Donations Resuscitate Fledgling Fund for AIDS

In the days leading up to a U.N. global conference on combating HIV and AIDS, new donors--public and private--have breathed life into an international trust fund whose fate hung in the balance as recently as last month.

A $100-million pledge this week from the Bill and Melinda Gates Foundation and $1 million given earlier this month by Switzerland-based Winterthur insurance group show that even the private sector sees benefit in joining the fight--now that it has become clear that the U.N. will not be in charge of the trust fund.

Combined with pledges from the United States, France, Britain, the International Olympic Committee and U.N. Secretary-General Kofi Annan himself, the fund now stands at $582.2 million.

“There were questions whether it would make it,” said Gates Foundation director of global health programs Gordon Perkin, who had feared that the fund might die when donors dawdled after Annan in April called for $7 billion to $10 billion in additional spending to fight AIDS. “I don’t think so now.”

At first, only the United States came forward with a “founding contribution” of $200 million--an amount considered paltry by AIDS activists and U.N. officials, who say privately that they hope the Bush administration will ultimately give more than $2 billion. Other countries have been reluctant to pitch in until there is a clearer plan for how the money will be managed and spent.

“It is a trust fund without the trust,” said one foundation member close to the fund, who said many potential donors had feared having the U.N. and World Health Organization in charge because of those groups’ reputations for bureaucratic inefficiency.

European Union nations decided at a U.N. meeting in Brussels last month not to participate in the fund, citing worries that the money would not be spent appropriately.

Other wealthy nations and private groups worried that the U.N. would favor government programs over more efficient grass-roots efforts. Some fretted that the new money would go mostly toward expensive treatments of already infected people rather than to prevention efforts.

But in a series of intensive meetings over the last several weeks among leaders of donor countries and developing nations, pharmaceutical companies and private aid organizations, representatives have begun to hammer out a plan.

The Global Fund for AIDS and Health will be modeled on an independent immunization program pioneered by the Gates Foundation, called the Global Alliance for Vaccines and Immunizations, or GAVI.

The fund, like GAVI, will be run by a small public-private board and have a small administrative staff to oversee projects proposed by recipient countries.

Deputy Secretary-General Louise Frechette, who heads the AIDS portfolio at the U.N., took pains Wednesday to explain that although the fund was born of Annan’s vision, it will be independent of the agency.

“It would not be a U.N. fund. It would not be linked to decisions of the General Assembly. It would not be a World Bank fund; it would have its own funding mechanism,” Frechette said at news conference.

The billions that Annan called on donors to raise over 10 years would include both increased spending by developing countries on their own AIDS programs and money raised by the trust fund, she said.

The trust fund will finance programs to fight tuberculosis and malaria as well as HIV and AIDS. It will balance prevention and treatment, Frechette said. She added that more donations to the fund are expected during the global AIDS conference Monday through Wednesday at the United Nations and that the fund should be operational by the end of the year.

In addition to the U.S. contribution, France pledged $127 million and Britain promised $100 million. The International Olympic Committee pledged $100,000, and Annan said he would turn over to the fund the $100,000 in prize money from the Philadelphia Liberty Medal he will be awarded July 4. More countries are expected to announce donations at a summit of the Group of 8 leading industrialized nations next month in Italy.

“That’s a pretty good start for a fund that doesn’t exist yet and that is still being defined,” Frechette said.

If nothing else, the intensified focus on acquired immune deficiency syndrome and new strategies to curb the pandemic have inspired private foundations and corporations to join the fight in their own way.

Coca-Cola Co., the largest employer in Africa, offered Wednesday to use its distribution and marketing networks to spread the word on how to prevent the disease. The company’s trucks could carry condoms and educational fliers, and the Coca-Cola Africa Foundation will provide testing kits and care for infected people, a company spokesman said.

DaimlerChrysler made a similar offer Tuesday, pledging to provide free condoms and anti-AIDS drugs to its South African employees and their families. The company estimates that 20% of its 4,400 employees there may be infected with the human immunodeficiency virus, which causes AIDS. And Unilever, a Dutch-Anglo consumer goods manufacturer, is expected to help transport goods in Botswana as part of an AIDS program there.