weighing it out

AIDS, malaria and tuberculosis kill over six million people worldwide each year, most of them in poor countries with limited resources (Smallman). AIDS in particular can devastate poor communities by killing mostly adults (over 3 million in 2002, and rising), which leaves many orphans and overburdening social structures. In developed countries public health systems usually have the infrastructure and funding to treat those suffering from like diseases, and to operate prevention strategies (e.g. the USA has allocated $17.5 billion for Fiscal Year 2005 for domestic programs against HIV/AIDS) (Drotman). Yet in the developing world such help is often either unavailable or unaffordable, and even in richer countries, able to pay for courses of antiretroviral drugs for HIV/AIDS costing thousands of dollars a year, there is still no vaccine against HIV. To address these challenges the Global Fund to Fight AIDS, Tuberculosis and Malaria was set up in 2002. Although independent of other international bodies such as the United Nations, it works closely with the World Health Organization and UNAIDS to deliver programs in over a hundred countries worldwide. To date (October 2005) the Global Fund has spent over $1.5 billion on programs which are treating an extra 220 000 people suffering from AIDS, as well as over 1 million people with malaria and 600 000 with tuberculosis. It is now seeking $7.1 billion to fund programs through to 2007. This money comes from donor states as well as private business and charities. (Drotman).

PROS: The Global Fund needs money to ensure it can do its essential work in combating three of the world's most deadly diseases. The USA is by far the world's biggest economy and it should do more to pay its share of the Global Fund's funding needs. The Fund needs $7.1 billion for fund projects in 2006-07, but after its September 2005 funding conference it is $3.4 billion short. The USA has yet to commit itself to contribute to the Fund for 2006, but the sums being talked of in Washington ($300m from the Bush Administration, $600m from the Senate) are far short of the $1.2 Billion that activists believe the US should provide. It is also important that US leadership continues on this issue, in order to inspire confidence in other donors and to encourage them to match its contributions with their own funding. Without greater US commitment the work of the Fund will inevitably suffer and the millions whose health and survival depend on its projects will be denied help (Denoon).

CONS: The USA has a fine record of supporting the Global Fund's work - it has provided nearly one-third of the Fund's money to date and is by far the largest single donor. And the money provided to the Global Fund should be seen in a wider context of the $15bn that the Administration has said it will spend on international programs to fight HIV/AIDS over a five year period. While the USA should continue to support the Global Fund as it has in the past, it would be inappropriate to greatly increase its level of funding. Apart from the need for the Administration and Congress to balance US priorities, it is not healthy for the Global Fund to be over-reliant on one particular donor. It is time for other countries to pull their weight in the struggle against these diseases - for example, countries such as Canada and many oil-rich states have yet to commit any funds for 2006-07 (Denoon).