August 10, 2010
Since its launch, the Global Fund to Fight AIDS, TB and Malaria has given China nearly $1 billion in grants. Despite this, few countries forced to compete for health grants with the world's second-largest economic power have voiced any opposition, according to Jack Chow. A former U.S. ambassador on global HIV/AIDS, Chow was the lead U.S. negotiator in the founding of the fund; his essay appeared in Foreign Policy magazine.
Although it is an economic powerhouse, China's low per capita income allows it to compete for grants with countries like Bolivia, Cameroon, and India, Chow said. China's aggregate award from the fund is nearly three times larger than that given to South Africa -- one of the countries most affected by the diseases, Chow wrote.
At the fund's inception, "We imagined the bulk of the money ending up in places like Lesotho, Haiti, and Uganda, where these diseases have reached crisis levels," Chow said. China may value Global Fund grants as a means through which it can access technical assistance from international health agencies, he suggested.
Nonetheless, a grant system under which China is the fourth-largest recipient threatens to undermine Global Fund efforts to raise $13 billion to $20 billion for projects during 2011-13, Chow said.
China has made Global Fund contributions of $2 million annually, or $16 million during the last eight years, "but China has recouped its spending by 60 times," Chow wrote. In comparison, the United States has donated $6.5 billon and Britain has pledged $2.2 billion.
"China has won malaria grants totaling $149 million in a country where only 38 deaths from the illness were reported last year," wrote Chow. "That is more money than the Democratic Republic of Congo, which reported nearly 25,000 malaria deaths in the same period."
"For many of the poorer countries that lose out, opposing China in international forums would risk incurring Beijing's diplomatic wrath," Chow suggested.