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Global Treatment Update

By Bob Huff

October 2002

Global Fund Slow to Take Off

The Global Fund for TB, Malaria and HIV has said that despite approving a first-round of initiatives in the spring worth $1.6B, no money has yet been disbursed. A second wave of funding requests, currently being evaluated, and subsequent waves, may push commitments to over $8B within the next two years (UN Secretary Kofi Annan estimates the need is $10B a year). Yet it's not clear at this point if the Fund will even have the cash to meet its initial check run. As of September, the Fund had only $500M in the bank to give out. Despite having received pledges of over $2B from world governments, there is a large gap between what has been promised and what has been deposited in the Fund's account. Furthermore, money that is available to be disbursed has been held up as the Fund establishes procedures to route the money and provide accountability. News reports have said the Fund is still struggling to get on its feet operationally and even lacks working voice mail on its telephone system. Still, requests for funding continue to stream in.

On a positive note, the Fund has finally given guidance to grantees over the issue of generic medications. Bucking intense pressure from the pharma lobby, grantees now have a green light to seek drugs at "the lowest price possible," whether generic or branded.

Excerpt From a Speech by Stephen Lewis

The Center for Strategic and International Studies -- Washington, D.C., October 4, 2002

"I'm no optimist about the virus. But I simply don't believe, on the basis of personal observation, that we have to face Armageddon. In fact it enrages me the way in which we pile despair upon catastrophe, over and over again, rendering everyone paralyzed. You don't have to be some pathetic bleeding heart to see the potential strength in these societies at the grass roots, and know that if we could galvanize the governments, indigenous and external, and equip civil society, and address capacity and infrastructure with external resources, then we could defeat this pandemic. It is not beyond our competence.

"I met not long ago with a thousand high school students in Addis Ababa, for a question and answer session that lasted an entire afternoon, and the intelligence and understanding and sophistication of those kids gives nothing but hope; I've met with the WFP truck drivers in Nazareth, south of Addis, as they tell their stories of the training they receive, and how they now always carry condoms on their routes; I've met at length with his Holiness, the Patriarch of the Ethiopian Orthodox church as we discussed how the UN family could set in process training for his 350 thousand priests so that they, in turn, could address their parishioners; I've sat over coffee with village women miles and miles from the Ethiopian capital, while neighbors gather to talk about how the virus is transmitted and how to protect themselves. They laugh self-consciously in the presence of a stranger, but they don't mince words.

"I've attended the two-day sensitivity sessions in Abuja, Nigeria, for the establishment of mother-to-child-transmission clinics -- a tremendously impressive undertaking; I've sat with the doctors and nurses in a leading hospital in Benue state as they decide how they'll choose those who should receive antiretroviral treatment when it begins, and how to handle the counseling; I've met with groups of People Living with Aids out in the Eastern region, near Onitsha, as the mothers talk about the kids they'll leave behind, and then make their eloquent, moving, unanswerable plea for treatment."

Coke Announces Plan -- Pressure to Continue

AIDS activists have been demanding that international Coca-Cola and it's local independent bottlers in Africa agree to pay for HIV treatment for all who need it among the 100,000 people employed to bottle and distribute Coke. On September 29, 2002, Coke, along with eight of the 40 bottlers they work with in Africa announced a plan to share the costs of AIDS treatment. According to a Coke statement: "The first bottlers to deploy the program are in Egypt, Morocco, Burundi, Congo, Democratic Republic of Congo, Reunion, Angola, Rwanda, Kenya, Tanzania, Ethiopia, Mozambique, Namibia, South Africa (some), Uganda, Botswana, Lesotho, Swaziland and Zambia. Given some of the infrastructure challenges, it will take up to 12 months to fully roll this out in these countries." The cost to Coke is estimated at about $5M per year.

Yet activists say this plan falls short on a number of counts. First, unless Coke presses holdout independent bottlers to join the plan, only a portion of Coke's workers will be covered. Second, the current plan will exclude children of Coke's workers. Finally, the plan intends to require a 10 percent co-payment to receive drugs. Activists fear that this amount -- easily affordable by the company -- may pose an insurmountable barrier for many low-pay workers.

Back to the GMHC Treatment Issues October 2002 contents page.

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