U.S. Ambassador Randall Tobias, head of the State Department Office of the Global AIDS Coordinator, on Wednesday said that the United States will not fulfill a request from U.N. Secretary-General Kofi Annan to contribute $1 billion annually to the Global Fund to Fight AIDS, Tuberculosis and Malaria, Reuters reports (Hirschler, Reuters, 7/14). Annan in an interview with BBC World Service on the sidelines of the XV International AIDS Conference in Bangkok, Thailand, requested that the United States and the European Union each contribute $1 billion per year to the fund (Kaiser Daily HIV/AIDS Report, 7/14). The House Appropriations Committee on Friday approved by voice vote a $19.4 billion foreign aid spending bill for fiscal year 2005, which includes $2.2 billion for HIV/AIDS, tuberculosis and malaria initiatives. Although the approved funding -- most of which will go to AIDS programs -- meets President Bush's request for FY 2005, an appropriations subcommittee allocated a larger portion of the money to the Global Fund than Bush had requested. Bush's proposed FY 2005 budget, which is $1.9 billion more than the total amount the subcommittee approved, includes $2.8 billion for international HIV/AIDS, TB and malaria programs. That amount includes $1.45 billion for the Office of the Global AIDS Coordinator, which will administer the President's Emergency Plan for AIDS Relief, and $200 million for the Global Fund. Because the draft spending bill would double the requested Global Fund contribution to $400 million, less money would go to PEPFAR (Kaiser Daily HIV/AIDS Report, 7/13). "The president has requested $200 million for next year and I think that is more than adequate to meet the requirements of the Global Fund in terms of getting money out for putting programs in place," Tobias said (Reuters, 7/14).

Global Fund
Tobias said that although the Global Fund is "a very promising vehicle and a critically important part" of the fight against AIDS, it is "a young venture and still maturing" (Boseley, Guardian, 7/15). Tobias said that the United States prefers to spend the majority of its AIDS funding through PEPFAR because it is an "effective mechanism to ensure that small and effective organizations can improve their work and get money fast in order to address urgent needs within communities" (Apiradee, Bangkok Post, 7/15). PEPFAR is the fastest way to "get that money to work," Tobias said. In contrast, the proposed $200 million FY 2005 contribution to the fund will end up "sitting in the World Bank in Geneva," Tobias said, adding that the Global Fund policy of waiting until enough money has accumulated to ensure completion of programs would "actually slow down" the fight against AIDS (Maugh, Los Angeles Times, 7/15). However, Annan said that the Global Fund is "ready to go," adding, "If individual governments begin to set up their own initiatives, they start from scratch, it takes longer; the money that they hold will not be spent for a long time" (Nolen, Globe and Mail, 7/15).

Reaction
U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis said that the Global Fund is the "most effective instrument against the pandemic," adding that PEPFAR represents the same "go-it-alone" approach that the Bush administration used for the war in Iraq. Lewis said that the United States eventually would accept the Global Fund's multinational approach to the epidemic in the same way that it is now seeking help from other nations in Iraq, according to the San Francisco Chronicle (Russell, San Francisco Chronicle, 7/15). Lewis added, "The American money going to 15 countries is not leadership on AIDS. It's a significant role, but the Global Fund is in 120 countries, ... respond[ing] to the problem in a far more universal way" (Reuters, 7/14). A senior figure connected with the fund said, "Everyone has gone out of their way to give (PEPFAR) a lot of support, but people have reached a limit." The Bush administration's suspicion of the fund is frustrating some of those working to fight global AIDS, he added, according to the Globe and Mail (Globe and Mail, 7/15).

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