Richard Feachem, who has led the Global Fund
since it was set up in 2002, said its annual scramble for donor funds was a
strain on the 131 countries dependent on the aid for drug treatments and other
They (recipient countries) are putting hundreds
of thousands of people on antiretroviral therapy on a financial promise that is
not secure, he told Reuters in an interview.
If the Global Fund were to renege on that promise
because the financing is not available, the recipient countries simply could not
buy the resources to meet the shortfall.
About half the 4.9 billion the fund has committed so
far -- mainly in sub-Saharan Africa -- has been used to buy otherwise
inaccessible drugs and equipment to extend the lives of people with HIV and
AIDS, treat and prevent malaria, and stop the spread of tuberculosis.
Together, they kill about 6 million people a year.
Feachem, a doctor and international health professor,
said any interruption of antiretroviral drug therapy could lead to death and
drug resistance among already vulnerable communities.
Poor countries like
would be unable to keep distributing expensive malaria and tuberculosis drugs
if Global Fund money was to disappear, he said, adding malaria could quickly
flare up again if mosquito spraying and distribution of bed nets were stopped.
We have entered into a moral commitment and an
ethical commitment that we have never entered into before, and we are beginning
to confront the implications of that, Feachem said
OPTIMISM AND GOOD INTENTIONS
The Global Fund has become the largest international
financier of efforts to control malaria and tuberculosis and is among the top
three funders of AIDS programmes, making up 20 percent of international
It has gathered nearly 9 billion in pledges but
remains far short of funds needed to meet United Nations targets on anti-HIV
drug treatment, malaria survival and tuberculosis control.
Feachem said donors should commit a clear portion of
their annual development assistance to the fund, because our recipients
need long-term security and finance. The Global Fund's board of directors
are due to agree new grants for 2006 at an April 27-28 meeting, even though
donors have not yet pledged the 1 billion needed. Without new cash, advocates
like the U.S.-based Global AIDS Alliance, have warned the fund may have to
postpone grant making this year.
Feachem said there were few signs that the recent focus
on avian flu had distracted donor funds from current epidemics.
It's not a competition between my pandemic and
your pandemic, he said. We have seen no evidence of that.
Instead, he said efforts to detect, monitor and contain
avian flu outbreaks could help abate other crises by better linking scientists,
health experts and governments.
More health professionals, better equipment, improved
hospitals and better access to labs and testing facilities in remote areas could
also have enduring public health impacts, whether or not a viral pandemic
emerges immediately, he said.
It all builds public health infrastructure, which
will always be used for what the challenge of the moment is, he said.
It very much helps us.