Donors at a replenishment meeting in New York on Tuesday pledged $11.7 billion over three years for the Global Fund to Fight AIDS, Tuberculosis and Malaria, “higher than past support but below the lowest target set by the agency in its efforts to combat disease in the developing world,” the Financial Times reports (Jack, 10/5).

“More than 40 countries, the European Commission, faith-based organizations, private foundations, and corporations committed funding at the pledging session,” a Global Fund press release states. The $11.7 billion figure includes “firm pledges as well as projections of financing expected from those countries, private sector groups and innovative funding sources that were not in a position to provide firm pledges on Tuesday,” according to the release, which includes a list of the pledges (10/5).

The new pledges “represented a more than 20 percent increase over the $9.7 billion pledged for 2008-2010, which U.N. Secretary-General Ban Ki-moon welcomed saying the money ‘is enough to give millions of people living in fear a new lease on life,'” the Associated Press writes (Lederer, 10/5). Ban added that funding needs are “likely to outstrip even the impressive commitments made today,” Reuters reports.

Michel Kazatchkine, executive director of the Global Fund, “noted that the pledges fell below the minimum of $13 billion the fund says is needed to sustain the fight against the killer diseases,” according to the news service (Worsnip/Kelland, 10/5). “Obviously, with less than the low scenario … the effort will now decelerate and not scale up at pace,” he said, the AP reports. He said the amount was especially “disappointing so soon after the [Millennium Development Goal] summit,” but added that he will continue “to seek the additional resources needed to meet the MDGs,” including through innovative funding avenues (10/5).

Kazatchkine said no one who currently receives treatment will be cut off, but that future targets must be lowered. While he “deeply appreciates” the new commitments, Kazatchkine said the total amount will result in “difficult decisions in the next three years,” the New York Times reports. “The fund pays for AIDS drugs for almost three million patients now, and still might be able to reach four million by 2013. It had hoped to reach five million or more,” the newspaper writes. 

Advocates Disappointed With Pledges

“AIDS activists vented open frustration, both with the overall result” and the U.S. $4 billion pledge. Paul Zeitz, executive director of the Global AIDS Alliance, said, “This is a modest course correction, not what we were hoping for in terms of U.S. leadership.” Zeitz’s group “lobbied the administration for a $6 billion contribution,” the newspaper notes, adding: “Under American law, the United States can contribute only one-third of the fund. If it had told other donors privately weeks ago that it intended a 40 percent increase, they would have been under pressure to match that, both to avoid sounding cheap, and because the United States cannot pay unless its donation is matched 2 to 1” (McNeil, 10/5).

According to the Washington Post, the State Department described the U.S. contribution as “‘a substantial increase, especially in light of the overall budget challenges’ confronting the U.S. government'” (Sheridan, 10/5). U.S. Global AIDS Coordinator Ambassador Eric Goosby said of the U.S. pledge, “There really is no stronger supporter to the global fund than the U.S. That’s a fact,” Bloomberg reports.

Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said, “U.S. funding is a bellwether. … This is an endorsement, showing that there’s not a single funding mechanism the U.S. is committed to, but several” Bloomberg reports (Randall/Varner, 10/5).

According to the New York Times, the Global Fund supports “about half of the world’s poor who are getting [HIV] treatment. The President’s Emergency Plan for AIDS Relief, or PEPFAR, started under the administration of President George W. Bush, pays for the other half” (10/5). 

In response to the pledge announcement, “Doctors Without Borders said the decision … to ‘massively underfund’ the Global Fund ‘will cost lives and severely weaken the ability of countries to implement programs’ to beat back the diseases,” Reuters writes. “Asia Russell of Health GAP called the New York conference ‘a flop,'” according to the news service (10/5). A PEPFAR press release about the Global Fund is available here (October 2010).