The International Response to HIV/AIDS

Josh Busbyjbusby@princeton.edu

http://blogs.law.harvard.edu/politicshiv/

Princeton UniversityCenter for Globalization and

Governance

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Map: WHO 2003

2

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Scope of the Talk

What is the need?What has been the response?How effective has it been?

3

Propositions

The global response is inadequate.The Bush Administration has done

more for HIV/AIDS than others. Scaling up is an issue.

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

4

The Need• 25 million have already died from AIDS• 40.3mn were living with AIDS in 2005• Nearly 5mn new infections in 2005,

3.2mn in sub-Saharan Africa• India had 5.1mn infections at end 2004• China faces 10 million infections by 2010

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Source: WHO 2005, Congressional Research Service

5

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Financing Gap

Source: UNAIDS 2005

Estimated AIDS Resources and Funding Gap 2005-2007

8.3 8.9 10

46

8.1

0

2

4

6

8

10

12

14

16

18

20

2005 2006 2007

Year

$US Billions

Estimated AIDS Resources and Funding Gap 2005-2007

8.3 8.9 10

46

8.1

0

2

4

6

8

10

12

14

16

18

20

2005 2006 2007

Year

$US Billions

Funding Gap

Estimated Resources

12.3

14.9

18.1

6

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Bush and HIV/AIDSActually, today I had to defend the Bush Administration in France again. They refuse to accept, because of their political ideology, that he has actually done more than any American President for Africa. But it's empirically so. - Bob Geldof, June 27, 2005

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Source: Time magazine

7

G-7 Shares and the Global FundPledges Nominal

Contributions % of

Pledges

2001-2008

% of Contributions

2001-2005

% of World

GDP 2004

2004 GDP (current

prices $US bn)

Canada $423,937,480 $210,267,796 4.94% 4.45% 2.43% $993.442

EC $630,353,299 $521,394,461 7.34% 11.04% 31.46% $12,865.602

France $1,121,415,920 $485,822,700 13.06% 10.29% 5.0% $2,046.292

Germany $396,869,318 $198,322,103 4.62% 4.20% 6.74% $2,754.727

Italy $756,819,051 $432,996,273 8.82% 9.17% 4.11% $1,680.112

Japan $859,993,443 $346,520,013 10.02% 7.34% 11.42% $4,871.198

United Kingdom

$623,629,467 $267,934,258 7.26% 5.67% 5.22% $2,133.019

United States

$2,295,606,279 $1,433,617,529 26.74% 30.36% 30.36% $11,734.3

Grand Total

8,584,382,220 $4,721,894,421 $40,894.78

Source: Global Fund 2005, IMF

8

G-7 Shares and the Global FundPledges Nominal

Contributions % of

Pledges

2001-2008

% of Contributions

2001-2005

% of World

GDP 2004

2004 GDP (current

prices $US bn)

Canada $423,937,480 $210,267,796 4.94% 4.45% 2.43% $993.442

EC $630,353,299 $521,394,461 7.34% 11.04% 31.46% $12,865.602

France $1,121,415,920 $485,822,700 13.06% 10.29% 5.0% $2,046.292

Germany $396,869,318 $198,322,103 4.62% 4.20% 6.74% $2,754.727

Italy $756,819,051 $432,996,273 8.82% 9.17% 4.11% $1,680.112

Japan $859,993,443 $346,520,013 10.02% 7.34% 11.42% $4,871.198

United Kingdom

$623,629,467 $267,934,258 7.26% 5.67% 5.22% $2,133.019

United States

$2,295,606,279 $1,433,617,529 26.74% 30.36% 28.69% $11,734.3

Grand Total

8,584,382,220 $4,721,894,421 $40,894.78

Source: Global Fund 2005, IMF

9

Bilateral/Global Contributions 2004

Source: Jennifer Kates 2005

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

10Source: Jennifer Kates 2005

Bilateral/Global Contributions 2004

11

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

2004 DAC commitments

Source: Kates 2005

Canada5.3%

Italy0.4%

UK16.6%US

45.4%

Other DAC13.2%

EC7.7

Germany3.5%

France3.9%

Japan

12

2004 DAC Contributions and GDP

% of Total HIV Contributions 2004

% of World GDP 2004

Canada 5.3% 2.43%

EC 7.7% 31.46%

France 3.9% 5.0%

Germany 3.5% 6.74%

Italy 0.4%* 4.11%

Japan 4.1% 11.42%

United Kingdom 16.6% 5.22%

United States 45.2% 28.69%

Source: Kates, IMF

13

% of Total HIV Contributions 2004

% of World GDP 2004

Canada 5.3% 2.43%

EC 7.7% 31.46%

France 3.9% 5.0%

Germany 3.5% 6.74%

Italy 0.4%* 4.11%

Japan 4.1% 11.42%

United Kingdom 16.6% 5.22%

United States 45.2% 28.69%

Source: Kates, IMF

2004 DAC Contributions and GDP

14

Bush and HIV/AIDS

PEPFAR $15bn over 5 years promised

in 2003 $1.656bn appropriated 2003 $2.327bn appropriated 2004 $2.84bn appropriated 2005 Bush request $3.2bn for 2006 Senate $3.6bn for 2006

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Source: Congressional Research Service, DATA

15

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Source: Kates, Summers 2004

16

Treatment Goals• 1mn on ARV’s worldwide in June

2005• Goal for June was 1.6mn• Target 3mn by end of 2005• 3 X 5 NOT LIKELY TO REACH

Source: WHO 3 by 5 Progress Report

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

17

Scaling Up

• The Global Fund needs $3.3bn to cover renewal in 2006-2007

• $3.7bn to fund new grants

Sept 2005 Donors pledged $3.7bn

Bush requested $300mn for 2006

Congress may provide more

PEPFAR and or vs. Global Fund

18

• Global Fund claimed 220,000 on HIV therapy in July 2005

• PEPFAR claimed 235,000 on ARVs

• Overlap 63,000