http://allafrica.com/stories/200204260101.html

The fight against AIDS, tuberculosis and malaria in Africa got a major boost today with the announcement of the first round of grants approved by the Global Fund To Fight AIDS, Tuberculosis and Malaria.

The Global Fund, a multilateral funding agency launched last year by UN Secretary-General Kofi Annan, approved a total of $378 mn over two years for treatment and prevention programmes to combat the three deadly diseases in 31 countries around the world. This includes 17 sub-Saharan African countries which will receive $145 mn in the first year. An additional 18 projects in 12 countries, totalling $238 mn, have been placed on a "fast track" for final approval within the next six weeks, bringing the total committed by the fund today to $616 mn over the next two years. Nearly three-quarters of the funding went to combat AIDS and related diseases. Sixteen per cent of the grants went to anti-tuberculosis projects, with the remaining 10 per cent directed at programmes to combat malaria.

According to Global Fund board Chairman Chrispus Kiyonga, a former Ugandan minister of health, this morning's announcement proves that the Fund is off to a good start. "Less than three months after the Global Fund issued its first call for proposals," Dr. Kiyonga told reporters in New York, "it is directing funds where it is needed. The Global Fund's grants will provide critical support to effective prevention and treatment programmes around the world."

According to Ms. Philippa Lawson, a member of the Global Fund board representing people living with the diseases, about half of the funding will go to purchase medications and supplies, including insecticide-treated bed nets and AIDS drugs, with the balance for training, salaries and education and prevention programmes. The proper distribution of funding between treatment and prevention projects has been a divisive issue among AIDS activists and donors. Some major donor governments, including the single largest contributor to the Global Fund, the US, have opposed proposals for widespread treatment of HIV/AIDS sufferers in Africa and other developing countries as unrealistic.

Some donors have also opposed efforts to lower the cost of expensive anti-retroviral drugs (ARVs) in poor countries through the issuance of mandatory manufacturing licences and the importation of generic versions of the medications from unauthorized manufacturers. They regard such moves as a threat to intellectual property rights. Many of the patents for ARVs are held by US and European firms. Ms. Lawson acknowledged that the treatment projects approved by the Global Fund exclude large-scale purchases of anti-retroviral medications.

The Fund's failure to support scaled-up ARV treatment programmes drew sharp criticism from the Health Gap coalition, a leading international anti-AIDS activist group. The organization charged that the Fund "missed an opportunity to save lives now" by funding ARV access for no more than 40,000 of the 10 million people in immediate need worldwide. Global Fund board members, said Health Gap representative Sharonann Lynch, "must re-commit themselves to closing the deadly gap in access to life-extending medicines."

But with just over $2 bn in funding commitments and over $5 bn in applications received, Ms. Lawson noted, the major problem remains a lack of money. "The Fund needs far more resources. Millions of lives are at stake." Mr. Annan and international health experts estimate that $7 - $10 bn is needed annually to control the three diseases in poor countries, where themajority of cases occur. Sub-Saharan Africa alone accounts for over 28 million of the estimated 40 million people worldwide infected with the virus that causes AIDS. Fewer than 10,000 Africans are currently thought to have access to the expensive drugs that have dramatically reduced AIDS deaths in Europe and North America.

Global fund grants to sub-Saharan Africa ($, first year)

Zambia $ 41,058,800
South Africa 24,868,652
Uganda 20,751,367
Malawi 19,979,782
Zimbabwe 10,046,250
Tanzania 9,966,040
Ethiopia 7,018,000
Senegal 4,571,428
Rwanda 3,330,849
Kenya 2,871,689
Ghana 2,516,059
Burundi 2,242,000
Benin 1,482,920
Mali 1,453,857
Madagascar 638,674
Zambia/Ethiopia (joint programme) 336,000
Total $ 145,312,747

Source: UN Africa Recovery from Global Fund To Fight AIDS, Tuberculosis and Malaria.