Global Fund for AIDS, TB and malaria opens shop.

We have the money, we have the commitment — now what do we do? This is the unusual question that will be facing AIDS, TB and malaria programme managers over the next few months. The reason? The Global Fund to Fight AIDS, Tuberculosis and Malaria is ready to spend its first moneys. The fund is a new international financing mechanism championed by Kofi Annan, Secretary-General of the UN, to tackle these diseases in low-and middle-income countries. In February of this year the interim secretariat, now based in Geneva, issued a worldwide appeal for proposals for interventions against the three diseases. Formal proposals, agreed by all partners in the countries concerned, must be in by 10 March 2002. On 23 and 24 April the Board of the fund will meet to make the first allocations from the US$ 800 million to be spent in the first year of operation. Donors have so far pledged US$ 2000 million over the next five years. Although this spending will be nothing like the US$ 13 000 million a year WHO estimates is needed in total — from all sources combined — to deal with the three diseases, it represents a large and sudden injection of funds into the control, treatment and prevention of HIV/AIDS, TB and malaria. If the whole US$ 800 million now made available by the fund can be allocated to effective programmes (probably in two or three separate rounds during 2002), it will increase the scale of existing spending on the three diseases by roughly half, according to Anders Nordstrom, the acting director of the fund. As he put it: ''WHO and UNAIDS projections we got just before the fund's first board meeting [28–29 January] were that without the fund, US$ 200 million would be spent in 2002 on malaria, US$ 200 million on TB, and US$ 1200 million on AIDS. That makes US$ 1600 million. Now, in addition, the fund has the possibility of disbursing between US$ 700 million and US$ 1000 million for the same year. So if we can disburse US$ 800 million, for example, that's a 50% increase — quite substantial.'' Nordstrom, who has been seconded until May from his post as director of the health department of the Swedish International Development Agency, told the Bulletin ''The increased political, economic, and financial interest in investing in health has been dramatic in the last two or three years. …