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20 August 2004
United States Seeks to Leverage Global Disease Funding
U.S. AIDS coordinator encourages other donors to contribute
Washington -- The U.S. global AIDS coordinator is using a little-known provision of federal law to encourage other international donors -- nations and institutions -- to make greater contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
If other nations of the world answer this challenge by September 30, then the United States, already the greatest contributor to the less-than-two-year-old granting institution, will increase its 2004 donation by $120 million.
"We believe it is a way to leverage resources," said Dr. Mark Dybul, deputy chief medical officer with the Global AIDS Coordinator's Office in the U.S. State Department. "For every dollar we give, we hope the world will give $3."
These events are triggered by a provision in the law that authorized the President's Emergency Plan for AIDS Relief -- the $15 billion, five-year program that targets assistance to 15 nations most severely stricken by the epidemic. The law divides overall U.S. contributions for fighting the world epidemic into two categories: bilateral assistance programs and donations to the Global Fund.
The Geneva-based institution was being formed when Congress debated the authorizing legislation. Lawmakers had no way to know how the Global Fund would take shape or how much international backing it might receive. So Congress built into the law what Dybul calls a "challenge grant." The law designates an amount for the U.S. contribution on an annual basis, but stipulates the U.S. donation cannot exceed 33 percent of the total Global Fund budget. The intent was to encourage the rest of the world to offer up the other 67 percent of the granting institution's bankroll.
"The U.S. government should not be solving [the world's AIDS crisis] on our own," Dybul explained in a Washington File interview August 19. "Congress was very clear."
The Global AIDS Coordinator's Office began operations in late 2003, so 2004 marks the first time that Ambassador Randall L. Tobias has been faced with complying with the challenge-grant provision. Tobias checked the bank balance at the Global Fund on July 31 to determine how much money was there and what portion was contributed by the United States.
Based on the July 1 figures, contribution of the entire amount authorized by Congress for 2004 ($547 million) would exceed the 33 percent ceiling. Currently, contributions by the rest of the world to the fund allow a U.S. contribution of only $426 million.
Therefore, Tobias has $121 million that he cannot give the Global Fund unless contributions from other countries increase by another $240 million. The coordinator could shift the $121 million into other bilateral disease-fighting programs the United States is backing in more than 100 nations around the world but has decided to attempt to leverage additional contributions from the world community before re-allocating the remaining dollars to bilateral programs.
In consultation with Global Fund Executive Director Richard Feachem, Tobias has challenged other nations to increase their contributions to the fund so the United States can increase its own contributions. If other donors come up with more money by September 30 -- the end of the U.S. fiscal year, when Tobias must commit all his budget dollars -- then the U.S. AIDS coordinator will release the additional $120 million.
"Regardless of what happens, the $120 million will be used for HIV/AIDS," Tobias said in a teleconference with U.S. reporters August 18. "We would just like to make it available to the Global Fund."
The flow of contributions into the Global Fund depends in part on the arcane business of budget processes and fiscal calendars. Various countries have made pledges to the fund but have not delivered the money because of disparate budgeting practices. News reports indicate that some donors are on track to fulfill their commitments and write their checks to the Global Fund by the September deadline.
"We're very hopeful that the world community will respond," said Dybul.
(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
