The Global Fund to Fight AIDS, Tuberculosis and Malaria may run short of money to help poor countries care for the sick, the Fund's executive director said in an interview Thursday. Many countries, expecting funding from the agency, are putting AIDS patients on antiretroviral therapy although financing from the Fund is not secure, Richard Feachem said.   (AlertNet.org/Reuters)

 By Laura MacInnis

GENEVA, March 30 (Reuters) - The agency spearheading the fight against AIDS, tuberculosis and malaria risks reneging on promises of help to millions of sufferers worldwide without a stable source of cash, its executive director said on Thursday.

Richard Feachem, who has led the Global Fund since it was set up in 2002, said its annual scramble for donor funds was a strain on the 131 countries dependent on the aid for drug treatments and other programmes.

"They (recipient countries) are putting hundreds of thousands of people on antiretroviral therapy on a financial promise that is not secure," he told Reuters in an interview.

"If the Global Fund were to renege on that promise because the financing is not available, the recipient countries simply could not buy the resources to meet the shortfall."

About half the $4.9 billion the fund has committed so far -- mainly in sub-Saharan Africa -- has been used to buy otherwise inaccessible drugs and equipment to extend the lives of people with HIV and AIDS, treat and prevent malaria, and stop the spread of tuberculosis.

Together, they kill about 6 million people a year.

Feachem, a doctor and international health professor, said any interruption of antiretroviral drug therapy could lead to death and drug resistance among already vulnerable communities.

Poor countries like Malawi and Mali would be unable to keep distributing expensive malaria and tuberculosis drugs if Global Fund money was to disappear, he said, adding malaria could quickly flare up again if mosquito spraying and distribution of bed nets were stopped.

"We have entered into a moral commitment and an ethical commitment that we have never entered into before, and we are beginning to confront the implications of that," Feachem said

OPTIMISM AND GOOD INTENTIONS

The Global Fund has become the largest international financier of efforts to control malaria and tuberculosis and is among the top three funders of AIDS programmes, making up 20 percent of international assistance.

It has gathered nearly $9 billion in pledges but remains far short of funds needed to meet United Nations targets on anti-HIV drug treatment, malaria survival and tuberculosis control.

Feachem said donors should commit a clear portion of their annual development assistance to the fund, because "our recipients need long-term security and finance". The Global Fund's board of directors are due to agree new grants for 2006 at an April 27-28 meeting, even though donors have not yet pledged the $1 billion needed. Without new cash, advocates like the U.S.-based Global AIDS Alliance, have warned the fund may have to postpone grant making this year.

Feachem said there were few signs that the recent focus on avian flu had distracted donor funds from current epidemics.

"It's not a competition between my pandemic and your pandemic," he said. "We have seen no evidence of that."

Instead, he said efforts to detect, monitor and contain avian flu outbreaks could help abate other crises by better linking scientists, health experts and governments.

More health professionals, better equipment, improved hospitals and better access to labs and testing facilities in remote areas could also have enduring public health impacts, whether or not a viral pandemic emerges immediately, he said.

"It all builds public health infrastructure, which will always be used for what the challenge of the moment is," he said. "It very much helps us."