1. Global Fund: Helping Fund the Just Fight Global AIDS Forum January 7, 2003

2. Overview of Presentation Global Fund Global Fund –What is the Global Fund? –Why do we need to fund it? Roundtable Topics Roundtable Topics –Finance –Targeting –Program/Activity Area –Intellectual Property

3. What is the Global Fund? Global Fund is a financial instrument, not an implementing entity Global Fund is a financial instrument, not an implementing entity Fund will base its work on programs that reflect national ownership, respecting country sovereignty Fund will base its work on programs that reflect national ownership, respecting country sovereignty Fund will evaluate proposals and distribute grants, with a priority on countries most at risk Fund will evaluate proposals and distribute grants, with a priority on countries most at risk Governing board includes equal amount of donor and developing countries Governing board includes equal amount of donor and developing countries

4. Why give to the fund? Empower countries financially to do their own work Empower countries financially to do their own work Minimize global security threats/instability Minimize global security threats/instability Advance gender equality & alleviate poverty Advance gender equality & alleviate poverty Ethical/Moral obligation to assist in humanitarian crisis Ethical/Moral obligation to assist in humanitarian crisis

5. Roundtable Topics Finance Finance Targeting Targeting Program/Activity Area Program/Activity Area Intellectual Property Intellectual Property

6. Financial Goals US $7 billion by end of 2003 US $7 billion by end of 2003 US $10.5 billion by 2005 US $10.5 billion by 2005 US $15 billion by 2007 US $15 billion by 2007 US $21 - $25 billion by 2015 US $21 - $25 billion by 2015

7. Participation Goals To involve as many facets of society in financing the alleviation of HIV/AIDS and in providing services for those impacted To involve as many facets of society in financing the alleviation of HIV/AIDS and in providing services for those impacted

8. Global Fund Financial Predicament National Government Pledges US $2.0 billion Private Sector Pledges US $100 million Total Pledges US $2.1 billion Pledge Promises US $1.6 billion

9. The Global Funds Challenge Inadequate pledge amounts Inadequate pledge amounts Failed delivery of pledges Failed delivery of pledges

10. Challenges Help us fund the just fight

11. Challenge #1: UNAIDS To raise the necessary US$10.5 billion by 2005 To raise the necessary US$10.5 billion by 2005 To have sustainable financial resources for the Fund’s future projects To have sustainable financial resources for the Fund’s future projects

12. Challenge #2: National Governments Short term: Annually allocate a percentage of your GDP to the Fund Short term: Annually allocate a percentage of your GDP to the Fund Long term: Establish a multilateral taxing mechanism as a financial resource for the Fund Long term: Establish a multilateral taxing mechanism as a financial resource for the Fund

13. Challenge #3: Private Companies and Foundations Add 25 private partners annually Add 25 private partners annually Designate “HIV/AIDS Goodwill Ambassadors” such as the Gates Foundation to help us build partnerships with this sector Designate “HIV/AIDS Goodwill Ambassadors” such as the Gates Foundation to help us build partnerships with this sector

14. Challenge #4: NGO community and citizens’ groups Assist the Fund in fundraising by educating the public and private sectors about the urgency and needs of the AIDS crisis Assist the Fund in fundraising by educating the public and private sectors about the urgency and needs of the AIDS crisis

15. Challenge #5: International Lending Institutions Forgive at least 25% of highly indebted and poor countries’ debt on the condition that this money is earmarked for social sectors including appropriate HIV/AIDS programs Forgive at least 25% of highly indebted and poor countries’ debt on the condition that this money is earmarked for social sectors including appropriate HIV/AIDS programs

16. Targeting The Global Fund places priority on The Global Fund places priority on –Areas with greatest burden of disease –Interventions that address social and gender inequalities and behavioral practices –Areas in conflict and distress

17. Targeting Developing Countries 96% of people living with HIV/AIDS live in developing countries 96% of people living with HIV/AIDS live in developing countries –Sub-Saharan Africa is the most affected region with 29.4 million people living with AIDS. Social and and economic impact of AIDS is greatest in developing nations Social and and economic impact of AIDS is greatest in developing nations

18. Targeting More specific targeting is needed More specific targeting is needed –Women –Mothers and Children –Youth ages 15-24 –Other vulnerable populations

19. Women Fastest growing rate of infection Fastest growing rate of infection Gender inequalities in sexual behaviors makes women more vulnerable Gender inequalities in sexual behaviors makes women more vulnerable Women’s physiology increases risk of infection Women’s physiology increases risk of infection Women are key to socio-economic cohesion Women are key to socio-economic cohesion

