Global Fund Cancels Fundraising; Seeks New Leadership (NEWS BRIEF)

(HN, November 23, 2011) The high profile Global Fund to Fight AIDS, Tuberculosis and Malaria has, in a surprise move, cancelled its multi-million dollar fundraising efforts and has instigated a search for a new chief.

The Geneva-based Fund aims to save 10 million lives and prevent 140-180 million new infections from AIDS, tuberculosis and malaria from 2012 to 2016. It has$4 billion in its trustee account and expects to sign grants for existing approved programs worth $10 billion for the period 2011 to 2013.

In a statement today issued in Ghana, the Fund said that in its last pledge round, in October 2010, it managed to raise only $11.7 billion, well short of the $13 billion “austerity budget” it said it needed as a minimum to continue programs already started. It had hoped to raise $20 billion.

Questionable disbursement practices by many countries, including Djibouti, Mali, Mauritania and Zambia, lost their grants or had new safeguards put in place after officials were accused of stealing. The Fund’s own inspector general exposed the fraud and earlier this month was trying to recover about $20 million that had been allegedly stolen.

The funding has its complications. Recipient country, Zimbabwe, for example, has blamed the United Nations Development Programme (UNDP) for delays in disbursements of Fund grants.

"The five-year strategy and transformation plan adopted at the meeting together commit the Global Fund to shift to a new funding model that focuses on investing strategically in countries, populations and interventions with high potential for impact and strong value for money,” said Fund board chair Simon Bland. “It will provide its funding in a more proactive, flexible and predictable way. It will better manage risk and it will work more actively with countries and partners to facilitate grant implementation success. In doing so, I believe the Global Fund will shift from an institution that has successfully provided emergency funding to allow countries to cope with the runaway pandemics, to become a sustainable, efficient funder of the global efforts to control them and eventually win the battle against AIDS, TB and malaria."

The fund’s board, while meeting in Accra, created a new general manager position to take some day-to-day authority from the executive director - French national and physician, scientist and diplomat, Michel Kazatchkine. His fundraising capabilities have reportedly come into question.

- HUMNEWS staff, agencies, Global Fund

Funding Countries Guilty of "Moral Betrayal" in Fight Against HIV in Africa - MSF

(HN, June 6, 2010) - A severe drawback in pledges from major donors in the fight against HIV represents a "moral betrayal" of millions of infected people on the African continent, says the respected organization Medecins Sans Frontieres (MSF).

Donor governments, blaming the ongoing global economic crisis, are drawing back support of HIV treatment programmes, such as anti-retroviral treatment (ART). MSF claims that had the international community not provided financial support, about 4-million people on treatment in Africa would not be alive today. Its also helped the scaling up of preventative treatment, such as mother-to-child transmission.

The Global Fund Against AIDS, Tuberculosis and Malaria, and the countries that fund it, the U.S. bilateral PEPFAR program, UNITAID and the World Bank are all beginning to retreat from their commitments to the global HIV response, according to MSF. The Geneva-based organization is currently facing a major funding shortfall of about $5 billion.

The impact is already being felt by frontline organizations like MSF, which provides HIV/AIDS treatment to 140,000 patients in 30 countries. MSF says it is reaching into its emergency buffer stocks of medicines deeper and more frequently.

Africa is Ground Zero in the fight against HIV: two-thirds of the 9 million people in need of urgent treatment live in sub-Saharan Africa. Because of funding gaps, already in South Africa and Uganda, patients are being shuffled from one clinic to another because of limited treatment slots.

Said Dr. Eric Goemaere, medical coordinator for MSF in South Africa: Some years ago, messages to governments in the region were unambiguous. They were told... we want to see ambitious targets because we want to see a population-level impact on the HIV epidemic. We want you to show that you can have an impact to stop this epidemic. And today the message switched to, ‘let's see what you and [we] can afford together.

"If this trend is confirmed, I would call it a moral betrayal. A moral betrayal because we will have failed first our patients, who were told to get tested and all the ones who tested positive. We promised them we'd provide them treatment. We will fail our health staff, who managed to start 4 million people on treatment, an unprecedented effort for the health services in developing countries in such a short time, and who are today told that they cannot initiate patients. And finally we would fail regional governments, with some of them already contributing a substantial amount of their own resources. The economic crisis is happening here as well as in the United States and Europe, and we would fail them if we would tell them that we cannot any more support this effort."

Aside from longer waiting lists, doctors and nurses are now having to face the agonizing choice of whether to prioritize late-stage cases or new cases, where treatment may have more of an impact, MSF says.

Experts say that the importance of international donors cannot be over-estimated: in Kenya, for example, it covers about 95% of HIV programmes and ARVs.

"If the international donors decide to withdraw their funding, the HIV programs will not be sustainable according to the present funding levels by the government," said Jimmy Gideyi, an activist and person living with HIV in Kenya. "We already have so many problems to take on, such as stigma, beliefs,  misconceptions, cultural practices, which contribute to the spread of HIV in the community, without having to worry [about] where more money will be coming from to catch up on our treatment."

Most African governments had committed some years ago to allocate 15% of their national budgets to health, but that has not happened - making the contributions of the donor community even more crucial, MSF says. It adds that the debate on funding is complicated over whether to prioritize preventative (such as distribution of condoms) or treatment programmes.

"African governments need to keep their commitments, but the international community also needs to keep its commitment," said MSF's Emi McLean. He added that even the richest country on the continent, South Africa - which depends only 20% on external aid - will stil need funding to treat millions of AIDS patients.

MSF's comments were made recently with the release of a report called Titled “No time to quit: HIV/AIDS treatment gap widening in Africa." The report builds on analyses made in eight sub-Saharan countries to illustrate how major international funding institutions such as the U.S. President’s Plan for Emergency AIDS Relief (PEPFAR), the World Bank, UNITAID, and donors to the Global Fund, have decided to cap, reduce, or withdraw their spending on HIV treatment and antiretroviral drugs (ARVs) over the past year-and-a-half.