The Global Fund to Fight AIDS, Tuberculosis and Malaria is the most important and effective financial facility addressing AIDS. It has saved and prolonged millions of lives. Yet at this precise moment when the global community should be doing all it can to support the Fund, it is under the most serious assault it has endured in its ten-year history.
In November, the Fund cancelled its call for applications for new proposals to scale up AIDS, TB and malaria programs. It’s hard to find the words to characterize what the cancellation of this new round of funding will mean. Quite simply, people will die in large numbers. Consider this: we put 1,350,000 people living with HIV on treatment in 2010. But in the same year, there were 2,700,000 new HIV infections, exactly double the number of people initiated on treatment. It’s appalling that such numbers continue to haunt us; but it’s heart-breaking beyond endurance to contemplate further exponential agony as a result of funding shortages. The Fund will attempt to sustain the programs presently in place, but the opportunity to enroll others who need treatment—and that number is 7.6 million—will be lost. It’s the latest blow in a long list of betrayals on the part of donor countries, in this instance the U.S. and the Europeans.
In a speech I gave in November, I addressed the Global Fund predicament by talking of the moral implications of a decision that donor countries know will result in death on the African continent.
I asked: “Do they regard Africans themselves as casually expendable? Is it because the women and children of Africa are not comparable in the eyes of western governments to the women and children of Europe and North America? Is it because defense budgets are more worthy of protection in an economic downturn than millions of human beings?”
These are not phrased as rhetorical questions. I mean each and every one of them.
Everyone knows that when it comes to financing wars, or bailing out the banks, or bailing out Greece, or reinstituting corporate bonuses, or even responding to natural disasters that threaten economies, there’s always enough money. We’re drowning in crocodile tears. It’s not a matter of the financial crisis; it’s a matter of human priorities. We have a right to ask the G8: What do you sanctify as governments—profits and greed or global public health?
That’s especially true in the case of the United States, which pledged $4 billion to the Global Fund over three years, 2011-2013. That’s just $1.3 billion a year. Even then, for 2011 and 2012 Congress has flat-lined support for the Fund at $1.05 billion and the U.S. is not on track to deliver on its pledge. In fact, over the three years, the U.S. is likely to be nearly a $1 billion short of its commitment (a commitment solemnly made by Eric Goosby, head of PEPFAR, at the Global Fund replenishment conference in October, 2010—so much for promises). The loss of that billion is the primary cause of the cancellation of the next round of grants.
But money to do battle against HIV/AIDS is one of those rare non-partisan issues in Congress. In my respectful submission, President Obama should put his moral authority on the line and ask Congress to not only deliver on the $4 billion that was promised, but increase it to $6 billion, which American AIDS groups said was the U.S. government’s fair share back in 2010.
Is the extra $2 billion dollars outrageous? The economist Jeffrey Sachs has answered that question. He points out that the United States defense budget amounts to $1.9 billion a day. In other words, we’re asking that the global fight against AIDS, TB and malaria receive an additional amount over three years equal to American military spending in one day.
Europeans also need to step up. Germany has flat-lined its support, while others, such as the Netherlands, reduced it and Italy, Spain, Belgium, and Ireland cut theirs altogether. It’s incredible that so many countries should default on their commitments at exactly the moment when we know what to do to defeat AIDS.
The modern world’s economy was built, to significant extent, on Africa’s human and natural resources, and it depends on them to this day. Western donors are not engaged in some kind of financial philanthropy: we owe Africa what we give to Africa. The donor countries to the Global Fund, having ransacked the continent for 600 years, have no right to withdraw. They must be confronted. We need African leaders to show their muscle and to demand that the Global Fund be restored to its intended level. We also need civil society groups to mobilize quickly and stand up to reckless governments who dare to decide whether Africans will live or die.
It’s time for a high-level crisis meeting, spearheaded by African leaders, to raise the money the Global Fund needs. The world’s financial and political leaders should also make the Global Fund’s funding shortfalls as much a priority when they meet at the World Economic Forum next week in Davos as they do the state of donors’ economies. We cannot stand by and allow people to die, in huge numbers, unnecessarily.
This blog post is based on a speech delivered by Stephen Lewis at the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), in Addis Ababa, Ethiopia, on December 6, 2011.