretary-General Kofi Annan urged that rich nations and private foundations contribute between $7 billion and $10 billion a year to a Third World health "war chest" to pay for disease prevention and treatment, including the drugs that have been far beyond the reach of millions of poor AIDS sufferers in sub-Saharan Africa and elsewhere. Africans constituted nearly 80% of the 5 million people who contracted HIV last year.

With its attention primarily on economic issues since taking office, the Bush administration had so far avoided committing itself to an AIDS fund. But top cabinet members, including Secretary of State Colin Powell, Health and Human Services Secretary Tommy Thompson and Treasury Secretary Paul O'Neill, have been pondering the Annan proposal, as well as plans for smaller funds that the Italian and British governments would like to announce at the Genoa summit. The recent decision by many major pharmaceutical companies to cut prices on AIDS drugs in the developing world has increased pressure on governments to help pay for the treatments.

The administration is taking a close look at legislation authored by Sen. Bill Frist (R., Tenn.) that would double AIDS-related foreign assistance over the next two years to $1 billion annually. "We're working on policy and programmatic issues related to this question now," Mr. O'Neill said.

The Treasury secretary discussed the AIDS fund this weekend during a private talk with his British counterpart, Chancellor of the Exchequer Gordon Brown, and in the larger gathering of G-7 economic officials.

Inside the room, Mr. O'Neill stressed that any fund should address the poor state of health facilities in Africa and the enormous difficulty in providing complex drug treatments to poor people. Before they make a specific financial pledge, administration officials want to be confident that the fund is designed to address those complexities.

"If we're really going to make a difference with all this well-intentioned work, it needs to be done not in a way that salves the conscience of those who are better off," Mr. O'Neill said after the G-7 meeting. "It needs to be done with a full understanding of what it means to accomplish meaningful change in the lives of real people. This is not an easy thing to do."

Write to Michael M. Phillips at michael.phillips@wsj.com

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