would raise spending on HIV/AIDS in low and

When member states of the United Nations unanimously adopted the Declaration of Commitment on
HIV/AIDS in June 2002, they called for the establishment of a “global AIDS and health fund” that
would raise spending on HIV/AIDS in low and
middle income countries to between $7-10 billion a
year.1 This sum was more than five times what was
then being spent on the epidemic. When the
Global Fund was established later that same year,
it encompassed not only HIV/AIDS, but also
tuberculosis and malaria. In order to meet the
challenges of all three diseases, many people
believe that the Fund has to raise $7-10 billion a
year in new money.
As of the middle of May 20022, pledges have
totalled only $1.922 billion, of which $1.821 billion
has come from governments and just $101 million
has come from the private sector (see box). Many
of these pledges are multi-year. The total amount
pledged for 2002 has been estimated at $725
million.3 This is a far cry from $7-10 billion. Even
more discouraging, contributions to the Fund have
decreased significantly in recent months.
Clearly, both wealthier nations and the private
sector need to give much more. It is time to set
specific targets. France, Ooms and Rivers have
called for an annual goal of $10 billion, of which
$1 billion would come from the private sector and
$9 billion would come from the 48 countries that
have a high human development index (HDI)4.2
Twenty-eight of these countries have made nocontributions at all to the Global Fund. The authors have designed an “Equitable Distribution
Framework” which calls for the 48 countries to divide up the $9 billion based on their gross domestic
product (GDP). The proposed contributions
would amount to 0.035%5 of each
country’s GDP.
Under the Equitable Distribution
Framework, the annual contribution of the
United States would increase from $250
million (the estimated portion of its
current contribution attributable to 2002)
to $3,479 million. Japan would go from
$68 million to $1,646 million, France from
$51 million to $453 million, and Sweden
from $20 million to $80 million. These are
just a few examples. For a complete
description of the Equitable Distribution
Framework, see The Global Fund: Which
Countries Owe How Much? on the website
of Health Development Networks at