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Debate: UN Global Fund

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Is the UN Global Fund a sound institution and worthy of greater funding?

Background and context

The Global Fund to Fight AIDS, Tuberculosis and Malaria was created in 2001 to dramatically increase resources to fight three of the world's most devastating diseases, and to direct those resources to areas of greatest need. As a partnership between governments, civil society, the private sector, and affected communities, the Global Fund represents an innovative approach to international health financing. It is important to note that the Global Fund operates as a financial instrument, and not as an implementing entity: it relies instead on the knowledge of local experts. Its purpose is to attract, manage and disburse resources to fight AIDS, TB and malaria. The Global Fund also relies on existing financial management, monitoring, and reporting systems where possible. In a November 4 news conference, President Bush cited an AIDS initiative as a key priority for his second term. However, under the pressure from the Bush Administration, the US congress has cut funding for the Global Fund by $200 million for the 2005 fiscal year. At the time of this writing, the administration is also blocking the Fund from receiving $88 million that Congress appropriated in the 2004 fiscal year.

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Argument #1

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Yes

• Today, war is the only plague that kills more people then AIDS, TB and malaria put together. These diseases kill over 6 million people each year and the numbers are still growing. At present the US is still the state with the highest political and economic presence on the global arena when it comes to worldwide phenomena. It has a tremendous impact and influence within the international community. It demonstrated many times that it can take decisions by itself concerning pressing international issues. Moreover, research shows that leaders of developing countries put all their hope in the industrialized world to help them fight against those diseases.

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No

• At the end of 2003, fewer than 7% of the people infected with HIV/AIDS had access to necessary treatments. The funds allotted to the program to prevent or treat the pandemic are inefficient because of the low access of people to education and health care; gender inequality is also a factor that is worth mentioning. Until these problems are addressed properly, any increase in funds will not be as efficient as the expected results of the Global Fund.

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Argument #2

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Yes

• UNAIDS estimates that at the end of year 2000 95% of people living with HIV/AIDS are in developing countries. 86% of these are living in Sub-Saharan Africa and South and Southeast Asia; these are also the poorest regions of the world. Because of the debt developing countries owe to the industrialized states, these countries are not able to invest in their own health systems. This fact makes developing countries very weak when it comes to protecting their own citizens from diseases such as HIV/AIDS, TB and malaria.

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No

• From all Global Fund resources, only 6% are allocated to monitoring and evaluation of grants’ distribution. Meanwhile, 51% percent of the grants go directly to the ruling elites in the impoverished countries without any way to track whether the funds are actually used to treat or prevent HIV/AIDS. Therefore, it is very dangerous and mostly ineffective to increase financial commitments of the donor countries until a strong monitoring system for the funds is established.

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Argument #3

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Yes

• Research shows that less developed countries could use the same amount of money from the Global Fund to treat twice as many patients when using generic drugs instead of patent drugs. US policy, however, requires developing countries to use expensive, brand-name, American-made drugs, rather than let them use their money to buy cheaper generics. This policy impedes developing countries in their fight against killer-diseases.

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No

• The credibility and reputation of financial institutions is much harder to be recovered than that of any other institutions. Most international institutions suffer from a lack of credibility and trust because of too many responsibilities undertaken and never fulfilled. A majority of the industrialized states today find themselves in economic recession and can not assume other major economic responsibilities besides their own recovery. Instead of committing themselves to goals that at present cannot be carried out, developed states should halt in increasing their financial commitments to the Global Fund.

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Argument #4

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Yes

• Statistics show that by 2010 there will be more than 18 million orphans in sub-Saharan Africa who lost at least one parent because of AIDS. These children do not go to school because they can not afford the school fees. The result, as research shows, is that the numbers of orphan street children torn from their familial roots, of orphan gangs, of orphan delinquency, are escalating. These children are unable to engage in normal social life - without any support from the society they live in, these children become a vulnerable group that can be easily recruited by underground organizations. This is a danger that should preoccupy the whole international community, especially given the terrorist movements that have mushroomed during the last few decades.

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No

• HIV/AIDS, TB, and malaria are epidemics with consequences affecting the security and health of the whole world as an integral community. When it comes to increasing a nation’s financial commitments to the Global Fund, states should be joined by an increase of commitments of the rest of the developed countries that have the resources to do it. A global effort to fight those epidemics will bring more efficiency and less tensions among states, and, at present, too few states give on equal terms.

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Argument #5

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Yes

• Statistics show that despite the funds already provided by the Global Fund to fight AIDS, TB and malaria, the numbers of people infected get higher and higher each year. Experts, however, agree that at present the Global Fund is the best vehicle states have to finance the struggle against the pandemic. Hundred of thousands of people have been reached with prevention campaigns and given access to effective treatment through programs funded with Global Fund grants. These efforts are not yet sufficient to demonstrate a significant impact on overall incidence and prevalence. Because of more cases of infection detected each year, the funds collected by the Global Fund should also increase.

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No

• The Global Fund is a young initiative that attracts more funds than many other initiatives with a much richer experience in the domain of these epidemics. As mentioned above, the Global Fund does not have an efficient monitoring and evaluation strategy and, therefore, its money can be easily mismanaged by governments or local NGOs. Instead of increasing financial commitments to the Global Fund, industrialized countries should better allocate their funds for struggling with HIV/AIDS, TB, and malaria to international organizations and initiatives with a longer and more productive experience.

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