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Africa: Global Fund Action Call
Nov 11, 2004 (041111)
(Reposted from sources cited below)
The board of the Global Fund to Fight AIDS, Tuberculosis and
Malaria is holding its first meeting to take place in Africa next
week in Arusha, Tanzania. Ironically, one of its decisions may be
to postpone announcement of a fifth round of funding, as donors led
by the United States press to reduce expectations and pressure for
future funding commitments. Activists in Africa and around the
world are calling for mobilization to demand that the Fund stick to
its original vision and continue to increase resources to fight the
As of the beginning of November, the Global Fund had received $5.7
billion in pledges for 2001 through 2208, of which $3.2 billion had
already been paid to the fund. $1.6 billion total is pledged for
2004, but only $905 million for 2005. (See
http://www.theglobalfund.org/en/funds_raised/pledges) While this
falls far short of the levels estimated to be needed, both
activists and the fund secretariat say that there are adequate
funds pledged to open applications for a new round of grants, to be
decided on in mid-2005. In any case, the need is urgent. The Fund needs to
be raising more money and scaling up operations, not cutting back.
Activists are also arguing for other measures, such as more rapid
disbursement of funds, increased involvement of people living with
AIDS in country committees, and a change in the current restrictive
policy that requires the Fund to have the total amount for a multiyear
grant in the bank before it can make an initial commitment for
This AfricaFocus Bulletin contains a press release from activist
groups in Kenya who are planning to demonstrate at the meeting in
Arusha; a call for organizational sign-ons for a letter to members
of the Global Fund board, and excerpts with background information
from the most recent issue of the Global Fund Observer. For contact
information, including where to send organizational endorsements of
the sign-on letter, see below.
++++++++++++++++++++++end editor's note+++++++++++++++++++++++
AIDS Activists to Donor Governments: Do not shut the Global Fund's
Kenya PWA Groups Announce Mobilisation at Fund's First Board
Meeting in Africa to Demand Launch of New Funding Round
November 10, 2004
Dandlora Community AIDS Support Organization (DACASA) | Kenya
Treatment Access Movement (KETAM) | Kenya Organisation of People
Living with HIV/AIDS (KOPLWA) | The Movement of Men against AIDS in
(Nairobi) AIDS activists today expressed outrage that the Global
Fund to Fight AIDS, Tuberculosis and Malaria is in danger of not
launching a new round of funding for poor countries at its upcoming
Board Meeting in Arusha, Tanzania, 18-19 November.
The Global Fund's Executive Director Richard Feachem arrived today
in Arusha for a meeting with a delegation of East African Heads of
State on the role of the Global Fund in meeting the Millennium
Donor countries have broken their promises to fully fund the Global
Fund, and will aggressively oppose the launch of a new funding
round during the upcoming Board Meeting, according to activists.
"It will be impossible for the Global Fund to aid in the
achievement of the Millennium Development Goals if the Global Fund
is bankrupt and forced to close its doors due to donor country
stinginess," said Siama Musine, Kenya Organisation of People Living
with HIV/AIDS (KOPLWA).
The Global Fund needs at least $3.5 billion in 2005 in order to pay
for the renewal of grants now reaching their 2 year anniversary,
and to finance the launch of two new funding rounds.
Donor countries are preventing the growth of the Global Fund in
2005 and delaying the launch of a scheduled Round 5 call for
proposals in November in order to relieve themselves of paying
their fair share of money to the Global Fund next year, according
to activists. "Next week in Arusha the board of the Global Fund
must agree to a new round of AIDS, TB, and malaria proposals. The
members of the board, including rich governments, must not turn
their backs on the original promise of the Global Fund to be a "war
chest" in fighting HIV/AIDS and on the millions of people who will
die without treatment. Countries are relying upon the Global Fund
to fill the funding gaps for AIDS medicines and more healthcare
workers", said Patricia Asero Ochiemg, Dandlora Community AIDS
Support Organization (DACASA), who is an adherence counselor in the
ARV clinic at Mbagathi District Hospital. Money already earmarked
for Kenya from an earlier round of funding is expected to provide
antiretroviral therapy to 4,000 people in the first 2 years and
fund the training of 1,800 health workers.
Some donor countries, particularly the U.S., have favoured their
own bilateral programs over support for the Global Fund, an
independent, evidence based, multilateral funding mechanism. The
U.S. program, PEPFAR, has come under harsh criticism for its
funding of unproven abstinence only prevention and the procurement
of more expensive brand name medicines.
