Global Fund Will Need $1 Billion ‘Very Soon,’ Executive Director Feachem Tells House Appropriations Subcommittee

Richard Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, yesterday told the House Appropriations foreign operations subcommittee that the fund only has about $300 million "on hand" and will likely need "five times" that amount "very soon" to support projects, the Washington Post reports (Brown, Washington Post, 5/8). A 51-page General Accounting Office report released yesterday found that the fund's biggest problem was a lack of resources. The Global Fund has about $250 million in pledges available to apply toward round three grants this year, leaving an estimated 2003 shortfall of $1.4 billion, and although another $500 million in pledges is available next year for rounds four and five, the fund estimates a 2004 shortfall of $3.3 billion. The report, requested by Rep. Jim Kolbe (R-Ariz.), states, "Pledges made for this year are insufficient to cover more than a small number of additional grants" and "without significant new pledges" the Global Fund -- which so far has committed grants to 153 projects in 92 countries -- would not be able to complete projects it has already begun (Kaiser Daily HIV/AIDS Report, 5/7). Despite the funding shortfalls, Feachem told the committee that the Global Fund was "already doing some good" with the money it has received thus far, according to Reuters. He added, "Large scale reductions in disease will take time, but soon we will be able to show increasing numbers of people receiving effective prevention and treatment services" (Fox, Reuters, 5/7). Overall, the GAO report lauded the Global Fund's efforts to assure that its grants are quickly disbursed and effectively used.

Fund Contributions
Feachem said that approximately 37% of pledges to the fund through 2004 are expected to come from the United States, according to the AP/Las Vegas Sun (Abrams, AP/Las Vegas Sun, 5/7). Last week, the House approved 375-41 an international AIDS bill (HR 1298), sponsored by Rep. Henry Hyde (R-Ill.), that would authorize $3 billion a year for five years to go to HIV/AIDS programs in Africa and the Caribbean, with up to $1 billion in fiscal year 2004 going to the Global Fund (Kaiser Daily HIV/AIDS Report, 5/7). In addition, the bill would establish a new federal task force to act as a shadow for the Global Fund as part of an effort to allay fears among many Republicans that the fund is inefficient (Kaiser Daily HIV/AIDS Report, 5/5). The bill is still up for debate in the Senate, and Congress then must complete the appropriations process (Kaiser Daily HIV/AIDS Report, 5/7). Kolbe, chair of the subcommittee, said that while his panel supports President Bush's HIV/AIDS initiative, which HR 1298 is meant to implement, "we are aware of the vulnerability of any organization awarding large sums of money in countries that are poorly governed and often corrupt" (AP/Las Vegas Sun, 5/7). HHS Secretary Tommy Thompson, who chairs the Global Fund, told the subcommittee that he and Feachem were pursuing other contributors, Reuters reports (Reuters, 5/7). Thompson and Feachem are scheduled to travel to Brussels, Stockholm and Berlin later this spring to "talk about resources, among other things," Feachem said. Feachem also told the subcommittee that he will ask the G8 countries for increased pledges at its upcoming meeting and will do the same at a meeting of all Global Fund donors, including nongovernmental organizations and individuals, scheduled for July in Paris (Washington Post, 5/8). Feachem said, "We are pursuing the private sector through a number of avenues and we are knocking on the doors of new public money, including the European Development Fund and the U.K.'s International Finance Facility." He added, "In the short term, the major donors, particularly the G8, will surely be responsible for most of the cost. Other donors need to step forward and they are stepping forward" (Reuters, 5/7). Thompson said, "The president and I are committed to making the fund work" (AP/Las Vegas Sun, 5/7).

A kaisernetwork.org HealthCast of the subcommittee hearing will be available online by noon ET today.