The Lancet
2 February 2002

fund on AIDS, tuberculosis, and malaria holds first board meeting

At the first meeting of its board of directors on Jan 28-29, the Fund to Fight AIDS, Tuberculosis, and Malaria approved a call for grant requests from countries worst hit by the three diseases, which claimed an estimated six million lives last year.

Paul Ehmer, team leader of the fund's secretariat, said governments and their health partners had 4-6 weeks to submit applications to a panel of technical experts. The board of directors hoped to approve projects at its next meeting in New York in April, clearing the way for the first round of disbursements to be made as early as June.

On the eve of the Geneva meeting, the fund was boosted by the promise of an additional US$200 million from the USA for 2003, in addition to the $300 million already committed. The fund now has $1·9 billion, with payments due to be spread over several years.

Uganda's former Minister of Health, Chrispus Kiyonga was elected president. Francis Omaswa, Director-General of Health Services at Uganda's ministry of health, said the resources were sorely needed in countries like his own where average life expectancy has fallen to about 42 years.

"The fund has come late, but it has come, and we welcome it. It has tremendous opportunities for turning around this very scandalous and shameful situation for mankind", Omaswa said.

"Every minute, ten people die of HIV/AIDS, tuberculosis, and malaria. Every day, 15 000 people die", he said, commenting that the daily toll in developing countries far outstripped the tragedy of the Sept 11 suicide attacks and that the deaths from these diseases were largely preventable.

Ehmer--on secondment from his post as deputy director of the Office of Health and Nutrition at USAID-- said there was consensus that the greater share of the budget should be devoted to HIV/AIDS, especially in Africa. All programmes must meet strict criteria and yield clear, measurable, and long-term results.

Priority would go to projects which were already planned but not implemented because of lack of resources, and there would be a balance between prevention, treatment, care, and support.

Ehmer played down differences within the 18-member board. This was after French Health Minister Bernard Kouchner accused Britain, in particular, of concentrating on prevention at the expense of treatment. But at a concluding press conference, Kouchner was upbeat, saying that the fund was a rare positive aspect of globalisation and would have been "unimaginable" even a few years ago. "We still have everything to do, but at least there is now hope", said Kouchner.

Clare Kapp