Calls for help exceed Global Fund resources

Keith Alcorn
Estimated reading time 3 minutes
This article is more than 23 years old.

PlusNews is a service of RHAIN, the Southern African Regional HIV/AIDS Information Network.

Funding proposals submitted to the Global Fund to fight AIDS, Tuberculosis and Malaria have exceeded the resources available for this year, the Fund's spokeswoman told PlusNews this week.

According to a preliminary count, the fund received 316 proposals from 101 countries, requesting almost US $1,15 billion for the first year of funding. Africa, the continent most affected by the diseases, made the largest number of requests, totalling US $641 million from over 36 countries, according to a statement by the fund.

Glossary

malaria

A serious disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. 

capacity

In discussions of consent for medical treatment, the ability of a person to make a decision for themselves and understand its implications. Young children, people who are unconscious and some people with mental health problems may lack capacity. In the context of health services, the staff and resources that are available for patient care.

nucleoside

A precursor to a building block of DNA or RNA. Nucleosides must be chemically changed into nucleotides before they can be used to make DNA or RNA. 

boosting agent

Booster drugs are used to ‘boost’ the effects of protease inhibitors and some other antiretrovirals. Adding a small dose of a booster drug to an antiretroviral makes the liver break down the primary drug more slowly, which means that it stays in the body for longer times or at higher levels. Without the boosting agent, the prescribed dose of the primary drug would be ineffective.

second-line treatment

The second preferred therapy for a particular condition, used after first-line treatment fails or if a person cannot tolerate first-line drugs.

The Global Fund has about US $700 million - well below the US $1.9 billion pledged by developed countries and private donors.

"Right now, we've got about $800 million for the year, and hopefully other resources will become available as the year progresses," said Melanie Zipperer, spokeswoman for the Global Fund.

Despite the fact that there might not be enough money to cover all needs, the Fund said its launch had boosted by 50 percent the amount of financing available for the developing world to battle the diseases.

"Without the Global Fund, total expenditures from all sources to fight HIV/AIDS, TB and malaria in the developing world would be approximately US $1.6 billion in 2002. By disbursing US $700-800 million, the Fund will effectively increase global spending by 50 percent," the Fund's statement said.

Meanwhile, in a statement released after the 10 March deadline for proposal submissions, international NGO, Health GAP Coalition, said that dozens of potential countries had weakened their project proposals in anticipation of money shortages.

It said proposals would be posted on the web site Access Project for the Global Fund . It called on the Fund to do the same, in the interests of transparency and good governance.

The coalition said posting proposals on the web would provide countries with information on how proposals should be made and enable a better understanding of the need for an increase in funding.

The coalition also called on the fund to ensure proposals were judged on their merits, not according to "artificial and undisclosed dollar limits dreamt up by donors".

A special technical panel was examining proposals at a meeting in Geneva this week to see whether they meet all the criteria, the fund said in its statement. Recipients of funds will be announced at the end of the month.

Proposal example

One example of what a country is bidding for in the first round of applications to the Global Fund is the Nigerian application, already available at the Access Project for the Global Fund website.

The Nigerian government is applying for $5.7 million to provide:

  • A three drug regimen for 6250 adults and 900 children by the end of 2002.

  • Twenty five strengthened ARV treatment centers with operational VCT programme.

  • Improved capacity of 136 doctors, 172 counselors, 86 laboratory scientists, 43 pharmacists, 43 records clerks and 10 programme managers in both public and private sectors on management of AIDS cases with antiretroviral drugs

  • Voluntary counseling and testing services provided at all 25 centres in the 17 states where the ARV programme is being implemented

The Nigerian government is already covering the cost of a triple regimen comprising d4T, 3TC and nevirapine, but the application recognises that treatment can be expected to fail in approximately 20-40% of cases in the first year, requiring the identification of other drugs at affordable prices that can be offered as second-line options. Both protease inhibitors and nucleoside analogues have been identified as likely options.

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