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Date: Mon, 22 Jul 2002 21:45:13 -0500
From: Africa Action <[log in to unmask]>
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Subject: Africa: Global Fund Update

Africa: Global Fund Update
Date distributed (ymd): 020722
Document reposted by Africa Action

Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africaaction.org

+++++++++++++++++++++Document Profile+++++++++++++++++++++

Region: Continent-Wide
Issue Areas: +economy/development+ +health+

SUMMARY CONTENTS:

This posting contains a speech by Dr. Richard Feachem, who took up
his post as the new Executive Director of the Global Fund to Fight
AIDS, Tuberculosis and Malaria on July 15, as well as a related
article by Bernard Rivers of Aidspan from the on-line magazine of
the Barcelona AIDS conference.

Particularly significant at the conference were the wide
consensus that
(1) there is an urgent need for treatment as well as prevention,
worldwide, and
(2) in practice rich countries still lack the political will to
mobilize sufficient resources to meet these needs.

Other related material can be found at the web sites below.

Aidspan
http://www.aidspan.org

Break the Silence Discussion
http://www.hdnet.org

Barcelona Conference
http://www.aids2002.com.

Global Fund
http://www.globalfundatm.org

For more background documents and links see the archive of recent
postings by Africa Action at
 http://www.africaaction.org/docs02/chr02.htm
and Africa Action's Africa's Right to Health campaign page
at http://www.africaaction.org/action/campaign.htm

Note that the Global Fund site has guidelines and application
information for the second round of proposal submissions.

+++++++++++++++++end profile++++++++++++++++++++++++++++++

Speech:

Dr. Richard Feachem
Executive Director
Global Fund to Fight AIDS, Tuberculosis and Malaria

At the XIV International AIDS Conference, Barcelona
Senior Lecture, 9 July 2002

I am Richard Feachem and I'm really really glad to be here.
(Applause)

I was in Durban and many of you were in Durban also. In Durban we
had no global fund. Now we have a global fund.

The Global Fund as you know has already committed 1.6 billion
dollars to 40 programs in 31 countries. And over 60 percent of
these monies are going to HIV/AIDS. These commitments will double
the current number of people receiving HAART in the developing
world and in Africa HAART recipients will increase six fold as a
result of these commitments. This is nothing like enough.
(Applause)

But it is a start and we commit to do much much more. (Audience: So
do we!) Good! The second round of proposals was launched on July
the second, less than six months after the birth of the Global
Fund. The Global Fund is committed and I am committed and you are
committed to raising many billions of dollars of additional
resources, and getting these funds to those on the frontlines who
are really making a difference.

Now I want to put credit where credit is due and I want to thank
everyone in this room. I want to thank everyone in Barcelona but
not in this room with us now. And I want to thank the thousands of
people who are working around the world fighting HIV/AIDS who have
not been able to come to Barcelona. The Global Fund is your
achievement. You have lobbied. You have fought. You have advocated.
You have analyzed. And you have shaken the world into recognizing
the magnitude of this crisis. Out of that, together with the
leadership of Kofi Annan and the backing of the G8 you have made it
happen and you have made the difference. I want to recognize that
very clearly here today. (Applause)

Let me make it absolutely clear that the Global Fund needs a
massive increase in resources, and it needs it quickly. (Applause)
I am well aware of the calculations that have been made concerning
the magnitude of the resources that we require. Estimates come from
the Commission on Macroeconomics and Health and I was a member of
that commission. Estimates have come from Schwartlaender and
Bertozzi and other experts.  I am familiar with those individuals
and those estimates. Kofi Annan on the basis of sound advice, has
called for a scaling up of the level of investments in HIV/ AIDS to
the 8 to 10 billion dollars per year mark. The Global Fund also has
to invest in tuberculosis and malaria. (Applause)

Following the October meeting of the board of the Global Fund, that
will be our third board meeting, we will be publishing and widely
disseminating the Global Fund's financial projection estimates of
resources needed and rates of expenditure over the next several
years. We will invite your critique and comments on those when they
are published later in October. I feel sure that you will not be
bashful in expressing your opinions to us, on those numbers. We
will also be calling on you to ensure that the resources are indeed
made available and that the expenditures are put to good use
quickly.

Let me now turn to the subject of prevention and treatment. The
Global Fund is committed to prevention and treatment. The board of
the Global Fund is committed to prevention and treatment. And I am
committed to prevention and treatment. Our financing decisions so
far confirm this commitment.

