*EPF310 06/27/01
Consensus Builds for Global Fund for Disease
(U.N. Secretary General Pledges Quick Action) (900)
By Charlene Porter
Washington File Staff Writer

A global fund to combat HIV/AIDS will be established by the end of this year if the international community promptly responds to the calls for urgent action heard in New York this week at the United Nations General Assembly Special Session on HIV/AIDS (UNGASS).

The session was set to end June 27 with the adoption of a declaration of commitment in which the 189 members of UNGA acknowledge the disease as a "global emergency" and pledge to develop national plans on how to deal with the epidemic.

U.N. Secretary General Kofi Annan first proposed the creation of a global trust fund to fight disease in April. Since the first donation of $200 million announced by the United States in May, pledges to the fund have mounted to more than $500 million. As UNGASS entered its final hours June 27, Annan said he hopes to begin making plans for creating the formal structure for the fund and its operations within a week or two.

In a press conference, Annan said he envisions that the fund will be overseen by a private-public partnership with board members representing governments, business and civil society. He predicted that operations of the fund will be managed by a small secretariat that will be "light, responsive and non-bureaucratic."

The Secretary General said he anticipates that selecting the membership of the board will be the most difficult and controversial matter to resolve in the first stages of creation of the fund, because so many competing interests will want to be part of the enterprise. Still, Annan is optimistic that hurdle can be successfully cleared to allow the fund to begin its work.

The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that a basic anti-disease program in all developing countries will cost at least $9,200 million a year by 2006. According to World Bank experts who have studied an anti-diseases financial plan, those funds would come from both developed and developing world governments, corporations, foundations, and civil society.

Through the United Nations Foundation, the non-profit support organization established by U.S. media millionaire Ted Turner, the U.N. has already begun to accept contributions for the new global AIDS funds. At his news conference, Annan showed reporters a $1,000 check from a private individual making a contribution to the cause. The Secretary General said boosting fund-raising from private donors -- individual and corporate -- will be an important function for the fund.

Duff Gillespie of the U.S. Agency for International Development said the United States will advocate a "lean structure" for the global trust fund. He also emphasized the importance of a technical review mechanism that will help the fund's governing board evaluate the requests for resources.

The need for transparency, efficiency and accountability in the operation of the fund was one point of consensus during a wide-ranging, multilateral discussion June 27. Representatives from a range of developed and developing world nations, in one of the roundtable discussions conducted on the sidelines of the U.N. General Assembly session, considered how the fund should operate.

Another point of agreement was that each nation must take the lead in deciding upon its own best plan for disease treatment and prevention, taking into account its own unique circumstances and the capabilities of its health system. "One size does not fit all," said Bhutan Ambassador Om Pradham.

While he urged nations to engage in some "introspection" to develop that plan, Pradham also emphasized the urgency of the process. "Each of our countries is being invaded ... We have to move at a war footing," he said.

In the first weeks since announcement of creation of the fund, most of the expectations for donations have focused on what the developed nations can contribute. But the focus turned to developing nations in this June 27 discussion, and their responsibility to devote a greater share of their domestic resources to disease control and strengthening their health care systems.

Representatives of the poor nations taking part in this roundtable acknowledged that they need to do more, but Dominica's Chief Medical Officer Paul Ricketts underscored how difficult it will be for nations that are also experiencing a decline in gross national product and international aid.

"Do we educate children, the leaders of tomorrow, or do we put these resources into HIV/AIDS where there is no cure?" Ricketts asked the group. He hoped his country could do both, but admitted that achievement of that goal would be difficult.

Because of the poverty and economic problems that plague, the developing world, speakers emphasized the need for the global AIDS fund to be drawn from new resources rather than from a diversion of other aid sources.

Initial agreement about the structure of a global AIDS fund is beginning to emerge, but many points of contention are yet to be resolved. Nations are divided about how resources should be apportioned between prevention programs and treatment programs. Developing nations plead for accelerated debt relief in order to make more funds available for programs, but international financial organizations counter that only 5 percent of debt relief granted to developing countries in recent years has been targeted toward health programs.

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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