"The Global Fund and its donors must not close the best chance we
have to drastically increase the number of people on
antiretrovirals", said James Kamau, Kenya Treatment Access Movement
East African HIV/AIDS treatment activists plan a public rally
outside the Arusha hotel where Board Members will be meeting, in
order to lobby the Global Fund Board to launch a new funding round
immediately. "We will be in Arusha when the Global Fund meets next
week in order to remind board members that their decisions have
life and death consequences for people directly outside their
doors. We cannot afford to have the Global Fund shut its doors to
new grant requests that could save lives and give people hope, "
said Nick Maisha, the Movement of Men against AIDS in Kenya
"As people from the grassroots, we need these drugs. We are not
ready to give up. The Global Fund and its board members must not
give up on us," said Kassim Issa, a co-founder of Kenya
Organisation of People Living with HIV/ AIDS (KOPLWA), based in the
Kibera slum, the largest slum in Africa.
For more information, contact:
Patricia Asero Ochiemg, Dandlora Community AIDS Support Org
(DACASA), Tel: +254 733-590-232
Nick Maisha, the Movement of Men against AIDS in Kenya (MMAAK), Tel
Siama Musine, Kenya Organisation of People Living with HIV/AIDS
(KOPLWA), Tel: +254 722-554-510
James Kamau, Kenya Treatment Access Movement (KETAM), Tel: +254 722
Global Fund Organizational Sign-on Letter
November 10, 2004
Please read below, and send your organizational endorsements to:
email@example.com Sorry, we are not accepting individual
endorsements at this time. This letter will keep circulating until
just before the Arusha Board Meeting starts, which means the
organizations can sign on until COB Nov 15.
Asia Russell, Health GAP
firstname.lastname@example.org; tel +1 267 475 2645
--begin Global Fund sign on letter--
To: Board Members, the Global Fund to Fight AIDS, Tuberculosis and
Malaria, and Richard Feachem, Executive Director, the Global Fund
to Fight AIDS, Tuberculosis and Malaria
We, the undersigned, write to you as supporters of the Global Fund.
The efforts of many of us were instrumental in creating the Global
Fund; the health and stability of our communities depend on the
strength and growth of the Global Fund.
As you know, when the Global Fund Board meets for its Ninth Board
Meeting November 18-19 in Arusha, Tanzania, you will face critical
policy decisions regarding Global Fund financing and governance.
Your decisions will determine whether the Global Fund's growth will
keep pace with the pandemics of HIV, tuberculosis and malaria, or
whether the Global Fund will shrink due to the broken promises of
donors who are not funding their fair share of the global fight
against AIDS, tuberculosis and malaria.
Your decisions will determine whether the Global Fund will endorse
minimum, enforceable standards for the substantial participation of
people living with HIV/AIDS in grant making and grant
implementation, or whether these and other basic expectations of
governance are rejected.
When the Global Fund was created, it also created a promise - an
end to "business as usual." The world envisioned when the Global
Fund was created would mobilize billions in additional resources,
support locally-driven responses to the three pandemics, and would
finally mount an emergency response to treatable, preventable
infectious diseases killing 16,000 people daily.
But this promise, like so many before and after it, has been
broken. UNAIDS estimates that $17 billion is needed by 2005,
increasing to $20 billion annually by 2007, to fight AIDS alone.
Yet donors are not paying their fair share. And despite successes
around the world, bureaucracies at country level are preventing
people in need in some countries from benefiting from approved
Global Fund grants.
We, the undersigned organizations call on you, Board Members and
the Secretariat to take the following urgent action at the 9th
- Support the immediate launch of Round 5, so that two Rounds of
grants may be approved in 2005, in addition to grant renewals;
- Fully finance the Global Fund, for 2005 and into the future,
through a framework of equitable contributions, based on the demand
of countries in need, not artificial calculations of what donors
choose to supply;
- Change the recommendations approved during the 8th Board Meeting
for civil society participation in Country Coordinating Mechanisms
(CCMs) to requirements; and
- Address significant bottlenecks in grant disbursement as
emergencies that must be addressed by relevant parties. We cannot
tolerate avoidable delays in disbursement of life-saving resources.
The fate of millions around the world is in your hands. We look
forward to your response to this urgent request; we will be
monitoring the decisions of all Board Members closely.
<list in formation>
Global Fund Observer (GFO) Newsletter, a service of Aidspan.
