Funding shortfall in the fight against AIDS

Posted: 28 January 2004

Author: Anna Baxter

Over two years ago, the G8 group of industrialised countries approved a Global Fund to fight AIDS, tuberculosis and malaria. Since then the Fund has approved two rounds of proposals totalling US$1.5 billion in 85 countries. Unfortunately, little of the money needed to adequately tackle HIV/ Aids has been pledged. Anna Baxter reports.

Every 15 seconds a young person (aged 15-24) is infected with HIV: a statistic that barely begins to explain the complex ways in which HIV/AIDS is affecting the lives of young people around the world.AIDS education in UgandaSchool children receive AIDS education, Uganda© Jorgen Schytte/Still PicturesMany young people in developing countries are forced to drop out of school to care for their parents or have to work in the fields to pay for medication and food.

In the absence of social services in many of the countries worst affected by the virus extended families are often the only safety net for AIDS orphans. But as the virus spreads, extended family diminishes. With an estimated 13.2 million children orphaned by AIDS worldwide, the numbers are just too great. There is an increasing shortage of resources to feed extra mouths, particularly in light of the high probability that the children themselves may carry HIV.

AIDS education gap

Young people are particularly vulnerable to sexual abuse and exploitation, including incest, rape and forced prostitution. This is especially so in the absence of adults to defend them.

Many young people do not fully understand the risks that they face from HIV/AIDS due to a lack of education. In Mozambique, for example, 74 per cent of young women and 63 per cent of young men aged between 15-19 are unaware of how to protect themselves.

Even when women are sexually aware, studies show that in cities across Africa and India the lower social and economic status of women reduces their ability to negotiate safer sex and may lead to 'survival sex,' prostitution driven by a need to find money to support families.

This is just one example of how poverty and inequality facilitate the transmission of HIV. The absolute level of poverty increases the susceptibility of the poor to infection from HIV due to lack of disposable income to purchase condoms, poor access to health facilities and HIV prevention programmes that could save lives.

Community projects

In Uganda, where there are 5,000 community projects tackling the epidemic, HIV prevalence is decreasing. Experience shows that the communities facing HIV/AIDS every day know best how to tackle the crisis.

Two years ago the G8 approved the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Fund's Africa Director, As Sy, describes the Fund as, "...trying to do one simple thing - which is to move from despair to hope."

The Fund takes as its premise the fact that communities themselves know what they need to help them prevent and manage HIV/AIDS. Proposals to the fund must be evidence-based, technically- and developmentally-sound, and must demonstrate that added resources will bring results.

Allocation of resources by the Fund is needs-based with highest priority being given to proposals from countries and regions with greatest need, "based on highest burden of disease and the least ability to bring the required additional financial resources to address these health problems."

Funding shortfall

Since becoming operational in January 2002, the Global Fund has approved two rounds of proposals with a total commitment of US$1.5 billion over two years to 85 countries. The majority of this sum, 65 per cent, has been allocated to HIV/AIDS prevention and management, 14 per cent TB and 17 per cent Malaria. Proposals from Sub-Saharan Africa have received 61 per cent of the total resources allocated, 15 per cent has gone to Asia and the Pacific, 10 per cent to Latin America and the Caribbean, 7 per cent to Europe and 6 per cent to Asia.

Despite this, the Global Fund has not received any substantial new pledge other than a potential pledge from the United States of US$1 billion over 5 years starting in 2004.

Even when taking the most optimistic view that all recent announcements of pledges to the Fund are met by donor countries, the Global Fund faces a critical US$1.6 billion shortfall in meeting its requirements.

The UK government should commit at least US$440 million towards the shortfall the Global Fund is facing over 2004-2005.

The Global Fund is the only multilateral funding mechanism that is democratic, transparent and participatory. It allows developing countries to set their own priorities and be involved at all levels of negotiation and decision-making. For all these reasons, it is vital that the Global Fund be allowed to flourish.

  • President George Bush, in his 2003 state of the union address announced the contribution of $15 million over five years to help the global AIDS initiative. Whereby the US would join the global fight against AIDS and donate to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    However, according to a Kaiser Network report on January 26, 2004, the government has yet to write the cheque, it should have been made as a one-off payment, instead it has been bundled in with a spending bill; which is fraught with delay and controversy.

    The report adds that the United States has been pushing trade policies and patent protectionism that work against efforts to provide cheap generic anti-AIDS medication to those countries that need it.

  • Anna Baxter is a member of the UK-based ActionZone Editorial Board.Related links:The Best Chance We Have ( ActionAid's report on the Global Fund) United Nations Programme on HIV/AIDS