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The USA should increase funding to fight disease in developing nations
The USA should increase funding to fight disease in developing nations
AIDS, malaria and tuberculosis kill over six million people worldwide each year, most of them in poor countries with limited resources. As well as the direct human suffering and loss these three killer diseases bring, they also help to keep poor countries poor by greatly reducing the ability of sufferers to work productively, both in the labor force in support of their families or in education.
AIDS in particular can devastate poor communities by killing mostly adults (over 3 million in 2002, and rising), leaving many orphans and overburdening social structures. In developed countries public health systems generally have the infrastructure and funding to treat those suffering from such illnesses, and to operate prevention strategies (e.g. the USA allocated $17.5 billion for Fiscal Year 2005 for domestic programs against HIV/AIDS). Yet, in the developing world, such help is often either unavailable or unaffordable, and even in richer countries that are able to pay for courses of antiretroviral drugs for HIV/AIDS costing thousands of dollars a year, there is still no vaccine against HIV.
To address these challenges the Global Fund to Fight AIDS, Tuberculosis and Malaria was set up in 2002. Although independent of other international bodies such as the United Nations, it works closely with the World Health Organization and UNAIDS to deliver programs in over a hundred countries worldwide. Since its creation in 2002, the Global Fund has spent 21.7 billion US dollars. Programs supported by the Global Fund have saved an estimate of 6.5 million lives through providing AIDS treatment for 3 million people, anti-tuberculosis treatment for 7.7 million people and the distribution of 160 million insecticide-treated nets for the prevention of malaria ( to date: April 2011).[1]
This money comes from donor states as well as private business and charities, but most is supplied by individual countries who pledged their support when the Fund was established. So far the United States has provided a third of the Global Fund's contributions (European countries have collectively donated just over 50%), after the Bush administration in 2009, Obama promised to increase the funding for the Global Fund. Currently the US donates 1.05 billion US dollars annually.[2]
America also puts billions more dollars into US-run international anti-AIDS initiatives, which have been seen by some as by-passing the Global Fund and undermining its work through conflicting policies.
The current implementation of the Global Fund is that it manages the funding that is pledged by countries and private companies. Through different projects they allocate funds to specific developing countries. Where there are signs of corruption, the Global Fund stops financing projects in that country until they research the issue.[3]
The proposal is that the US should immediately increase its annual payment to the Global Fund to $2 bn.
[1]European Aids Treatment Group, The Global Fund welcomes U.S. budget allocation of US$1.05 billion for 2011, published 04/20/2011, http://www.eatg.org/eatg/Global-HIV-News/World-Policy/The-Global-Fund-welcomes-U.S.-budget-allocation-of-US-1.05-billion-for-2011, accessed 08/22/2011
[2]European Aids Treatment Group, The Global Fund welcomes U.S. budget allocation of US$1.05 billion for 2011, published 04/20/2011, http://www.eatg.org/eatg/Global-HIV-News/World-Policy/The-Global-Fund-welcomes-U.S.-budget-allocation-of-US-1.05-billion-for-2011, accessed 08/22/2011
[3] The Global Fund, Protecting the Grant Money, http://www.theglobalfund.org/en/about/protecting/, accessed 08/22/2011
Read more
| Points For | Points Against |
|---|---|
| US is currently the greatest economic power, therefore it should spend the most on helping others. | Unfair to demand the biggest contributor pays even more. |
| An increase in funding will incentivize other countries to give more aid. | Investment in the Global fund could reduce contributions to other funds and causes |
| USA should show through financial means the standard which they expect for projects. | Organizations should use more effectively the already available funds. |
Remember to choose a winning argument!
US is currently the greatest economic power, therefore it should spend the most on helping others.
Point
The USA is by far the world’s biggest economy and it should do more to pay its share of the Global Fund’s funding needs.
The Global Fund needs money to ensure it can do its essential work in combating three of the world’s most deadly diseases.