Issue 34 - Monday 8 November 2004.
[The GFO Newsletter is an independent source of news, analysis and
commentary about the Global Fund to Fight AIDS, TB and Malaria
(http://www.theglobalfund.org). Aidspan and the Global Fund have
no formal connection, and Aidspan accepts no grants or fees from
the Global Fund. The Global Fund bears no responsibility for the
content of GFO or of any other Aidspan publication.
For formatted web, Word and PDF versions of this and other issues,
see http://www.aidspan.org/gfo/archives/newsletter ]
1. NEWS: Global Fund Encounters Criticism in Washington, DC by
Esther Kaplan, GFO Contributing Editor
The US Capitol Hill briefing in late September started out as a
routine event - a discussion of what to do about the portion of the
United States' 2004 allocation to the Global Fund that hadn't been
matched, two-to-one, by other donors. But the briefing of Senate
staffers by US administration officials quickly turned into an
indictment of the Global Fund for everything from having poor
financial management to supporting rogue states. The meeting
nearly sparked one Senator to introduce legislation slashing the
United States' 2005 contribution by $150 million, and it spurred
Global Fund operations chief Brad Herbert to fly to the US Capitol
for three days of damage control. The flurry of criticism may
still have an impact on the United States' 2005 contribution to the
Fund, likely to be finalized later this month.
The September 21 briefing for more than half a dozen Democratic and
Republican Senate staffers was led by Bill Steiger (who directs the
Office of Global Health Affairs in the department of Health and
Human Services (HHS), is a senior advisor to HHS Secretary and GF
Chair Tommy Thompson, and has long been a senior member of the US
board delegation to the Fund), Pam Pearson (of the office of the
Global AIDS Coordinator, which runs the President's Emergency Plan
for AIDS Relief (PEPFAR)), and other administration officials.
Steiger, whom the journal Science describes as "a political
appointee with close ties to the Bush family," often comes across
as skeptical of multilateral organizations; last spring, he
instituted a policy that US government scientists must submit
paperwork for foreign travel approval to meet with any UN
organization - even if its office is just across town.
At the briefing, Steiger and the other administration officials
raised significant concerns about the Global Fund's performance,
including slow disbursements, inadequate staffing at the
Secretariat, insufficient strength to manage a Round 5, and
irresponsible disbursements to corrupt or repressive states.
(Steiger and Pearson did not respond to GFO requests for comment.)
What started out as an update on the Fund turned into a laundry
list of complaints.
Facing this flurry of criticism, the Fund Secretariat responded
decisively. Feachem sent a 10-page letter to Senate staffers
responding to the issues raised at the September 21 briefing, and
the Fund's Herbert flew to Washington on September 29 for meetings
with Senators, Senate staffers, and administration officials.
Advocates close to these developments said that efforts by the
Secretariat to smooth the feathers ruffled by the September
briefing went well, and that people on Capitol Hill and in the
administration were appreciative of Herbert's whirlwind of
Looking back on the meetings, Herbert told GFO, "I was expecting
the worst, that it would all be political, but it wasn't. The
meetings played out as frank exchanges and I really enjoyed them.
I was talking with concerned staffers who had done their homework.
Every question they asked was legitimate, and they were questions
we should be answering on a more regular basis." As an
illustration of the cooperative attitude, he pointed to the fact
that his meetings with members of Congress were facilitated by
Scott Evertz and other AIDS staffers in Secretary Thompson's
office. "That demonstrates the confidence they have in us," he
But several Washington-based advocates for the Fund feel that the
climate in Washington has deteriorated. "I saw that briefing as a
shift in administration tactics," said Paul Zeitz of the Global
AIDS Alliance, who attributes the shift in part to the beating that
PEPFAR took at the Bangkok AIDS conference, and the perception that
the Fund didn't adequately defend the US program. "For the first
time, the administration was aggressively trying to undermine the
Fund. And that has a ripple effect, because it sends a political
The House and Senate will reconvene on November 15 to work out
discrepancies between their numbers for the US contribution to the
Fund in 2005 - $250 million on the Senate side and $400 million on
the House side in the Foreign Operations bill, an additional $150
million on the Senate side and $100 million on the House side in
Labor and Health appropriations, and a possible additional $150
million in emergency spending on the Senate side. It is difficult
to predict the impact that the return to office of President Bush
and the strengthened position of Republicans on Capitol Hill will
have on US contributions to the Fund, given that the Fund has
supporters on both side of the aisle. But it looks unlikely that
the Fund will get more than the $547 million it was promised
(subject to some matching requirements) for 2004, and it might get
2. ANALYSIS: Topics for Discussion at the Forthcoming Board Meeting
Round 5 was the other issue on which the Partnership Forum [a 400-
person informal advisory body to the Global Fund that met in July;
see http://www.theglobalfund.org/en/about/forum] had strong views.
