Fun with numbers: U.S. boosts & shrinks support for the Global Fund

Global Fund

The Obama Administration announced today it has pledged an “unprecedented” $4 billion over the next three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

You gotta love these politicians and their way with numbers and words.

The U.S. pledge is indeed unprecedented as it is the largest-ever single donor pledge to the Global Fund — and partly because it’s the first time the U.S. has made a multi-year commitment to this global health initiative.

Obama’s point-man on AIDS Ambassador Eric Goosby characterized it as a major boost, a 38 percent increase, in funding over past years.

True enough, but the U.S. has always been the largest donor to the Global Fund, as it should be given the size of our economy. This is definitely better than what some other countries, like Germany and Italy, are reportedly planning to do — cut their donations.

But the $4 billion is actually about one-third less than the $6 billion most global health advocates — and many members of Congress — had asked President Obama to pledge for the next three years. Sen. Richard Lugar, R-Indiana, similarly expressed concern about the Obama Administration’s shrinking interest in supporting the global effort to combat AIDS.

Part of what makes this all so difficult to track is that the U.S. now works through three different mega-funding mechanisms for fighting the AIDS pandemic internationally — the Global Fund, PEPFAR and Obama’s new and somewhat ill-defined Global Health Initiative. It seems like kind of a mess, frankly.

The bottom line is that the Global Fund has fallen short of its bare minimum $13 billion required to meet current needs — and well short of the $20 billion goal aimed at meeting expanding needs to treat and prevent AIDS, TB and malaria worldwide. As of today, the Global Fund now has only $11.7 billion in pledges for the next three years.

On AIDS alone, only about one-third of those who need the life-saving drugs now get them. A shortfall in the Global Fund means more people will not get treatment and will die.

Now, all this talk of billions of dollars sounds like a lot of money. But it isn’t really.

The Obama Administration’s pledge represents less than $1.4 billion per year to fight these three massive killers worldwide — as compared to the $20 billion the U.S. military spends annually to air-condition tents in Iraq and Afghanistan. And let’s not even start talking about the banking industry bail-out.


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Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.