Obama Pledge to Global Fund Can Bring Millennium Goals Within Reach

In a speech before the United Nations General Assembly last September, President Obama declared, “We will support the Millennium Development Goals, and approach next year’s summit with a global plan to make them a reality.” As the time approaches to present that plan, a substantial, multi-year pledge to the Global Fund to Fight AIDS, TB and Malaria is essential for achieving the 2015 MDGs related to global health. To continue the work of life-saving programs and to accelerate the progress against these killer diseases, the United States must commit to contributing $6 billion to the Global Fund over a three-year period beginning in 2012.                                       

When the nations of the world agreed on the MDGs at the start of the century, the odds seemed long for making headway against the three diseases responsible for killing 6 million people each year. Virtually no one living with AIDS in developing countries had access to life-saving antiretroviral therapy (ART). Malaria was unstoppable and the biggest killer of children in Africa. Tuberculosis rates were climbing, and strains of TB resistant to drugs were spreading at an alarming pace.

In many respects, the MDGs have been humanity’s moon shot – a bold commitment made without knowing precisely how they would be achieved. The path to success on global health goals emerged in 2001 when UN Secretary General Kofi Annan proposed the Global Fund as a mechanism to galvanize and distribute badly-needed resources for countries sinking under the burden of AIDS, TB and malaria. Since then, the picture has improved dramatically. Global Fund-assisted programs now provide treatment for 2.8 million people living with HIV/AIDS. It’s estimated that 40 percent of those in urgent need now have access to ART. The Global Fund has financed the distribution of 122 million insecticide-treated bed nets to prevent malaria, and ten countries in Africa have reported declines of 50 to 80 percent in child mortality from the disease. Seven million people have received tuberculosis treatment through Global Fund-backed programs, and the world is on track to cutting the prevalence of TB in half by 2015.

A new model for development assistance

The success of the Global Fund can be attributed to its method of operation. Assistance is demand-driven, meaning that countries assess what their needs are and then apply for the funding to meet those needs. Goals are set by recipient countries – numbers of patients treated, bed nets distributed, numbers of health-care workers trained, etc. – that are then held accountable for achieving these goals. Countries that don’t measure up or mismanage funds have their grants suspended until corrective actions are taken.

By using the multilateral approach of the Global Fund, the U.S. is able to leverage its contributions and its effectiveness. Every dollar the U.S. contributes to the Global Fund is matched by other donors 2-1.

Foreign aid reformers in Congress can look to the Global Fund for ways to improve the performance of development assistance. A Global Fund for Education is under consideration to help achieve the Millennium Development Goal of universal access to basic education.

Funding in line with U.S. policy

The $2-billion-a-year contribution to the Global Fund is in line with funding approved by the Lantos-Hyde U.S. Global Leadership Against HIV/AIDS, TB, Malaria Act. Under Lantos-Hyde, Congress is authorized to provide an initial $2 billion to the Global Fund.

Nearly 100 members of the House of Representatives, citing the Lantos-Hyde commitment to the Global Fund, have signed a letter to President Obama asking him to make the three-year, $6 billion pledge.

This commitment to the Global Fund would be a key component for the Obama Administration’s Global Health Initiative, which aims to provide $63 billion to improve global health over the next six years. Though it would represent less than 20 percent of GHI resources, the $6 billion for the Global Fund over three years would be expected to leverage an additional $12 billion from other donor nations. With this level of funding in place, the Global Fund expects that by 2015, programs in recipient countries will succeed in:

• Eliminating malaria as a public health problem in most malaria-endemic countries.
• Preventing millions of new HIV infections.
• Dramatically reducing deaths from AIDS.
• Virtually eliminating transmission of HIV from mother to child.
• Containing the threat of multidrug-resistant TB.
• Achieving significant declines in TB prevalence and mortality.

• Further strengthening health systems.

Continuing America’s global health legacy

In 2003, President Bush stunned the world with his announcement that the U.S. would launch a five-year, $15 billion Emergency Plan for AIDS Relief. It was a pivotal moment in efforts to contain the most challenging pandemic in modern times. Because of this initiative and America’s leadership in support of the Global Fund, countries that were decimated by AIDS and on the verge of collapse have now turned the corner.

President Obama has the opportunity to build on that legacy and lead the world to a new age of prosperity, where preventable and treatable diseases no longer terrorize millions of people. When the President attends the UN High-level Plenary Meeting on the Millennium Development Goals in late September, he can inspire and motivate the international community to usher in this new age by announcing a three-year, $6 billion pledge for the Global Fund.

Quick facts on the Global Fund