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The Fund to Fight AIDS, Tuberculosis & Malaria



Richard Feachem

Dr. Richard Feachem
Executive Director
Fund to Fight AIDS, Tuberculosis and Malaria

At the XIV International AIDS Conference, Barcelona
Senior Lecture, 9 July 2002

I am Richard Feachem and I'm really really glad to be here. (Applause)
I was in Durban and many of you were in Durban also. In Durban we had no global fund. Now we have a global fund.

The Fund as you know has already committed 1.6 billion dollars to 40 programs in 31 countries. And over 60 percent of these monies are going to HIV/AIDS. These commitments will double the current number of people receiving HAART in the developing world and in Africa HAART recipients will increase six fold as a result of these commitments. This is nothing like enough. (Applause)

But it is a start and we commit to do much much more. (Audience: So do we!)
The second round of proposals was launched on July the second, less than six months after the birth of the Fund. The 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.

Now I want to put credit where credit is due and I want to thank everyone in this room. I want to thank everyone in Barcelona but not in this room with us now. And I want to thank the thousands of people who are working around the world fighting HIV/AIDS who have not been able to come to Barcelona. The Fund is your achievement. You have lobbied. You have fought. You have advocated. You have analyzed. And you have shaken the world into recognizing the magnitude of this crisis. Out of that, together with the leadership of Kofi Annan and the backing of the G8 you have made it happen and you have made the difference. I want to recognize that very clearly here today. (Applause)

Let me make it absolutely clear that the Fund needs a massive increase in resources, and it needs it quickly. (Applause) I am well aware of the calculations that have been made concerning the magnitude of the resources that we require. Estimates come from the Commission on Macroeconomics and Health and I was a member of that commission. Estimates have come from Schwartländer and Bertozzi and other experts. I am familiar with those individuals and those estimates. Kofi Annan on the basis of sound advice, has called for a scaling up of the level of investments in HIV/ AIDS to the 8 to 10 billion dollars per year mark. The Fund also has to invest in tuberculosis and malaria. (Applause)

Following the October meeting of the board of the Fund, that will be our third board meeting, we will be publishing and widely disseminating the Fund´s financial projection estimates of resources needed and rates of expenditure over the next several years. We will invite your critique and comments on those when they are published later in October. I feel sure that you will not be bashful in expressing your opinions to us, on those numbers. We will also be calling on you to ensure that the resources are indeed made available and that the expenditures are put to good use quickly.

Let me now turn to the subject of prevention and treatment. The Fund is committed to prevention and treatment. The board of the Fund is committed to prevention and treatment. And I am committed to prevention and treatment. Our financing decisions so far confirm this commitment.

I have been asked repeatedly at this conference about cost effectiveness and the implications of recently published cost-effectiveness analyses. Cost-effectiveness analyses can be well used and it can be stupidly used. Let me tell you a fairy tale. I was driving across Uganda with an economist, as one does. (Laughter) We came upon a horrendous traffic accident. A school bus had collided with a truck. Children were lying all over the road. Some were dead. Some were dying. Others were seriously injured. I said ¨hurry hurry let us call for ambulances and get these children to hospital quickly. Many of them maybe saved.¨ The economist said, ¨No! Let us drive on to Kampala, to discuss seatbelt legislation with the government. It's more cost effective." The Fund will not be calling on that economist. (Applause)

Before Durban, there was genuine economic and clinical uncertainty about ARV therapy and its widespread application. Now we have the tools and the tools are affordable. We have achieved an intellectual consensus. The Fund working with WHO, with UNAIDS and many other partners including many organizations represented in this room today, has the task of translating this intellectual consensus into a practical reality. A practical reality bringing hope and life to millions of people throughout the world.

Let me turn now to NGOs. There is no country with which I am familiar where the public infrastructure alone can mount an adequate response to HIV/AIDS, tuberculosis or malaria. It just cannot be done. In all countries we need to mobilize and empower the non-government actors alongside the government actors, alongside the public infrastructure. These non-government actors come in many different colors and flavors. Many different shapes and sizes. They include international NGOs, local NGOs, faith-based organizations, and the private sector ranging from large corporates who can do so much more to show leadership by providing effective services to their workforces and the families of their workforces. Right through to small traders and little shops as you find in every village in every community who sell drugs, who sell condoms, who sell bednets, who sell other products relevant to the task that we collectively face. All these actors must be mobilized and the Fund expects to invest across the whole spectrum of significant frontline actors.

I was at this point going to show some slides to provide some more factual detail about the Fund so far and the Fund over the next few months. In deference to my friend and colleague Dr. Gro Harlem Brundtland, and the fact that we are running a bit late, in this session, I won't show those slides but I would invite you all to come to the symposium at 4.30 where I and others are speaking and where those slides will be shown and where we can have more of an interaction about the work of the Fund.

I want to conclude by making a number of commitments which you should hold me to, and also seeking your help and assistance:

I commit to maximizing resources that flow into the Fund.

I commit to ensuring that the expenditures to the Fund go quickly to those on the frontlines who can use them and make a real difference in people's lives.

I commit to accountability. The resources with which we are entrusted must not be lost, diverted, stolen or in any way misspent.

I commit to results. We will measure with your help process indicators. We will measure outcome indicators. And we will allocate resources where they can do the most for the most number of people.

I commit to balance across the three diseases with which we are mandated. No doubt HIV/AIDS will continue to take the lions share, and rightly so. But we will also invest in malaria and tuberculosis, and we will not turn our backs on the communities that suffer terribly from these diseases, also. (Applause)

I commit to geographical balance. We will invest in those parts of the world already devastated by HIV and we will also invest in countries which have high vulnerability but where it is not too late to prevent a disaster from unfolding.

I commit to balance in the interventions that we support. We will fund prevention. Lots and lots of prevention. We will fund treatment. Lots and lots of treatment. (Applause) Treatment for malaria. Treatment for tuberculosis. And treatment for HIV/AIDS. (Applause)

And finally I call on your help. The Fund is a financing mechanism. I anticipate that the total number of people that it employs will rise to no more than 50. In a short period of time we expect to be disbursing several billions of dollars per year. This will be a world record in bureaucratic efficiency and the lightness of the bureaucratic touch. (Laughter) I think the Guinness book of records will have to invent some new category to capture this. This is only possible if our partners work with us on every aspect of what we are all trying to achieve. We need our partners to ensure that funds flow into the Fund. We need our partners to ensure that the best possible applications are received from countries and communities in greatest need. We need our partners to ensure that funds are well spent and have the maximum impact on people's lives. We need our partners to conduct the operational research which will improve subsequent investments. And we need our partners to independently and robustly measure the impacts and the outcomes in order that we may know what we are achieving and allocate our funds accordingly.

As the Fund goes forward, together with all of you here, we tread into the unknown and into the darkness. No one has gone where we are going. The only light is the light of our imaginations. The only vehicle is the vehicle of our commitment and our vision. And the only trail is the trail that we will break. Together we will do this. Together we will make a difference. Together we will change the world.

Thank you very much.


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