The Global Fund Confronts AIDS

"This week the House passed a bill that would authorize greatly increased spending to combat AIDS overseas, including a doubling of the American contribution to the new Global Fund to Fight AIDS, Tuberculosis and Malaria. It is critical that Congress actually appropriate the full $750 million the house has authorized for the global fund.

". . .The fund is intended to respond to official requests from governments, but many deny that they have a problem, South Africa being the most notorious example. There needs to be a mechanism to consider proposals from independent groups in countries where governments are shirking their responsibilities.

". . . Many wealthy donor nations are worried that buying [antiretroviral] drugs for the poor would eat up money that should go to AIDS prevention. But countries that do provide AIDS treatment, like Brazil, have found that it helps prevention, too."

". . . The global fund could provide a major service by negotiating for the lowest possible prices on behalf of countries too small and poor to have clout with manufacturers. Some donor nations are pressing for each country to negotiate on its own. That would impede poor nations' ability to get low prices. The fund must also be willing to pay for generic copies of drugs patented in wealthy countries, so as to help the most people.

"The grants may not hit the ground until late 2002, yet the project must show results soon or see its donations dry up. The transition team is examining one worthy solution: to provide antiretrovirals to Africa's networks of hospitals, to large corporations and to mission clinics working with the poor in rural areas. These well-run facilities could begin administering drugs soon, without complex government applications. The fund might then achieve a sharp drop in the death rate next year.

"When Kofi Annan announced the program, he said it would need $7 billion to $10 billion a year for AIDS alone. This year donors have pledged only about $1.5 billion. The cost and difficulty of dealing with AIDS rises with each passing month. AIDS must be treated as the emergency it is -- a plague the likes of which the world has not seen since the Black Death seven centuries ago."

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