Fund to Fight AIDS, Tuberculosis and Malaria
the XIV International AIDS Conference, Barcelona
Senior Lecture, 9 July 2002
I am Richard Feachem and I'm really really glad to be here.
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.
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)
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.
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)
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)
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.
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.
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)
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.
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
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.
want to conclude by making a number of commitments which
you should hold me to, and also seeking your help and assistance:
commit to maximizing resources that flow into the
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.
commit to accountability. The resources with which we are
entrusted must not be lost, diverted, stolen or in any way
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.
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,
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.
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)
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.
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.
you very much.