The Forum report says that "a large majority of delegates called
for the Global Fund to launch Round 5 in November 2004 or early in
2005." And the Forum recommended that a board committee make a
decision regarding Round 5, "soon enough to allow possible
announcement at the November 2004 Board Meeting."
In June, the board asked the Secretariat to begin preparations for
Round 5, in order to make it possible for a decision to be made at
next week's board meeting regarding when Round 5 might take place.
[GFO adds: The US delegation has strong views on the timing of
Round 5 that conflict with those of the Partnership Forum and the
Global Fund Secretariat. The delegation has sent a memo to some
board members as follows:
"The United States opposes a launching of Round Five at the Arusha
board meeting. This is a position we hold with great regret; we
support a strong and robust Global Fund, and would have wished to
be in a position to support a strong new Round at this point in
time. However, given its current level of performance, we do
not believe the Fund currently has the capacity to support another
round of grants. While a few grants have performed well or even
exceeded expectations, far too many grants are in trouble
"We believe that in 2005 the Global Fund should focus on
consolidating its work and [that it] will be in a better position
to provide support for a new Round at the end of 2005. In addition
the Fund regrettably does not have the financial means to launch a
Fifth Round at this time
"We remain committed to finding additional sources of funding,
particularly from the private sector and government donors that
have never pledged to the Global Fund, that will allow us to move
forward; but we believe that it would be an irresponsible move to
raise the hopes of potential recipients by generating a round
of grant writing that drains scarce resources, without any
certainty that we will have the funds to approve a single grant at
the July 2005 Board meeting."
Asia Russell of Health GAP, who will attend the board meeting as a
member of the Developed Countries NGO delegation, responded, "The
reason the US does not want a new funding round launched is because
they know it would increase pressure on them to contribute their
fair share to fully fund that round."
3. Commentary: It's Time to Soften the Comprehensive Funding
Policy by Bernard Rivers
The Global Fund board looks all set for a difficult discussion
about Round 5 next week. What are the factors?
First, precedent: Until the last board meeting, the Fund has always
launched a new round of grants every second board meeting - that
is, every eight months. According to that schedule, the board
should have agreed in June to launch Round 5 two months ago. If,
at next week's meeting, the board delays Round 5 until some
unspecified future time, it will anger many, particularly the 52
countries that the board encouraged to improve and resubmit their
Round 4 proposals in the next Round. (Those proposals alone had a
2-year value of $980 m.)
Second, capacity: As quoted in this issue of GFO, the US says "We
do not believe the Fund currently has the capacity to support
another round of grants", yet Brad Herbert, the Fund's Chief of
Operations, says "It's a board decision when and how we initiate a
Round 5. But the Secretariat will have no problem implementing
it". And in July, Richard Feachem told GFO, "One of the strongest
messages to emerge at the Partnership Forum was the urgent need to
launch Round 5 immediately following the board meeting in Arusha in
November. While recognizing the need for financial prudence, I
fully support this call."
Third, money: The Fund calculates that if pledges for 2005 are
approximately what they will be for 2004, there will be about $400
m. available for Round 5 grants next year (significantly less than
the Round 4 cost of about $1,000 m.). That's true. But a
continuation of those assumptions into 2006 shows that the Fund
will then be $1,100 m. short of cash in 2006, because the cost of
renewing Round 1-4 grants really escalates that year.
However, all this assumes that the Fund continues to follow its
current financial rules, known as the Comprehensive Funding Policy.
This policy says that before a 2-year (Phase 1) or a 3-year (Phase
2) grant agreement is signed, the Fund must put the entire cost in
the bank, and that money cannot be used for any other purpose. The
money then sits idle for up to 3.5 years.
The Comprehensive Funding Policy is a conservative approach that
was perfectly appropriate when the Fund was new. But the Fund is
now approaching its third birthday, and it's now both possible and
appropriate to soften the policy. ...
[Bernard Rivers (email@example.com) is Executive Director of
Aidspan and Editor of its GFO. He will attend the Global Fund
board meeting next week as an observer.]
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with
a particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.
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