20. Mothers & Children 1500 HIV positive infants are born daily, 95% in developing countries 1500 HIV positive infants are born daily, 95% in developing countries Transmission rates are increased due to cultural norms Transmission rates are increased due to cultural norms –Abortion is prohibited –Breastfeeding is sole option –Low rate of pre/post natal care

21. Youth Half of all new infections (over 7000 daily) are young people between 15-24 Half of all new infections (over 7000 daily) are young people between 15-24 Youth are vulnerable Youth are vulnerable –Risky sexual behavior –Substance abuse –Lack of access to information and health care Young women and girls are most vulnerable Young women and girls are most vulnerable

22. Other vulnerable populations Injecting drug users Injecting drug users Sex workers Sex workers Homosexual men having unsafe sex Homosexual men having unsafe sex Prisoners Prisoners Migrants and refugees Migrants and refugees All have high HIV prevalence rates and rates of transmission to other populations All have high HIV prevalence rates and rates of transmission to other populations

23. Effective programming Education programs to change behavior Education programs to change behavior Treatment options for mothers and babies Treatment options for mothers and babies Education programs tailored for youth Education programs tailored for youth Targeted programs for sex workers Targeted programs for sex workers

24. Program/Activity Area Who Can Apply Who Can Apply Characteristics of Successful Proposals Characteristics of Successful Proposals Ideas for the Future Ideas for the Future

25. Who Can Apply National Country Coordination Mechanism (CCM) National Country Coordination Mechanism (CCM) Regional CCM (Multiple Countries/Small Island States) Regional CCM (Multiple Countries/Small Island States) Sub-national CCM Sub-national CCM Individual Organizations Individual Organizations

26. Characteristics of Successful Proposals Soundness of approach Soundness of approach Feasible program implementation Feasible program implementation Potential for sustainability Potential for sustainability Evaluation and analysis Evaluation and analysis

27. Soundness of Approach Consistent with internationally accepted best practices Consistent with internationally accepted best practices Priority to most affected/at risk groups Priority to most affected/at risk groups Develops, strengthens, expands partnerships Develops, strengthens, expands partnerships Eliminate stigma and discrimination Eliminate stigma and discrimination Respect intellectual property rights Respect intellectual property rights

28. Feasible Program Implementation Programmatically and technically specific to country’s needs Programmatically and technically specific to country’s needs Transparent in financial arrangements Transparent in financial arrangements Increase quality and coverage of proven and effective practices Increase quality and coverage of proven and effective practices Augments/coordinates with existing regional and national programs Augments/coordinates with existing regional and national programs Uses equitable supply and distribution systems Uses equitable supply and distribution systems

29. Potential for Sustainability Sustained political involvement for allocation of national resources Sustained political involvement for allocation of national resources Strategy for ensuring that Global Fund investments will be additive and catalytic Strategy for ensuring that Global Fund investments will be additive and catalytic Approved by Country Coordination Mechanism Approved by Country Coordination Mechanism

30. Evaluation and Analysis Results focused using a clear and measurable set of indicators Results focused using a clear and measurable set of indicators Include a monitoring and evaluation mechanism Include a monitoring and evaluation mechanism

31. Ideas for the Future Maintain balance between prevention, treatment, and support Maintain balance between prevention, treatment, and support Continued CCM efforts to coordinate with NGOs and other smaller organizations Continued CCM efforts to coordinate with NGOs and other smaller organizations More in-depth monitoring process to ensure maximized success More in-depth monitoring process to ensure maximized success Expanded support of programs directed at previously specified targets Expanded support of programs directed at previously specified targets

32. Intellectual Property Background What is intellectual property? What is intellectual property? TRIPS Agreement TRIPS Agreement Doha and going forward Doha and going forward Relation to Global Fund efforts Relation to Global Fund efforts

33. Problems for poor countries High prices of patented pharmaceuticals High prices of patented pharmaceuticals Even generics unaffordable to poorest countries Even generics unaffordable to poorest countries Limited opportunity to procure generics Limited opportunity to procure generics –Few countries have ability to produce –Trade agreements limit generic exports

34. Recommended Solution Waiver for AIDS medications for needy countries Waiver for AIDS medications for needy countries –Protections against re-importation and parallel importing to rich countries and potentially for middle income countries –Requires tight definition of needy countries

35. Other solutions To prevent reimportation, UN purchases drugs in bulk at discounted prices, becomes sole distributor To prevent reimportation, UN purchases drugs in bulk at discounted prices, becomes sole distributor Increase incentive subsidies for R&D to produce at marginal cost (separate incentives from low cost distribution) Increase incentive subsidies for R&D to produce at marginal cost (separate incentives from low cost distribution)

36. HAPPY BIRTHDAY LINDA!