AIDS Alert International

Global Fund seeks improvements as costs to fight AIDS, TB, and malaria exceed funding commitment

Global Fund leaders plan for future

Less than half way into 2005, the Global Fund to Fight AIDS, Tuberculosis and Malaria is short by $950 million of the $2.3 billion needed to renew current grants and make new grants, according to Global Fund data.

"For 2006, the Global Fund is $2.6 billion short — in pledges thus far — of its target," says Anil Soni, executive director of friends of the Global Fight Against AIDS, Tuberculosis and Malaria based in Washington, DC.

The nonprofit organization advocates for increased public leadership and private action to support the Global Fund. Soni responded to an e-mail request sent by AIDS Alert to the Global Fund for an interview about the fund’s current status and the level of its U.S. support.

Should U.S. fund a third?

Global Fund backers and benefactors will meet in September to discuss strategies for establishing what they are calling a Voluntary Replenishment Mechanism.

Most of the fund’s donors will be at the meeting, which will be convened by Great Britain Prime Minister Tony Blair and chaired by United Nations Secretary General Kofi A. Annan, Soni says.

However, Japan and the United States officials have said they will not be among them, he adds.

"Significant political support is building for donors to make major new commitments at that time, hopefully setting a precedent for roughly $2 billion per year from non-U.S. donors," Soni continues.

"Advocates hope that this success will encourage the U.S. Congress to appropriate more in FY06 and encourage the [Bush] administration to include a higher mark for the Global Fund in its FY07 budget request," he adds.

President Bush’s FY06 budget contains a $300 million allocation for the Global Fund, which is a 50% increase from the president’s request in the FY05 budget, Soni says.

Nonetheless, $300 million is short of the 33% share of the Global Fund’s minimum needs for FY06, which is what is needed from the United States, he notes.

"The U.S. government should fund one-third of the Global Fund’s annual needs," Soni states. "This argument is rooted in the belief that the Global Fund represents a critical component of the U.S. strategy to fight AIDS, tuberculosis, and malaria globally."

Since the Global Fund estimates its needs for this period to be at least $3.4 billion, a 33% share from the U.S. would total roughly $1.1 billion, Soni explains. About $800 million of this total is necessary for the renewal of existing grants, he says.

The existing grants are five-year proposals that were approved by the board of the Global Fund, but which have been funded thus far on their initial two years of implementation, Soni points out.

Hope lies in the Senate

In March 2005, U.S. Sens. Richard Durbin (D-Ill) and Rick Santorum (R-Pa) sent a letter to the chairman of the Senate Budget Committee, stating their request to increase the president’s proposed budget for the Global Fund to $800 million, and the senators said they plan to introduce a budget amendment with the additional funding on the full Senate floor if their request is unanswered, according to news reports.

"We hope and expect the Congress will increase the allocation for the Global Fund," Soni says.

"The Congress has consistently appropriated more for the Global Fund than requested by the president, meeting one-third of the Global Fund’s needs for FY02, FY03, FY04, and FY05," he explains.

As world leaders prepare to meet later this year to discuss the Voluntary Replenishment Mechanism, the Global Fund has issued several reports that discuss its successes and failures and the increasing need for programs to improve health care in the developing nations most afflicted by AIDS, tuberculosis, and malaria.

Millions are living with the disease

About 6 million people die each year from the three diseases, and in 2004, an estimated 4.9 million people became newly infected with HIV, bringing the total number of people living with HIV/AIDS close to 40 million.1

In its first round of grants, the Global Fund approved giving $3.1 billion over two years to 310 programs in 127 countries, and nearly all of these countries are the locations that are experiencing the most severe burdens of disease or are at great risk for an epidemic disaster.2

"The Global Fund extends American investment in the fight against AIDS," Soni says. "In many of the next wave countries, like India, China, and Russia, more U.S. money is invested in fighting AIDS through the Global Fund than through bilateral programs."

While the United States has begun its own global AIDS initiatives, the Global Fund remains the primary vehicle for American investment in the fight against TB and malaria, Soni notes.

"TB kills 2 million people per year, and malaria kills 1 million," he notes. "Bilateral funding to fight these diseases has remained modest and does not fund commodities, such as drugs, beds, nets, etc., needed to prevent and cure them."

By contrast, the Global Fund has invested 44% of its $3.1 billion to TB and malaria programs, Soni adds.

Another argument for having the United States spend more on the Global Fund is the fact that the money the United States sends to the Global Fund has been matched by more than 2-to-1 from other donors, he says.

"As long as this dynamic continues, the Global Fund represents a tangible way for the U.S. to get other donors to do more to match its own generosity in the fight against AIDS," Soni points out.


  1. Lawson L, Marais H, Archer J, et al. HIV/AIDS, Tuberculosis and Malaria: The Status and Impact of the Three Diseases. Geneva: Global Fund to Fight AIDS, Tuberculosis and Malaria; 2005.
  2. Liden J, Low-Beer D, Archer J, et al. Investing in the Future: The Global Fund at Three Years. Geneva: Global Fund to Fight AIDS, Tuberculosis and Malaria; 2005.