African Leaders Sign Resolution Increasing Health, AIDS Spending

At Friday's closing of a two-day conference on AIDS in Abuja, Nigeria, African leaders signed a joint resolution calling for a "boost" in health care spending and "emphasizing the need for affordable drugs" for the continent's 26 million HIV-positive people, the AP/Dallas Morning News reports. The resolution calls on all 53 African nations to devote 15% of their national budgets to health care spending -- a "significant proportion" of which should be set aside specifically for HIV/AIDS. The document also calls for additional funds to be designated for AIDS education, training and research programs, but gave no timeline for reaching the new "spending target." Most African governments currently budget 5% to 7% of their funds for health care. In addition, African nations were "encouraged" to use "appropriate legislation and international trade regulations" to secure "affordable, effective" AIDS medications for those infected with HIV. Nigerian President Olusegun Obasanjo said that the agreement marked "the end of the beginning and beginning of the end" of Africa's AIDS epidemic. "For some time, we seemed to be unsure and uncertain of what to do about HIV/AIDS. I believe we have come to the end of that uncertainty with the end of this summit. We are clear in our minds of where to go and how to go," he said.

'Devil is in the Details'
Now that the declaration has been signed, it remains to be seen how African governments will proceed in fulfilling the agreement's promises. "The devil is in the details. The conference participants had very laudable goals, but let's see how well they will be able to implement them," Babar Hashmi, a Pakistani official attending the conference, said. Some observers said that the final version of the declaration signed Friday was "significantly watered down" from a preliminary version drawn up by African ministers, as the approved version lacked a proposal to import and manufacture "controversial" generic AIDS medications. Multinational pharmaceutical companies oppose generic drug importation and manufacture, practices that they say "infring[e]" on intellectual property laws. GlaxoSmithKline's Gunther Faber, vice president of operations in sub-Saharan Africa, "urged" the leaders to instead sign "cooperation agreements" with the major drug firms. Six African countries have recently agreed to deals with the multinationals for discounted AIDS drugs, but the annual price of $300 per patient companies offered for the drugs "remain[s] out of reach for most of the region" (AP/Dallas Morning News, 4/28). Other observers said that the declaration "just reached first base" in the fight against AIDS, adding that more must be done to "deal with the long term crisis" ahead. Conference participants' "emphasis was on defining the problem. The summit should have been devoted to looking at what works and what's ahead," Rev. Gideon Byamugisha, who last week publicly challenged African leaders to get tested for HIV, said. The conference and its resulting declaration did not address several large HIV/AIDS-related issues, including the 40 million AIDS orphans projected by 2010, the additional 100 million five-year estimate of new HIV infections worldwide and the CIA's recent estimate that HIV/AIDS could cause a 20% drop in some nations' gross domestic products. "It was rarely said during the summit that this is not going to be over in three or four years. Let's think of the orphans alone. They are not going to get their parents back. If there are troubles dealing with 12 million orphans, what will it be like with 40 million?" UNAIDS Executive Director Peter Piot asked (Donnelly, Boston Globe, 4/29).

Annan to Ask for Funding
Hoping to capitalize on the Abuja conference and the signing of the declaration, U.N. Secretary-General Kofi Annan will ask 2,500 officials from 686 private foundations gathered today in Philadelphia for the Council on Foundations' annual meeting to contribute to a global $7 billion to $10 billion AIDS fund. Monetary support is expected to come from charitable groups such as the Bill and Melinda Gates Foundation, but Annan's "real challenge" will be in securing increased funding from the Bush administration, Knight Ridder/Arizona Republic reports. The administration has signed on to contribute to a global AIDS fund (see story #2), but has not provided details of funding amounts, although Annan indicated that he wants "several billion dollars a year" from the United States. Administration officials "made it clear" last week that in order for them to support additional funding, they would need evidence of a "strengthened resolve" among African leaders toward battling HIV/AIDS. Annan hopes that the declaration will offer the assurance for which the administration is looking (Knight Ridder/Arizona Daily Star, 4/29).