Something funny happened on the way to establishing U.N. Secretary-General
Kofi Annan's proposed Global Fund to fight HIV/AIDS: The community
of nations forgot to bring their wallets.
The goal of the special session
on HIV/AIDS in late June was two-fold: to adopt a U.N. Declaration
of Commitment, setting specific goals for an increased response,
and to inaugurate a fund of at least $7 billion to pay the bills.
"Money is needed for education and awareness campaigns for HIV tests,
for condoms, for drugs, for scientific research, to provide care
for orphans, and of course to improve our health care systems,"
Annan said, announcing the fund in Abuja, Nigeria in April. "$7
billion sounds like a lot--and it is a lot."
In the end, "a lot" may have been too much. Before the session
began, the Bush
administration ponied up the first pledge, for an underwhelming $200
million. The United States also sent Secretary of State Colin Powell
to the conference--along with Secretary of Health and Human Services
Tommy Thompson, who kept a low profile--to vaguely suggest that there
may be more to follow: "More will come from the United States as we
learn where our support can be most effective," Powell said.
George W. Bush plays host
Kofi Annan in the Oval Office.
After the United States anted up, France and Britain dutifully
made their commitments, and the Bill and Melinda Gates Foundation
kicked in $100 million. More pledges came from the usual suspects
like Canada ($73 million) and Norway ($110 million, or the more
impressive-sounding 1 billion kroner). Uganda chipped in a symbolic
$2 million, but in general the fund is expected to work on the Robin
Hood system: Money will come from rich nations to be distributed
among needy countries in the developing world. More donations are
expected in the months to come, but by the end of the session Annan
seemed like the beleaguered host of a TV telethon, waiting hopelessly
for pledges as the hours dragged on.
The final tally: $644 million pledged to the Global Fund as of
the end of June. The fact that only a small fraction of the hoped
for amount could be cobbled together led to some rhetorical dancing
around the $7 billion figure; U.N. spokesmen now suggested that
the amount represents what is needed for the worldwide AIDS response,
of which the fund is to be the cornerstone.
The hesitancy of member nations to kick in may stem from the many
issues still up in the air regarding the exact purpose and organization
of the fund. Not yet decided is who exactly will administer it--thus
far it is envisioned as a private financial entity housed under
the World Bank--or what the application process will be for the
distribution of its funds. There will be a "nimble secretariat"
to actually receive applications and cut the checks, and a "governing
body" to be comprised of delegates from both donor and receiving
countries, and representatives of civil society groups and the private
This private sector presence suggested to some activist groups
attending the session--including members of ACT
UP and the Health GAP Coalition,
who stole the spotlight with a raucous press conference and demonstration
on day two--that the fund will be unhealthily skewed toward a big-business
perspective. Will the fund withhold donations to nations trying
to purchase those cheaper generic drugs loathed by the pharmaceutical
companies? There was an audible murmur of skepticism when a U.S.
delegation spokesman was asked whether any pharma groups will have
a seat on the fund's board. He suggested that they "probably won't
want the headache" of being involved.
A London-based nonprofit group called Christian Aid released a
statement asking whether the fund is simply a giant red herring,
and direly predicted that it will only divert donations from existing
and effective channels: "The fund will attract little more than
a token amount of money, and it is certain that a new, global bureaucracy
will be required to administer it."
But if the rich nations of the world can't pony up for action on
HIV/AIDS, who will? MTV, of course. Bill Roedy, president of MTV
Networks International and chairman of the Global
Business Council on HIV/AIDS, noted that the business of business--"the
organization, communication, delivery systems"--uniquely suits it
to "play a tremendous role" in the fight against AIDS.
Roedy's statement was followed by a frank admission from former
U.N. ambassador Richard Holbrooke, newly appointed CEO of the Global
Business Council: "Whatever business has done so far has been grossly
But if Annan's Global Fund doesn't begin with an effective mandate
and a healthy bank statement--and if the global business community
fails to turn strong rhetoric into day-to-day practice--gross inadequacies
will continue to carry the day.