Wealthy nations must give at least US$9 billion for AIDS, tuberculosis and malaria in 2003, according to a panel yesterday of four leading global health policymakers.

Peter Piot of UNAIDS, Richard Feachem of the Global Fund, Jeffrey Sachs of Columbia University, and Stephen Lewis, the UN Secretary-General’s Special Envoy on AIDS, addressed the Conference together as the first step towards a possible global consensus on essential health spending.

According to Jeffrey Sachs, Chairman of the WHO’s Commission on Macroeconomics and Health, $5.5 billion of the required sum should go to the Global Fund to Fight AIDS, Tuberculosis and Malaria – nearly three times the sum that was pledged to the Fund during 2002.

The United States should provide about $3.5 billion of the total – $2.5 billion for the Global Fund and $1 billion in bilateral aid, he said. These sums do not include the amounts that will be spent by the governments and people of affected countries.

During the meeting, it was also proposed that three plans should be developed over the next few months. The Global Fund will develop over the next 90 days a plan for how much it needs to raise and spend each year. UNAIDS and WHO should simultaneously develop a related but separate plan, showing total needs from all sources, not just from the Global Fund. And the US government should develop a plan, based in part on the other two, spelling out how much and in what ways the US would contribute.

Earlier in the day, Dr Richard Feachem, in his first speech as the newly-appointed head of the Global Fund, announced the development of the Fund’s financial plan. It will be drafted over the next three months, for review and approved by the board at its October meeting. As a result, the Fund would for the first time have public goals regarding its fundraising for the coming years.

Speaking to an appreciative audience, Feachem said: “The Global Fund is committed and I am committed and you are committed to raising many billions of dollars of additional resources, and getting these funds to those on the frontlines who are really making a difference. The Global Fund needs a massive increase in resources, and it needs it quickly.”

Discussing accountability, he said “The resources with which we are entrusted must not be lost, diverted, stolen or in any way misspent.”

Feachem extended a friendly arm to the audience, saying “Together we will do this. Together we will make a difference. Together we will change the world.” He also acknowledged the importance of NGOs, saying that he couldn’t think of a single country where the government alone could mount an adequate response to the three diseases.

“It just cannot be done. In all countries, we need to mobilize and empower the non-government actors alongside the government actors.”

Discussing recent studies in which the cost effectiveness of various forms of intervention are compared, he told a “fairy tale” of driving in Uganda with an economist and coming upon a horrendous road accident involving a school bus. “I said ‘Hurry, hurry, let us call for ambulances and get these children to hospital quickly!’ The economist said, ‘No! Let us drive on to Kampala, to discuss seatbelt legislation with the government. It’s more cost effective.’”

To chuckles, Feachem added “The Global Fund will not be calling on that economist.”

In an interview with AIDS 2002 Today, Feachem said “whether our fundraising goal is $5 billion, $6 billion, or $7 billion, we know we haven’t got anything close to that right now, so we need a lot more money.”

He said that the funds will be sought not only from governments, but also from corporations, adding that when the Fund was started, corporate contributions had been promised, but “they haven’t been forthcoming.” Foundations will be encouraged to act in ways that are synergistic to what the Fund is doing – for instance, by supporting the provision of technical assistance to groups that are seeking Global Fund grants.

Feachem confirmed that 45% of the funds approved by the Fund in its first round of grants are for products and commodities, including essential medicines such as antiretrovirals. When asked whether the Fund would create – or develop links with – a bulk procurement facility, he said that that is one of several options being studied by a Procurement Working Group, for report to the October board meeting.

He added that it’s “certainly not, to me, beyond the pale” for a bulk procurement facility, if created, also to operate on behalf of others who have access to non-Global Fund money.

Concluding the interview, he said “What is most exciting about the Global Fund is that it is, unquestionably, the most important initiative in global health in my professional lifetime. It is an entirely new structure to transfer resources from those who have them to those who need them.

“The future of investment in global health rides on its success. And I think to a considerable degree, future attitudes towards official development assistance, and towards ways of transferring resources from the North to the South, rest on its success.”

AIDS 2002 Conference News produced by Health & Development Networks/Key Correspondent Team