U.S. May Keep Part of Grant for AIDS

The United States will be forced to withhold $120 million from this year’s donation to the Global Fund to Fight AIDS, Tuberculosis and Malaria unless other contributors can come up with twice that amount by the end of September, U.S. AIDS czar Randall Tobias said Wednesday.

By U.S. law, the American share of the fund can total no more than 33% of all contributions. But as of July 31, donations from other countries fell $243 million short of the amount required for a full U.S. grant of $547 million for the period.

Tobias said he would exercise his discretion to wait two months in hopes that the full grant could be made. Otherwise, the money would be used as part of the President’s Emergency Plan for AIDS Relief.

“We want to comply with the letter of the law but, at the same time, we are also doing everything we can do within the letter of the law to [encourage donation of] as much money to the global fund as we can,” Tobias said in a telephone news conference.

Tobias signaled the United States’ intentions in a letter to Richard Feachem, executive director of the fund, and in a telephone call to Feachem on Wednesday afternoon.

The Global Fund was created in 2001 with hopes that it could provide prevention and treatment services to impoverished developing countries, but its vision has far outpaced reality. Estimates by UNAIDS and other groups indicate that the fund requires a minimum of $10 billion a year to provide those services effectively, but donations have fallen far short of that goal.

A U.S. audit showed that for the 10 months ending July 31, contributions to the fund by foreign governments and foundations totaled $866 million, Tobias said. U.S. contributions during the period were $426 million -- 33% of the total. For the U.S. to contribute the maximum $547 million budgeted, the rest of the world needed to contribute $1.11 billion.

Tobias is extending the period by two months, in hopes of obtaining the additional funds so that the rest of the U.S. contribution can be made.

“Regardless of what happens, the $120 million will be used for HIV/AIDS,” Tobias said. “We would just like to make it available to the Global Fund.”

Tobias and the U.S. were heavily criticized at last month’s International AIDS Conference in Bangkok, Thailand, because of the perception that too little of the money in the Bush administration’s five-year, $15-billion AIDS program is going to the Global Fund. The bulk of that money is being spent in bilateral programs with about 20 heavily affected countries.

The main focus of the criticism is that treatment funds in the president’s emergency plan can be used only for drugs approved by the U.S. Food and Drug Administration. That list includes only brand-name drugs and not the inexpensive copies produced abroad -- which means the number of people who can be treated is much lower than it would be if generic versions could be used.

Ranbaxy Laboratories Ltd. of India and Thailand’s Government Pharmaceutical Organization have applied to the FDA for approval of their anti-AIDS drugs under the agency’s fast-track program, but approval has not yet been granted.