I have been asked repeatedly at this conference about cost
effectiveness and the implications of recently published
cost-effectiveness analyses. Cost-effectiveness analyses can be
well used and it can be stupidly used. Let me tell you a fairy
tale. I was driving across Uganda with an economist, as one does.
(Laughter) We came upon a horrendous traffic accident. A school bus
had collided with a truck. Children were lying all over the road.
Some were dead. Some were dying. Others were seriously injured. I
said "hurry hurry let us call for ambulances and get these children
to hospital quickly. Many of them maybe saved." The economist said,
"No! Let us drive on to Kampala, to discuss seatbelt legislation
with the government. It's more cost effective." The Global Fund
will not be calling on that economist. (Applause)

Before Durban, there was genuine economic and clinical uncertainty
about ARV therapy and its widespread application. Now we have the
tools and the tools are affordable. We have achieved an
intellectual consensus. The Global Fund working with WHO, with
UNAIDS and many other partners including many organizations
represented in this room today, has the task of translating this
intellectual consensus into a practical reality. A practical
reality bringing hope and life to millions of people throughout the
world.

Let me turn now to NGOs. There is no country with which I am
familiar where the public infrastructure alone can mount an
adequate response to HIV/AIDS, tuberculosis or malaria. It just
cannot be done. In all countries we need to mobilize and empower
the non-government actors alongside the government actors,
alongside the public infrastructure. These non-government actors
come in many different colors and flavors. Many different shapes
and sizes. They include international NGOs, local NGOs, faith-based
organizations, and the private sector ranging from large corporates
who can do so much more to show leadership by providing effective
services to their workforces and the families of their workforces.
Right through to small traders and little shops as you find in
every village in every community who sell drugs, who sell condoms,
who sell bednets, who sell other products relevant to the task that
we collectively face.  All these actors must be mobilized and the
Global Fund expects to invest across the whole spectrum of
significant frontline actors.

I was at this point going to show some slides to provide some more
factual detail about the Global Fund so far and the Global Fund
over the next few months. In deference to my friend and colleague
Dr. Gro Harlem Brundtland, and the fact that we are running a bit
late, in this session, I won't show those slides but I would invite
you all to come to the symposium at 4.30 where I and others are
speaking and where those slides will be shown and where we can have
more of an interaction about the work of the Global Fund.

I want to conclude by making a number of commitments which you
should hold me to, and also seeking your help and assistance:

I commit to maximizing resources that flow into the Global Fund.

I commit to ensuring that the expenditures to the Global Fund go
quickly to those on the frontlines who can use them and make a real
difference in people's lives.

I commit to accountability. The resources with which we are
entrusted must not be lost, diverted, stolen or in any way
misspent.

I commit to results. We will measure with your help process
indicators. We will measure outcome indicators. And we will
allocate resources where they can do the most for the most number
of people.

I commit to balance across the three diseases with which we are
mandated. No doubt HIV/AIDS will continue to take the lions share,
and rightly so. But we will also invest in malaria and
tuberculosis, and we will not turn our backs on the communities
that suffer terribly from these diseases, also. (Applause)

I commit to geographical balance. We will invest in those parts of
the world already devastated by HIV and we will also invest in
countries which have high vulnerability but where it is not too
late to prevent a disaster from unfolding.

I commit to balance in the interventions that we support. We will
fund prevention. Lots and lots of prevention. We will fund
treatment. Lots and lots of treatment. (Applause) Treatment for
malaria. Treatment for tuberculosis. And treatment for HIV/AIDS.
(Applause)

And finally I call on your help. The Global Fund is a financing
mechanism. I anticipate that the total number of people that it
employs will rise to no more than 50. In a short period of time we
expect to be disbursing several billions of dollars per year. This
will be a world record in bureaucratic efficiency and the lightness
of the bureaucratic touch. (Laughter) I think the Guinness book of
records will have to invent some new category to capture this. This
is only possible if our partners work with us on every aspect of
what we are all trying to achieve. We need our partners to ensure
that funds flow into the Global Fund. We need our partners to
ensure that the best possible applications are received from
countries and communities in greatest need. We need our partners to
ensure that funds are well spent and have the maximum impact on
people's lives. We need our partners to conduct the operational
research which will improve subsequent investments. And we need our
partners to independently and robustly measure the impacts and the
outcomes in order that we may know what we are achieving and
allocate our funds accordingly.

As the Global Fund goes forward, together with all of you here, we
tread into the unknown and into the darkness. No one has gone where
we are going. The only light is the light of our imaginations. The
only vehicle is the vehicle of our commitment and our vision. And
the only trail is the trail that we will break. Together we will do
this. Together we will make a difference. Together we will change
the world.

