Global Fund Chief Says U.S. Needs to Make High-Level Long-Term Commitment

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The full-court press is on for Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. With the Global Fund’s replenishment conference set for early October, “this must be an intensive period of advocacy of all of us,” he told a group of D.C.-based global health advocates on Wednesday.

One of the first—and most important—signals on the Global Fund’s prospects for a robust replenishment will come from Washington, when lawmakers in Congress set the U.S. contribution to the Fund in the FY2011 appropriations bills, he said. The Global Fund’s conference is set for Oct. 4 & 5 at the United Nations, and Kazatchkine urged advocates to push for Secretary of State Hillary Clinton to be there in person, instead of a lower-level U.S. representative.

“It would be extremely meaningful if Secretary Clinton could attend and come with a pledge for three years,” he said. “It’s essential for stability and planning,” he said of the three-year pledge, adding that he and others understand such a multi-year commitment would be contingent on congressional approval.

So how much money is he talking about? “Big money … but peanuts if we compare it to what the world could find in three weeks times to rescue the financial markets,” he said. “Money is political choice.”

Kazatchkine said the Global Fund has drafted three different potential funding scenarios, and he focused on the middle one in his talk on Wednesday. Under that scenario, the Global Fund could continue funding all its current programs and expand at the same pace as it did in Rounds 8 & 9. To do that, the Fund will need $17 billion over three years, with a $5.5 billion three-year contribution from the U.S., he said.

He acknowledged that the political climate for making this request is tough, but said advocates must stress that poor countries have been hit even harder by the economic crisis and much is at stake.

“All the gains we have achieved are fragile, and if we slow down on this, it can be very dangerous,” he said. If access to treatment for HIV, TB or malaria becomes more restricted, “we can lose drugs because of resistance,” he noted.

On the other hand, the potential gains are immense. He cited, for example, the Fund’s efforts to improve and expand access to prevention of mother-to-child HIV transmission. “It remains unacceptable that 400,000 children were infected with HIV in Africa last year, when in France it was 4,” he said.

If resources for the Fund are sustained and expanded, he said, the world could see virtual elimination of mother-to-child HIV transmission by 2015. “It would have not only a huge human impact, but also a huge symbolic impact,” he said. “I call it the beginning of the end.”

More broadly, the replenishment conference will go a long way to determining “where the world will be in 2015 in terms of global health,” he said.

In the video clip above, you can hear Kazatchkine’s response to a question about how advocates can answer questions from Capitol Hill about why robust funding is needed for both PEPFAR and the Global Fund, as opposed to one versus the other.

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