The US has been hit hard by the economic crisis. But even though their economy has suffered, the US still has considerable funds available. While the economy is bruised, it is still worth remembering that the US economy is nearly three times the size (nominal GDP) of its nearest competitor, China. It boasts states with economies the size of many countries. If California were a country, it would have the ninth largest economy in the world. At least five other US states – New York, Texas, Florida, Illinois and Pennsylvania – have economies that would rank them in the top 20 of countries.[1]
US leadership is split on the new amount of money; they do want to spend on the Global Fund. The Obama government has declared that they would be able to spend even in the recession the US is making a three-year (FY11–FY13) $4 billion commitment to the Global Fund. However currently the commitment is 1 billion USD per year (even though obviously they have the resources to fund far more).[2] This can be shown as the United States still has plenty of money that it does give to others, often those who do not need it. For Example aid to Israel has escaped cuts to foreign aid despite it being a developed country that does not need aid the U.S. is to give $3billion in Foreign Military Financing in 2011.[3] As the United States has the most available funds it is their duty to give more than the others and increase funding.
[1] Molavi A., US economic power is part of a healthier global order, 07/04/2011, http://www.thenational.ae/thenationalconversation/comment/us-economic-power-is-part-of-a-healthier-global-order, accessed 08/22/2011
[2]Kaiser Family Foundation, The U.S. & The Global Fund to Fight AIDS, Tuberculosis and Malaria, published November 2010, http://www.kff.org/globalhealth/upload/8003-02.pdf, accessed 08/22/2011
[3] Sharp, Jeremy M., ‘U.S. Foreign Aid to Israel’, 2011
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Counterpoint
The Global Fund is an obligation that the whole world should be meeting, not just the United States. In August 2011 the Economist issued a report explaining that the real GDP in most rich economies is still below its level at the end of 2007. In contrast, emerging economies’ (India, China, Brazil …) output has jumped by almost 20% over the same period. The rich world’s woes have clearly hastened the shift in global economic power towards the emerging markets. Actually the emerging economies account for 46% of world retail sales, 52% of all purchases of motor vehicles and 82% of mobile phone subscriptions. Almost a quarter of the Fortune Global 500 firms come from emerging markets; in 1995 it was only 4%.[1] As the economic power shifts to countries other than the US it is also logical that other countries should increase their funding for such foreign aid programs far more. China, Brazil, India are the ones that have the resources to increase funding due to the economic growth. The US is, given their current economic status, doing more than enough to help support the global fund. Why should America, having been in economic decline, contribute more than the “emerging countries”? The pressure of giving more should be put on those countries rather than the US.
[1]The Economist Blog, Power shift, published 08/04/2011, http://www.economist.com/blogs/dailychart/2011/08/emerging-vs-developed-economies, accessed 08/22/2011
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An increase in funding will incentivize other countries to give more aid.
Point
America is seen by many people over the world as an influential country that paves the way in international policies. An increase in funding will also have therefore a major effect on other donor countries. With the increased funding of the USA, there will also be a greater demand to invest more from other countries.
The USA is still a big player in the global economic and political market. Therefore it is not surprising, that if they increasingly support or neglect a policy, other countries may use that as a good excuse to not do anything (or provide very little support) to the Global Fund. As we have seen in the example of the Kyoto protocol; when the US did not sign the protocol this gave China, Russia, Japan, Australia and other countries a free pass to say that they feel no moral obligation, as the US, one of the biggest polluters does not participate in the agreement.[1] So through pressure (or the lack there of), countries control each other and many times also justify their actions.
So in the case of increased funding a greater financial support by the US will also represent a wakeup call for other countries to donate more. The Global fund has for a long time been telling countries, they need more funds, yet they have not gotten them yet. Part of the reason is probably that there is too little pressure on countries. An increase from the US, which is already now one of the biggest contributors to the Fund, will therefore be seen as a moral step that will put pressure also on other countries to increase their funding. It pressures the countries to give more, when they see that the biggest contributor is increasing their financial funds. So with this “role model” effect, the Global Fund will get more financial support – not only from the US, but also from other countries who will not want to be seen in the world as the ones restraining their support for lifesaving projects.
