AIDS and promises - an alphabet soup of good intentions

Between July 2000 and July 2002 high level meetings and political declarations proliferated. Although the attention of world leaders resulted in the creation of the Global Fund to Fight AIDS, TB and malaria and led to WHO and UNICEF developing a series of useful tools, most promises remain unrealised.

  • G8 Summit in Okinawa, July 2000: "We have widespread agreement on what the priority diseases are, and basic technologies to tackle much of the health burden are in place. We therefore commit ourselves to […] mobilising additional resources ourselves […] and working to make existing cost-effective interventions including key drugs, vaccines, treatments, and preventive measures more universally available and affordable in developing countries [...]"(8)
  • EU Commission "Access" Meeting, September 2000: The EU adopted a new Communication on "Accelerated action targeted at major communicable diseases within the context of poverty reduction."(9)
  • OAU Abuja Summit, April 2000: "We pledge to set a target of allocating at least 15% of our annual budget to the improvement of the health sector."(10)
  • UNGASS June 2001: UN Secretary General Kofi Annan announced the creation of a global fund and called for US$7-10 billion annually in donations from rich countries, foundations and private donors (a Harvard University study estimated that US$10 billion a year would be required to tackle AIDS alone).
  • G8 Summit in Genoa, July 2001: Leaders pledged US$1.5 billion to the Global Fund over a number of years.
  • 4th WTO Ministerial Conference, November 2001: Declaration on the TRIPS Agreement and Public Health is adopted, outlining measures to protect public health and promote access to medicines for all.

    WHO and UNICEF work to help access affordable AIDS drugs

  • 12 ARVs added to essential medicines list: "12th Model List of Essential Medicines, WHO".
  • Treatment guidelines issued: "Scaling up antiretroviral therapy in resource limited settings: guidelines for a public health approach"
  • Some generic AIDS drugs pre-qualified by WHO: "Access to HIV/AIDS Drugs and Diagnostics of Acceptable Quality, Pilot Procurement Quality and Sourcing Project"
  • Detailed pricing information on AIDS drugs disseminated: "Sources and prices of selected drugs and diagnostics for people living with HIV/AIDS"

The Global Fund illustrates the extent of the funding deficit. So far only US$2.08 billion have been pledged and only US$700-800 million will be available for disbursal in 2002. This figure is less than a tenth of what is estimated to be required each year to tackle AIDS alone.

It is instructive to examine how closely country contributions match their share of the total need. A recent analysis of country pledges versus their share of the total UN-assessed annual need shows the extent of the funding deficit (in the study, need is defined as US$10 billion, with $1 billion coming from the private sector).

A review of the G7 and other high Human Development Index countries showed that only Sweden and Italy contributed 15% or more of their share for 2002, while the three wealthiest countries - the US, Japan and Germany - all contributed 7% or less than their share. If the countries had funded at the $9 billion level, this would have represented only 0.035% of each country's Gross Domestic Product (GDP).

In addition, many developing countries' political declarations have not led to significant increases in health allocations. Health ministers are often stymied by a lack of funds, both because health funding is not prioritised, and because national resources are insufficient to meet the overwhelming need.