Dear Secretary Thompson,

As Chair the Board of the Global Fund to fight AIDS, TB and Malaria, you sit at the helm of the only organization with the current capacity to stem the AIDS crisis--the greatest pandemic our world has ever known. As much as advocates hope that the U.S. bilateral program will develop capacity over time, at present the only program delivery life-saving resources for comprehensive treatment, care, and prevention is the Global Fund. With your role as chairman comes with great responsibility--a responsibility to ensure that the Global Fund is as effective and efficient in saving lives as it can be and that donor nations are called upon to fulfill obligations to invest in this fight against AIDS, TB and malaria.

When you tally money invested so far in the Global Fund, the U.S. comes out ahead in absolute dollars. However, the Global Fund is a multilateral organization, whereby its ability to raise capital depends heavily on how much each donor nation invests on a proportional basis. In a world where humanitarian spending focuses on donor country contributions as a percentage of GDP or GNP, it is not accurate for the U.S. to say that it invests more in the Global Fund than any other nation when it does not do so a percentage of its wealth. Inevitably, other wealthy nations gauge their investment on what percentage of gross domestic product that the U.S. chooses to invest.

As a result of anemic funding by the U.S., the E.U. and other donor countries, the Global Fund is falling desperately short both on its short term ability to finance viable Round 3 proposals in 2003 as well as its long term ability to collect pledges that are consistent with escalating global "demand" for comprehensive programs that fully utilize and then expand existing treatment, care, and prevention capacity.

Once the U.S. government invests its "fair share" based on an "equitable contribution" framework--as a percentage of global wealth--other donor nations can be coerced or cajoled to respond in kind. Thus, instead of taking a "wait and see" attitude with respect to significantly increased funding for the Global Fund, it is incumbent that you use your position as chair not only emphatically promote the Global Fund's role in saving lives, but to alter the climate within this Administration and the U.S. Congress around securing desperately needed money for 2003 and 2004. It is unacceptable that the U.S. Chair not be more proactive within his own government when that government proposes to invest at a tiny fraction of the internationally agreed-upon amount, only $200 million/year (or even up to $ 1 billion/year pursuant to pending Hyde bill). Additionally, as Chair, it is incumbent that you pressure G7 nations and other wealthy OECD countries to ante up the complementary capital that will ensure an end to the Global Fund's funding crisis.

From the last board meeting in January 2003, you will have learned that considerable funding is needed from donor countries for 2003 and 2004 ($1.4 billion and $4.9 billion respectively at a minimum) in order for the Global Fund to be able to finance new funding proposals. Shortly thereafter, by early 2005 at the latest, additional money will be needed for renewal of Round 1 and 2 proposals.

What are you going to do as Chair to ensure that this money is forthcoming from donors, including the U.S.? Civil society both in the U.S. and abroad expect for you to play a vital role in promoting the Global Fund as the premier funding mechanism in the fight against the three diseases. And, in your capacity as Chair for you to defend the Global Fund when its performance and principles are challenged on the floor of Congress as it has in recent weeks during the appropriations debate.

Fortunately, there several timely opportunities to show leadership in this area by proposing a bold plan to fully fund the Global Fund. Such a plan could be laid out in anticipation of any of the upcoming meetings: the World Health Assembly in Geneva on May 19-28; the G7 Finance Ministers meeting in Paris on May 16; or the G7 Summit in Evian on June 1. This plan must include agreement by donors to commit to ongoing and sustainable financial investment. This investment should be based on credible, internationally agreed upon figures that are dynamic in response to disease progression and a scale-up in programmatic capacity. The plan must also include an agreed upon "equitable framework" of investment, based on percentages of wealth, to avert future disputes regarding funding levels.

Specifically, you have multiple opportunities and a duty to create political commitment and financial support for the Global Fund. In this regard, we demand, at a minimum, that you promote the Global Fund and a credible funding plan in the following venues in the very near future:

• Hold a press conference or sponsor a meeting at the World Health Assembly outlining the accomplishments of the Global Fund, the need for increased funding, and the important role the WHO must play in providing technical assistance to scale up recipient proposals and to expand programmatic capacity in developing countries.
• Travel to the G7 meeting in June to assist Executive Director Richard Feachem in events promoting the Global Fund.
• Hold a hearing or panel presentations in Washington D.C. on the successes to date and future potential of the Global Fund and the necessity of meaningful commitment from the U.S. to leverage money from other donors.
• Agree to co-host the Global Fund Donor's Conference with French President Chirac.
• Agree to chair the Global Fund Resource Mobilization Committee meeting.

In just two years you have been appointed to two positions of leadership in the arena of public and international health. You clearly have the opportunity to be responsible for saving the lives of millions of people dying from AIDS, TB and malaria. In that capacity, we are looking to you to take the necessary bold acts to bring success to the Global Fund and life to the millions who deserve it.

Sincerely,

Kris Hermes
Sharonann Lynch
Brook K. Baker

On behalf of Health Global Access Project (GAP)