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Dismantling the Global Fund

Yale Medicine Magazine, 2012 - Winter


In November the Global Fund to Fight AIDS, Tuberculosis and Malaria learned that donor nations, including the United States as well as several European nations, had reneged on their monetary commitments. Instead of the $1.5 billion the fund expected to spend in 2011, there would be nothing—and an 11th round of funding was suspended.

About two weeks later, just days before World AIDS Day on December 1, Stephen Lewis minced no words in a talk in The Anlyan Center auditorium sponsored by the YSPH Global Health Seminar/Yale AIDS Colloquium Series and the Global Health Leadership Institute. Lewis, who has spent a decade working in Africa to stem the HIV/AIDS pandemic, blasted the donor nations for what he called their hypocrisy, cynicism, and betrayal.

“It’s hard to find the words to characterize what the cancellation of Round 11 means. People will die in large numbers,” said Lewis, a co-founder and co-director of AIDS-Free World, an international advocacy organization. “Unless there is a drastic intervention, the graveyards will burgeon again.”

Timing is critical. Although funding will continue for existing programs, Lewis said, about 7.6 million people around the world who need treatment will not be enrolled in HIV/AIDS programs. And, he said, the world was on the verge of seeing an “AIDS-free” generation thanks to a combination of prevention strategies. The three components of the strategy include antiretroviral therapy to prevent vertical transmission from mother to child; male circumcision, which has been found to reduce the spread of HIV/AIDS; and treatment as prevention—those who are receiving therapy for HIV/AIDS are far less likely to transmit the virus. But implementation of these strategies depends on international funding.

“Is it not a crime against humanity to abandon tens of thousands of people, perhaps hundreds of thousands of people, to certain death?” asked Lewis, who has also served as the United Nations special envoy for HIV/AIDS in Africa; deputy executive director of UNICEF; and Canada’s ambassador to the United Nations. “Where is the leadership of the United Nations in the wake of the dismantling of the Global Fund? Why hasn’t a press conference been held by the Secretary-General to denounce the donor decision and to demand reversal?”

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