AFTER THE STATE OF THE UNION ADDRESS in January, David Tell suggested that some might object to the United States acting “unilaterally” by spending $15 billion over then next 5 years to alleviate the AIDS crisis in Africa. It seemed like a funny joke at the time.
But some Democrats, including presidential hopeful John Kerry and Sen. Joseph Biden, are now calling for the lion’s share of the money budgeted for Bush’s Emergency Plan for AIDS Relief to go into the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund is a U.N.-initiated public-private partnership based in Geneva that has “multilateralism” written all over it.
The administration favors a plan consisting mainly of bilateral programs managed by the State Department. These programs would focus on the 14 African countries that account for 50 percent of the HIV infections in the world, and 70 percent of the infections in Africa. They would build on successful local programs like Uganda’s.
Why does the administration favor bilateralism over multilateralism for the bulk of this “work of mercy”? The reasons lie in the structure and history of the Global Fund.
The Global Fund is young; it opened for business in January 2002. The United States was instrumental in its creation and continues to support it. In fact, U.S. contributions constitute almost 50 percent of the fund’s budget, making America its biggest investor. The United States has contributed $275 million of the Global Fund’s $724 million cash on hand, about 37 percent, and the president has committed additional funding as part of the Emergency Plan, bringing the total of U.S. contributions up $1.5 billion of the Global Fund’s $3.2 billion.
Further demonstrating its commitment to the Global Fund, the United States recently fought to get HHS secretary Tommy Thompson the chairmanship of the Global Fund’s board. He took over the chair just days after the State of the Union.
But, while some multilateral fetishists–including the New York Times editorial page–want the United States to commit half of Bush’s proposed Emergency Plan funding to the Global Fund, the administration cannot, in good conscience, do so.
The appointment of Thompson to the board increases the Global Fund’s accountability to U.S. taxpayers, who are footing the biggest part of the bill, but the fund has not yet implemented financial rules and procedures, engaged an auditor, had an audit, or even reported on its first year of financial operations.
Many who have expressed reservations about increasing the U.S. contribution to the Global Fund dwell on this concern. Representative Christopher Smith of New Jersey says “The question is accountability,” noting that at present no independent entity can force the Global Fund to open its books.
The Global Fund recently took $1.4 million from the World Health Organization, however. Which ties it to the WHO’s rules and regulations on hiring, pay scales, and contracting, which are based on the U.N. system–a worrisome development for those familiar with the bureaucratic nightmare which is the United Nations.
Many of the Global Fund’s current grants are in limbo, voted on but not signed. However few million dollars will soon be headed directly to the governments of Iran, Sudan, and Burma. And a $4.8 million grant has been approved for North Korea.
There are other disparities between the Global Fund’s mission and the president’s plan. For example, 40 percent of the fund’s grants are targeted at stopping tuberculosis and malaria. Worthy causes, to be sure, but not part of the Emergency Plan as envisioned by Bush.
The Global Fund sprung out of a lack of confidence in the World Bank’s ability to handle the AIDS crisis in Africa. The United States has high hopes that the Global Fund will not get mired in the same problems. But it seems irresponsible to commit even more money at an essentially unproven entity with little accountability and different aims.
The Global Fund is multilateral, and thus holds a certain appeal for a certain type of politician. But recent events in other arenas suggest that multilateral action alone won’t get the job done. And that’s a lesson the administration finally seems to be taking to heart.
Katherine Mangu-Ward is a reporter at The Weekly Standard.
