UNAIDS: The First 10 Years

Chapter 6not to replace existing disbursements. Total international (donor) spending on AIDS andsexually transmitted infections in 2000 was estimated to be US$ 396 million according tofigures reported to the Netherlands Interdisciplinary Demographic Institute, but US$ 521million according to what was reported to the Development Assistance Committee of theOECD 15 . According to a Futures Group assessment: ‘A warranted conclusion may be thatyear 2000 donor assistance was almost US$ 600 million’ 16 .161UNAIDS had also been working with relevant partners, such as the World Bank, on otherways to release more resources. At the Monterrey International Conference on InternationalConference on Financing for Development, Marika Fahlen, then UNAIDS Director of SocialMobilization and Strategic Information, highlighted debt relief efforts as an important additionalmechanism to slowing down the spread of HIV, as long as the monies freed up by debtrelief were channelled into national AIDS programmes.In the same speech, Fahlen described some of the developmental impacts of AIDS oncountries. Botswana, one of the worst affected countries, estimated the government wouldlose 20% of public revenue by 2010 due to the economic impact of AIDS. Zimbabwe’s lifeexpectancy between 2000 and 2005 was estimated to be 26 years lower that it would havebeen without AIDS. In Haiti, where prevalence had risen to 6%, life expectancy had droppedby six years for the same reason.By July, the Global Fund had received over 400 proposals and the new Executive Director,Feachem, a public health official and academic who had worked at the World Bank, was broughtin to assist. During 2002, with two rounds of funding, grants totalling almost US$ 1.5 billion hadbeen approved for two years, covering 154 programmes in 93 countries. The first US$1 millionwas disbursed in December 2002. By July 2003, over US$ 70 million has been disbursed 17 .Desmond Johns, Head of the UNAIDS New York office when the Global Fund was created,commented: “If the Global Fund worked as intended, if it could truly serve as this majorconduit to get resources to countries with minimum overheads and a lot less bureaucracy– and to the extent that they have succeeded in doing that – this should be recorded as thesuccess story of the Fund”.Plumley took a more optimistic view than some of his former colleagues. “You could arguethat the Global Fund in 2001 is not a huge success for UNAIDS, because it is the creation ofa new multi-lateral financing mechanism, outside the UN. But I don’t see it that way … [it is]a way of channelling the needed new resources into AIDS. Who [fought] for those resources?UNAIDS did …”.15UNFPA (2004). Financial Resource Flows for Population Activities in 2002. New York, UNFPA.16McGreevey W, Bertozzi S, Gutierrez J-P, Izazola J-A, Opuni M (2002). ‘Current and future resources for HIV/AIDS’, in State of the Art: AIDS and Economics. International AIDS Economic Network for IAEN symposium,Barcelona, Spain, June.17The Global Fund to Fight AIDS, Tuberculosis and Malaria (2003). The Global Fund Annual Report 2002/2003.Geneva, The Global Fund.