Nine months after Secretary General Kofi Annan called on wealthy nations to contribute at least $7 billion a year to a global fund to fight AIDS, donations have fallen far short of that goal. Advocates and some lawmakers blame the White House, saying its pledge of $200 million this year sets a poor example for other countries.
The Bush administration's commitment "just does not come close to meeting the need," said Senator Richard Durbin, Democrat of Illinois, who introduced legislation today that would authorize an annual commitment of $1.2 billion. "It is a totally inadequate response to a problem that could literally overwhelm the world."
The fund, proposed with much fanfare by Mr. Annan last spring, has collected $2 billion in pledges, but less than half that will be available this year, officials say. All told, the United States has pledged $500 million -- $100 million in 2001, $200 million this year and the same amount for 2003.
United Nations officials, including Dr. Peter Piot, executive director of Unaids, say they would like nations to increase their pledges by 50 percent each year. One official noted that the United States would contribute more this year to rebuilding Afghanistan than to the global fund.
"The tremendous disappointment, although no one will say it publicly, is the United States, and that the $200 million per year is really not setting the example that is required," the official said. "In everyone's mind, there is the juxtaposition with Afghanistan."
A White House spokesman today defended the administration's pledge. "The United States is a global leader in the fight against AIDS," said the spokesman, Scott McClellan. He noted that the United States had committed more money to the fund than any other government.
On Wednesday, Mr. Annan will be in Washington, where he is scheduled to meet privately with members of the Senate Foreign Relations Committee to talk about the fund's progress. While Mr. Annan's speechwriter, Edward Mortimer, said the secretary general was "not going to Washington to beat up on the administration," he is nonetheless expected to make the case for more money.
Prior to the meeting, several top administration officials, including Tommy G. Thompson, the secretary of health and human services, will testify before the committee, whose members say they intend to raise the issue.
"What I'm going to say, as subtly and politely as possible, is: half a billion bucks? Does that do it here?" said Senator Joseph Biden, Democrat of Delaware and the chairman of the committee.
Another Democrat on the committee, Senator John F. Kerry of Massachusetts, described the Bush administration's pledge as "in the de minimus range." He said that he and Senator Bill Frist, Republican of Tennessee, were working on bipartisan legislation that would authorize more money, but he would not say how much.
At a time when the United States is focused on terrorism, Mr. Biden hopes to use the hearing on Wednesday to draw attention to AIDS as a security concern. If the epidemic is not turned around, he said, "We will have much more than a health problem, we will have a security problem," because unstable countries "are susceptible to the future bin Ladens of the world."
An expert panel convened by the World Health Organization drew much the same conclusion in a report issued in December. But with more than two million people dying of AIDS each year in Africa alone, the panel's chairman, Prof. Jeffrey D. Sachs of Harvard University, said the most compelling reason to fight AIDS was the humanitarian one.
"What every study, including our own, has shown is that this fund needs in the neighborhood of what Kofi Annan originally said," Dr. Sachs said, referring to the secretary general's plea for $7 billion to $10 billion a year. "We will have millions of people dying if we fail to look at the real need."
The global fund, which operates out of Geneva as an independent nongovernmental organization, is intended to help poor nations pay for prevention and treatment of AIDS and two other public health scourges, tuberculosis and malaria. Anders Nordstrom, who serves as the fund's interim executive director, said the fund is currently soliciting grant applications and hopes to make its first awards in April, after its board meets in New York.
Dr. Nordstrom said he hoped pledges would increase, both from industrialized nations and the private sector, once the fund demonstrated that it could do good work. But advocates for people with AIDS worry that if governments do not commit enough money to the fund soon, it will be unable to demonstrate that it is making a difference.
"We're saying, let's get the $10 billion now," said Dr. Paul Zeitz, founder of the Global AIDS Alliance, an advocacy group. "The virus is outpacing the response."