2 June 2006
AIDS Panel Considers Steps to Ensure Sufficient, Predictable Funding for Scaled-Up Responses, Ensure Universal Access to Prevention, Treatment, Care
NEW YORK, 1 June (UN Headquarters) -- Participants in a panel this morning discussed ways in which the international community could find sustainable and predictable financing for scaled-up AIDS responses.
Recognizing that coming as close as possible to universal access to HIV prevention, treatment and care would require funding well into the future, the panel considered innovative steps to secure sufficient and predictable funding from all sources, including domestic budgets, without imposing the burden of sustainability on poor nations and the poorest communities for the next 10 years. Moderated by Jean-Louis Sarbib, Senior Vice-President of the World Bank, the panel also discussed sustainable and predictable financing for research and development, as well as the shifting of resources to communities.
Panellist Richard Feachem, Executive Director of the Global Fund to fight AIDS, Malaria and Tuberculosis, spoke about three main sources of funding: the gradual development of insurance schemes to cover the catastrophic costs of dealing with HIV/AIDS; greater financial assistance by rich nations to poor countries, an effort that must involve global solidarity to support non-traditional donors that would contribute according to their means; and innovative funding mechanisms, including the international financing facility proposed by the United Kingdom's Finance Minister, and the airline levy proposal by the President of France.
Emphasizing the need to maximize private-sector contributions, he said that, while those were growing, they should expand further to include in-kind donations, co-investments by companies in programmes covering the workforce, as well as their families, and cash contributions from large corporations and wealthy individuals. The launch on 1 March of the Red Campaign in the United Kingdom had been a major breakthrough that would raise substantial amounts, particularly for Africa, and included such firms as Giorgio Armani and Motorola. The longer it took to invest in anti-AIDS strategies and programmes, the more difficult and expensive stopping the pandemic would become, he said.
Fellow panellist Joep de Lange, an HIV/AIDS researcher from the Netherlands, noted that, even though AIDS killed off health-care workers in the poor countries, insufficient numbers of people were being trained to replace them. Moreover, between 1985 and 1995, a large proportion of medical graduates from Ghana and Zimbabwe had left home for better pay and career prospects in the developed world, while nothing was being invested in attracting health workers or improving medical infrastructure in their home countries. While it was the Government's role to supervise, set standards and address inequity and other failures, the people, rather than the Government, were the real stakeholders.
Another panellist, South African Health Minister Manto Tshabala-Msimang, said countries should continue to bear responsibility for closing national resource gaps, noting that her own country's HIV/AIDS programme was 90 per cent government-funded. However, the long-term sustainability and predictability of financing could be assured by progressively increasing domestic investment in the health care and other determinant sectors, like water and sanitation. But, even with such investment, some low- and middle-income countries would clearly still need additional resources. It was, therefore, important that the Organisation for Economic Cooperation and Development (OECD) fulfil the pledges made by its member countries to devote 0.7 per cent of their gross national income to official development assistance (ODA).
Urging multilateral institutions to commit themselves to work with national authorities, she pointed out that the conditionality attached to external funding should be limited to fiduciary commitments and be aligned to a country's strategic plan. In addition, significant savings could be made through intervention from the HIV infection stage to the onset of full-blown AIDS, which could also ensure the promotion of responsible lifestyles, thus maintaining optimal health at the same time. Finally, it was important to underline a country's ownership of the process to ensure that targets were set nationally, even if they were directed regionally or internationally.
During the discussion that followed, a civil society participant from Bangladesh said that, while the "brain-drain" of health workers from the developing world to developed nations was an important issue, it was distracting attention from the vital question of health-care conditions in poor countries, with weak infrastructure and poorly-paid health workers. Financing for the strengthening of health workforces was in itself a viable strategy.
Another speaker said that the dimensions of HIV/AIDS in Eastern Europe and Central Asia were often neglected. Consideration of the situation in those parts of the world was restricted to the countries of the former Soviet Union, particularly the Russian Federation and Ukraine. However, the countries of the Commonwealth of Independent States were still characterized by high poverty, wide disparities in income, rising numbers of refugees and a massive deterioration of living standards over the last decade.
Also speaking from the floor, a participant from Kenya said that, considering his country's dependence on development partners, lack of sustainable financing would leave many at risk. Also, the commitments made by those partners were often jeopardized by the excessive politicization of assistance, such as tying it to unrelated issues, thus affecting the way in which programmes were put in place. Debt relief could also help, but a lot of conditionality was attached to that solution, whereas it should be applied uniformly.
Citing his country's role as one of the major contributors to international anti-HIV/AIDS programmes, a Member of Parliament from the Netherlands said that, without ensuring that concrete targets, goals, commitments and standards were being formulated for inclusion in the High-Level Meeting's final document, it would be very difficult to convince Dutch taxpayers that their money was being spent properly.
A South African civil society participant said there was a need to focus on a longer-term strategy than just the purchase of antiretroviral drugs, stressing the importance of avoiding the temptation to treat HIV/AIDS as a short-term emergency.
Speaking for the International Confederation of Free Trade Unions, another participant said it was surprising that little mention had been made of the pharmaceutical industry during discussion of contributions by the private sector.
The other members of the panel were: Bharat Wakhlu, President of India's Tata Inc.; Omolou Falobi of Journalists Against AIDS, from Nigeria; and Sheika Ghalya Mohamad Al Thani, Head of Qatar's National Health Authority.
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