Funds tighten for fighting AIDS and malaria worldwide

Global health leaders are urging the Obama administration to make up a deepening shortfall.

The international financial crisis could set back recent progress in international efforts to combat malaria, AIDS, and tuberculosis, global health leaders are warning.

They want the Obama administration to make up a deepening shortfall in pledged American funding for the global antidisease campaign and set an example for the developed world.

The United States has yet to approve its 2009 contribution to the Global Fund, the international public-private partnership that since 2001 has become the primary source of funding to fight these three scourges of the developing world. In fact, the US is already $1 billion behind in honoring pledges made under the Bush administration. But if it comes up with even $2 billion of its $2.7 billion pledge for 2009, "I'd be very happy," says Rajat Gupta, chairman of the Global Fund and a prominent international businessman. "We could close the gap."

The "gap" that worries health experts is the shortfall in funding that they say is tied to the international program's success: More developing countries, particularly in Africa, are coming up with effective and popular programs for combating the three diseases. But the successes are actually prompting greater demand, even as developed countries like the US fall behind in meeting their funding pledges.

"It's a different kind of crisis," says Mr. Gupta, who spoke in a conference call to journalists from the World Economic Forum in Davos, Switzerland, where he discussed the Global Fund's predicament. "It's the result of a very successful investment strategy."

The gap between funds pledged and eligible programs stands at about $5 billion, he says.

The Global Fund brings together international institutions, developed countries, and major private donors with more than 135 developing countries. It is responsible for one-quarter of global AIDS funding, two-thirds of funding to fight tuberculosis, and three-fourths of all funding for malaria.

The international economic turmoil must not be allowed to sidetrack attention from global health initiatives, especially with many countries in the midst of multiyear programs that are delivering impressive results, say health experts. With a hint of exasperation, some experts note that the world's wealthy are managing to come up with huge sums of money for business bailouts and national stimulus plans.

"We're talking about a few billion dollars and millions of lives," says Jeffrey Sachs, director of the Earth Institute at Columbia University in New York and a special adviser on development and health to UN Secretary-General Ban Ki Moon. Arguing that national governments are coming up with trillions of dollars for economic stimulus packages and that Wall Street managed to pay out nearly $20 billion in bonuses for 2008, Mr. Sachs says, “Is the money there? Yes, the money’s there.”

Malaria alone costs Africa $12 billion a year in productivity, says Peter Chernin, president of News Corp. and also chairman of Malaria No More.

Mr. Chernin was one of the business leaders at the World Economic Forum who began a $100 million fundraising campaign to fight malaria in Africa. The effort, called the Malaria Capital Campaign, already has commitments of $40 million, according to Chernin and Rex Tillerson, Exxon’s CEO.

Moreover, the Global Fund has already had notable successes – sometimes through initiatives as simple but effective as the distribution of bed nets to ward off mosquitoes. Malaria cases are down by two-thirds in Rwanda, Chernin says, and by 80 percent in Eritrea.

Chernin says it would be inaccurate to tar the US as a laggard in international health issues. “The Bush administration deserves credit for a dramatic increase in global health funding,” he says. That funding included President’s Bush’s HIV/AIDS initiative in Africa and increased attention to malaria.

But that does not alter the fact that the US, which makes up about a third of the Global Fund, is falling further behind in its contribution.

The next opportunity for making up lost ground will be in April, when Spain hosts a donors’ “replenishment” conference. Sachs of Columbia University says he and other experts will be working to put the issue on the agenda of the Group of 20 summit in London, also in April.

In the meantime, Gupta says, he and others will press the US for action on its funding pledges. Noting that President Obama underscored his support for “programs that work” in his inaugural address, Gupta says Mr. Obama would send a “strong message” around the world by supporting proven global health programs.

Material from the Associated Press was used in this report.