[1] S. Fred Singer, "The Kyoto Protocol: A Post-Mortem," The New Atlantis, Number 4, Winter 2004, pp. 66-73., accessed http://www.thenewatlantis.com/publications/the-kyoto-protocol-a-post-mortem
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Counterpoint
Why should other countries be incentivized in the future to give more if the USA, the biggest contributor, is going to be doing more? This will simply encourage other countries to think that the US will contribute the necessary funding. The US has already done enough to be a good role model for other countries when it comes to supporting the Global Fund. An increase in support therefore will not have the wished for effect and should not be implemented.
The time has come for the small contributors with emerging markets (such as China) to step up and offer more support, as they are taking the economic and political lead there is also a higher likelihood that their contribution could spark more international pledges to the Global Fund.
Improve thisUSA should show through financial means the standard which they expect for projects.
Point
The US should show through spending on aid, the values it wants to promote in its humanitarian projects. Therefore well managed and effective projects should get more funding, and giving more funding to the Global Fund is the first step in this “re-education” of NGOs. This will serve other projects as a pointer what they have to do in order to receive more support and also set an example how projects must work in order to get increased funding.
Currently the Global Fund deserves fuller US support as a model of a well-run and transparent international agency. Its multilateral funding frees it from the problems associated with programs run by individual governments, with their duplication and the often politicized conditions which are attached to their aid. Unlike more traditional international bodies, it has a small staff (c600 in Geneva)[1] and tiny overheads, ensuring that the money it collects is pushed out into the field where it can do well.
By inviting countries affected by HIV/AIDS, tuberculosis and malaria to make proposals, it gives them a big stake in the programs it funds. This makes the Fund's activities more likely to be successful, but it also monitors the effectiveness of programs very carefully, being willing to withdraw funding if it is badly spent or proves ineffective.
Finally it is innovative in making use of partnerships with the private sector - a key US development policy priority. Such novel approaches deserve US support and could set new standards by which other multilateral institutions could be judged in future, but without adequate backing the Global Fund will be seriously compromised and discredited.
So an increased amount of financial support of the Global Fund will show many other organizations, that in order to get more funding they have to down size and become more cost effective, so that the invested money gives the most outcome for the people.
[1] The Final Report of the High-Level Independent Review Panel; on Fiduciary Controls and Oversight Mechanisms of the Global Fund to Fight AIDS, Tuberculosis and Malaria, 2011, p.31
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Counterpoint
First of all it is immoral to tie funds that could decide on the life or death of a person to some policy restrictions a government seems to believe in. It is also wrong to assume that If an effective initiative has a high number of employees that they should not be eligible for increased funding. Countries funding the global fund should do so by weighing up the benefits increased funds would bring, rather than how the organization is structured.
Secondly the Global Fund is not without its problems and the United States should be cautious in throwing increased amounts of money at it. Grants to Uganda were recently halted after an audit found that local partner organizations guilty of a variety of dubious practices. For example, due to the problems Germany has actually suspended its annual payment of more than 200 million euros in January 2011, following corruption claims.[1]
Until the Global Fund can convincingly show that it has enough people with business and financial expertise to manage the billions of dollars it is asking for, the USA is justified in channeling much of its spending in this area elsewhere. In addition, there are obvious disagreements between the Global Fund's Secretariat and Board over how particular programs should be funded, which does not help to inspire confidence in the organization.
[1]BBC News, Germany halts Aids fund payment over corruption claims, published 01/27/2011, http://www.bbc.co.uk/news/world-europe-12294232, accessed 08/22/2011
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Unfair to demand the biggest contributor pays even more.
Point
The USA has a fine record of supporting the Global Fund’s work – it has provided nearly one-third of the Fund’s money to date and is by far the largest single donor. Because it is the largest donor, it has no responsibility to step up and give more, rather other countries should give additional financing to the fund.
In 2007 the U.S. lost its seat as the world’s largest economy to the European Union. The EU’s economy produced $14.4 trillion in goods and services, while U.S. GDP came in at $13.86 trillion. Combined, the two produce over 40% of the world’s economic power, which totals $65.82 trillion.[1] Yet the US is still the biggest single contributor to the Global Fund. For example the US pledged 9,556,872,254 USD to the Global Fund between 2001 and 2013, while Germany has only pledged 200 million[2].
