U.S. Rejects Global Fund's Request for More Funding

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The top U.S. AIDS official yesterday rejected outright a request from the United Nations to raise the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria to $1 billion, saying that doing so would "actually slow down" the fight against the disease.

"It's not going to happen," said Global AIDS Coordinator Randall Tobias at the 15th International AIDS Conference in Bangkok, adding that most of the money collected by the Global Fund is "sitting in the World Bank in Geneva."

Tobias said Washington would donate $200 million to the Global Fund next year, "but to send them any more money is not going to help people. There is an emergency here. To put more money in the Global Fund will actually slow down" the global anti-AIDS effort, he said.

Tobias defended the U.S. commitment to the effort, saying Washington will spend $2.4 billion this year fighting AIDS, "nearly twice as much as the rest of the world's donor governments combined."

The Bill & Melinda Gates Foundation announced at the conference that it will contribute an additional $50 million to the Global Fund, bringing its total contribution to $150 million.

The United States has come under sharp criticism at the conference for what many see as its go-it-alone approach to fighting the epidemic. Instead of joining multilateral efforts to defeat AIDS, the United States is directing most of its money to U.S. President George W. Bush's $15 billion five-year initiative.

The administration's approach has struck some recipient countries as high-handed and neocolonial, according to yesterday's New York Times. Mozambique, for example, was not consulted before the United States designated it one of the beneficiaries of the Bush initiative. Although the aid was welcome, Health Minister Francisco Songane said, the manner in which it was rendered was not.

Songane said Mozambique had spent a lot of time developing a national AIDS strategy that included using generic 3-in-1 pills. When the United States informed the southern African country of its eligibility for U.S. aid, but with the caveat that most of the funding be used to purchase costly brand-name antiretrovirals, Mozambican officials were put off.

In the end, however, the Bush administration proved more flexible than critics expected it to be, the Times reports, tailoring its aid to Mozambique's need for better laboratories, blood-transfusion centers and general funding for its Health Ministry.

Other recipient countries, like Zambia, have not fared so well, the Times reported, with Zambian Health Minister Brian Chituwo saying that plans for spending the U.S. money in Zambia "all come from Washington." Zambian officials did not have a formal meeting on the program with U.S. representatives until May, 15 months after Bush announced that Zambia would receive aid.

Yesterday a report released at the conference said Zambia has been hardest hit by declining life expectancies due to HIV/AIDS. Life expectancy in the country is now only 32.7 years.

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