Thank you very much.

****************************************************


New Goals for Global Fund (10 July 2002)

Wealthy nations must give at least $9 billion for AIDS,
tuberculosis and malaria in 2003, according to a panel yesterday of
four leading global health policymakers.

Peter Piot of UNAIDS, Richard Feachem of the Global Fund, Jeffrey
Sachs of Columbia University, and Stephen Lewis, the UN
Secretary-General's Special Envoy on AIDS, addressed the Conference
together as the first step towards a possible global consensus on
essential health spending.

According to Jeffrey Sachs, Chairman of the WHO's Commission on
Macroeconomics and Health, $5.5 billion of the required sum should
go to the Global Fund to Fight AIDS, Tuberculosis and Malaria -
nearly three times the sum that was pledged to the Fund during
2002.

The United States should provide about $3.5 billion of the total -
$2.5 billion for the Global Fund and $1 billion in bilateral aid,
he said. These sums do not include the amounts that will be spent
by the governments and people of affected countries.

During the meeting, it was also proposed that three plans should be
developed over the next few months.  The Global Fund will develop
over the next 90 days a plan for how much it needs to raise and
spend each year. UNAIDS and WHO should simultaneously develop a
related but separate plan, showing total needs from all sources,
not just from the Global Fund.  And the U.S. government should
develop a plan, based in part on the other two, spelling out how
much and in what ways the U.S. would contribute.

Earlier in the day, Dr. Richard Feachem, in his first speech as the
newly-appointed head of the Global Fund, announced the development
of the Global Fund's financial plan.  It will be drafted over the
next three months, for review and approved by the board at its
October meeting.  As a result, the Fund would for the first time
have public goals regarding its fundraising for the coming years.

Speaking to an appreciative audience, Feachem said "The Global Fund
is committed and I am committed and you are committed to raising
many billions of dollars of additional resources, and getting these
funds to those on the frontlines who are really making a
difference.  The Global Fund needs a massive increase in resources,
and it needs it quickly."

Discussing accountability, he said "The resources with which we are
entrusted must not be lost, diverted, stolen or in any way
misspent."

Feachem extended a friendly arm to the audience, saying "Together
we will do this. Together we will make a difference. Together we
will change the world."  He also acknowledged the importance of
NGOs, saying that he couldn't think of a single country where the
government alone could mount an adequate response to the three
diseases.  "It just cannot be done. In all countries, we need to
mobilize and empower the non-government actors alongside the
government actors."

Discussing recent studies in which the cost effectiveness of
various forms of intervention are compared, he told a "fairy tale"
of driving in Uganda with an economist and coming upon a horrendous
road accident involving a school bus.   "I said 'Hurry, hurry, let
us call for ambulances and get these children to hospital quickly!'
The economist said, 'No! Let us drive on to Kampala, to discuss
seatbelt legislation with the government. It's more cost
effective.'"  To chuckles, Dr. Feachem added "The Global Fund will
not be calling on that economist."

In an interview with AIDS 2002 Today, Dr. Feachem said "whether our
fundraising goal is $5 billion, $6 billion, or $7 billion, we know
we haven't got anything close to that right now, so we need a lot
more money."

He said that the funds will be sought not only from governments,
but also from corporations, adding that when the Fund was started,
corporate contributions had been promised, but "they haven't been
forthcoming." Foundations will be encouraged to act in ways that
are synergistic to what the Fund is doing - for instance, by
supporting the provision of technical assistance to groups that are
seeking Global Fund grants.

Dr. Feachem confirmed that 45% of the funds approved by the Fund in
its first round of grants are for products and commodities,
including essential medicines such as antiretrovirals.  When asked
whether the Fund would create - or develop links with - a bulk
procurement facility, he said that that is one of several options
being studied by a Procurement Working Group, for report to the
October board meeting.  He added that it's "certainly not, to me,
beyond the pale" for a bulk procurement facility, if created, also
to operate on behalf of others who have access to non-Global Fund
money.

Concluding the interview, he said "What is most exciting about the
Global Fund is that it is, unquestionably, the most important
initiative in global health in my professional lifetime.  It is an
entirely new structure to transfer resources from those who have
them to those who need them.  The future of investment in global
health rides on its success.  And I think to a considerable degree,
future attitudes towards official development assistance, and
towards ways of transferring resources from the North to the South,
rest on its success."

************************************************************
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