The US’ donations should also be seen in a wider context of the $15bn that the Administration has said it will spend on international programs to fight HIV/AIDS over a five year period. While the USA should continue to support the Global Fund as it has in the past, it would be inappropriate to greatly increase its level of funding. Currently the US gives by far the most money, while its economy is decreasing more than many other countries.
Therefore it is unfair to expect the US to contribute even more, when others are not.
[1]Amadeo K., U.S. No Longer World’s Largest Economy, published 02/12/2008, http://useconomy.about.com/b/2008/02/12/us-no-longer-worlds-largest-economy.htm, accessed 08/22/2011
[2] The Global Fund, Core Pledges, http://www.theglobalfund.org/documents/core/financial/Core_PledgesContri..., accessed 10/03/2011
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Counterpoint
The USA has a unique role in modern world politics. The country has dominant influence in the International Monetary Fund, World Bank, NATO, UN Security Council and many other international organizations. The administration is also highly involved in domestic matters of countries around the world, especially in South America. The USA can also get away with signing bilateral agreements outside the mainstream international policies and withdrawing from important global treaties, (e.g. Kyoto and the International Criminal Court).
The power of a country is not determinate only by it’s the size of its economy, but also by influence it has on other countries and multilateral agreements. Even if we agree that the US has lost its economic dominance, it still has a great role in giving an example on charity. With increasing its funding it is more likely, that this is going to incentivize also other countries (through the role model effect) to start supporting the Global Fund more. Through such action mostly the developing world would benefit.
Improve thisInvestment in the Global fund could reduce contributions to other funds and causes
Point
With higher investment in a relatively new fund, there is a danger, that countries will lose focus on old well established programs and possibly reduce funding to such organizations.
The Global Fund is a young initiative that attracts more funds than many other initiatives with a much richer experience in the domain of these epidemics. In many cases programs can have problems, such as inefficient monitoring or evaluation strategies (as was the case with the Global Fund) and, therefore, its money can be easily mismanaged by governments or local NGOs. This problem for example occurred in Zambia in 2009, where authorities in its own Ministry of Health were unable to manage grant money. The country had to return 8 million and this came close to disrupting lifesaving activities.[1] It is a lot more effective to increase funding also for many programs rather than concentrating funding with into one fund.
We can surely assume that countries only have a limited amount of funds available to fund projects in developing countries. What happens if funding is increased for one initiative is, that probably others will have available less funding or will be forgotten. With giving the same amount of money as is done currently, the US ensures, that if one initiative has problems (such as the Global Fund did in Zambia), there will be other well supported initiatives that will be able to take care of the HIV/AIDS, TB, and malaria in the region. So rather than favoring one organization with increased funding, countries should get as much of an equal stand as possible so that in the case of a fall out we assure uninterrupted flow of funds to the ones which need the aid the most.
[1]Boseley S., Global Fund freezes grants to Zambia over fraud, published 06/16/2010, http://www.guardian.co.uk/society/sarah-boseley-global-health/2010/jun/16/zambia-international-aid-and-development?INTCMP=SRCH, accessed 08/22/2011
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Counterpoint
It is actually right to favor one organization and give them more money, because the Global Fund does more efficient work than other organizations and will most certainly also have a good back up plan for any problems.
The Global Fund is the best way for the USA to spend its money in combating disease globally. There is nothing wrong with the USA having other international programs to tackle HIV/AIDS in developing countries, but these are potentially not as effective as the work of the Global Fund in relieving suffering. For example, the USA's choice of countries in which it will work can be politically motivated, as can its greater emphasis on treatment over prevention. The USA's own programs also tend to focus very heavily on HIV/AIDS, the Global Fund was in 2004 responsible for over half the donor spending’s on malaria and two-thirds of donor spending on tuberculosis so it makes a good fit with the United States’ own priorities. Ten years ago (in 2001), malaria was a neglected disease; today, at least 10 of the African countries hardest hit by malaria have reported declines in new malaria cases and a fall in malaria mortality of 50 to 80% through the Global Fund.[1] Without proper funding, these other deadly diseases risk being forgotten once again. For these reasons, the US should make proper funding of the Global Fund its highest priority in this area, and ensure that its other programs are truly complementary, rather than competing with it.
