The Obama administration is pledging $4 billion dollars over the next three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The United States is the largest contributor to the global fund, donating more than $5 billion since 2002.  However, many activists and NGOs say its pledge this year falls far short of what?s needed.  They say the global fund needs at least 20 billion dollars from donors just to sustain current programs and pay for new ones ? a figure not expected to be reached.


Eric Goosby, U.S. Global AIDS Coordinator and the person in charge of PEPFAR, the President?s Emergency Plan for AIDS Relief, attended the fund?s replenishment meeting in New York.

Amb. Eric Goosby
Amb. Eric Goosby

?The Obama administration is making an unprecedented three-year pledge of $4 billion,? he says.  ?The pledge is a 38 percent increase in the U.S. investment over the preceding three years and is by far the largest increase of any donor nation this year.?

Goosby says the pledge will not only save lives, but will also increase life expectancies.

?Moreover,? he says, ?this pledge is linked to a firm call to action that calls upon the fund to make needed reforms and for other donor nations to share in the responsibility of saving more lives effectively and efficiently.?

Three goals

In making the $4 billion dollar pledge, the U.S. has set three goals regarding the global fund.

?First,? says Goosby, ?we need to drive needed reforms and ensure smart, effective investments are being made,? including ?clear timelines? to measure progress.

The second goal is to ?encourage other donor nations? to donate more to the fund.  ?This commitment serves as a challenge to other donors to do their share to save more lives, alleviate suffering and increase life expectancies,? he says.

Finally, Goosby says the pledge is a way of showing what he calls ?continued U.S. leadership to the ultimate measure of success ? increasing the number of lives saved.?

The U.S. global AIDS coordinator says the pledge is part of the administration?s comprehensive approach, which includes President Obama?s Global Health Initiative.  ?Ultimately this pledge will allow the global fund to do its job and do it better,? he says.

This is the first time the United States has projected its commitment over a three year period, instead of the usual one year.  ?I believe it is a smart change in the way we support the global fund,? he says, allowing the fund to project its goals over a ?three-year trajectory.?

Two billion more

Dr. Jen Cohn, HIV policy advisor for the medical aid group Doctors Without Borders, also known as MSF, says the U.S. pledge was not big enough.

?MSF is extremely disappointed and we?re also very concerned about the effects this is going to have for our patients, but also for millions of people living with HIV around the world.  Essentially, the $4 billion, although it sounds like a significant amount, does not come anywhere close to the U.S.?s share of providing the global fund with even the most austere funding projections,? she says.

Cohn says the fund needs at least $13 billion just to keep its doors open.  Many groups estimate that $20 billion is needed ?to provide additional scale-up in the coming years for countries and people living with HIV.?

She says the AIDS community had hoped the Obama administration would pledge $6 billion over three years.  Cohn says at the $20 billion level, the fund would have been able to provide treatment for seven and a half million people.  At $13 billion, she says, that figure drops by three and a half million.

Even though the U.S. pledge is much higher than that of other donors, Dr. Cohn says, ?We can only think about all these commitments in terms of what the global fund needs and in terms of what the global fund requires to function.  This isn?t meeting it at the $13 billion level.?

Doctors Without Borders says funding levels now put health-related Millennium Development Goals and universal access to treatment, care and prevention in jeopardy.

Cohn does praise U.S. efforts to combat disease, including Mr. Obama?s Global Health initiative and PEPFAR.  But she says, ?The global fund works in many more countries?is much more country driven.?

MSF and other groups say neither PEPFAR nor the global fund are being adequately funded.  ?That?s not going to result in adequate scale-up.  And that?s not going to be a scenario that results in turning the tide of HIV,? she says.

Cohn rejects the argument that donations are in keeping with the tough economic times.  ?It is such a small percentage of really what the overall budget of wealthy countries, including the U.S., is.  I don?t think that countries can really hide behind the global economic crisis.?