[1]Bruni-Sarkozy C., Together we can fight Aids, TB and malaria, published 09/21/2010 http://www.guardian.co.uk/commentisfree/2010/sep/21/global-fund-fights-aids?INTCMP=ILCNETTXT3487, accessed 08/22/2011
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Organizations should use more effectively the already available funds.
Point
Development aid is a great example why more money, does not necessarily mean a greater success. In spite more than US$1 trillion in aid to Africa over the last 50 years, the big payoff in resulting economic development that is the only sustainable way to defeat disease and pull the continent out of poverty has yet to occur. Also, for example, the UK has each year been giving an increasing amount of funding, without real achievements of the receiving party to show for the increases.[1]
This is also occurring within the Global Fund, despite increasing financial support for the Fund there has not been an increase on pressure on being more efficient. Thus the Global fund have not increased the amount of people although they have received increased financial support.
[1] Ericson F., Why Aid doesn’t work, published 09/11/2005, http://news.bbc.co.uk/2/hi/science/nature/4209956.stm, accessed 08/23/2010
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Counterpoint
It is true that there will always be room to be using existing funds more efficiently. However this does not mean that increasing funding does not lead to an increase in results or that it is not necessary. Aid, particularly the sort that the global fund provides is not about creating sustainable economic growth but is about saving lives, in this case through combatting disease. Even donors who believe that much aid has been wasted have to agree that programs to fight diseases are necessary. There are always more projects that could be funded. The Global Fund needed $7.1 billion for fund projects in 2006-07, but after its September 2005 funding conference the fund was $3.4 billion short. So there is a very big need which, without an increase cannot be covered.
Improve thisBibliography
Amadeo, Kimberly, ‘U.S. No Longer World’s Largest Economy’, About.com, 12 February 2008, http://useconomy.about.com/b/2008/02/12/us-no-longer-worlds-largest-economy.htm
BBC News, ‘Germany halts Aids fund payment over corruption claims’, 27 January 2011, http://www.bbc.co.uk/news/world-europe-12294232
Boseley, Sarah, ‘Global Fund freezes grant to Zambia over fraud’, guardian.co.uk Global Health Blog, 16 June 2010, http://www.guardian.co.uk/society/sarah-boseley-global-health/2010/jun/16/zambia-international-aid-and-development?INTCMP=SRCH
Bruni-Sarkozy, Carla, ‘Together we can fight Aids, TB and malaria’, guardian.co.uk, 21 September 2010, http://www.guardian.co.uk/commentisfree/2010/sep/21/global-fund-fights-aids?INTCMP=ILCNETTXT3487
Erixon, Fredrik, ‘Why Aid Doesn’t Work’, BBC News, 11 September 2005, http://news.bbc.co.uk/1/hi/sci/tech/4209956.stm
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Molavi, Afshin, ‘US economic power is part of a healthier global order’, The National, 4 July 2011, http://www.thenational.ae/thenationalconversation/comment/us-economic-power-is-part-of-a-healthier-global-order
Sharp, Jeremy M., ‘U.S. Foreign Aid to Israel’, Congressional Research Service Report for Congress, 16 September 2011, http://www.fas.org/sgp/crs/mideast/RL33222.pdf
Singer, S. Fred, ‘The Kyoto Protocol: A Post-Mortem, The New Atlantis, Number 4, Winter 2004, pp. 66-73., http://www.thenewatlantis.com/publications/the-kyoto-protocol-a-post-mortem
The Economist, ‘Emerging vs developed economies Power shift’, Daily chart, 4 August 2011, http://www.economist.com/blogs/dailychart/2011/08/emerging-vs-developed-...
The Global Fund, Core Pledges, http://www.theglobalfund.org/documents/core/financial/Core_PledgesContributions_List_en/
The Global Fund, Protecting the Grant Money, http://www.theglobalfund.org/en/about/protecting/
The Henry J Kaiser Family Foundation, ‘The U.S. & The Global Fund to Fight AIDS, Tuberculosis and Malaria’, November 2011, http://www.kff.org/globalhealth/upload/8003-02.pdf
The Final Report of the High-Level Independent Review Panel; on Fiduciary Controls and Oversight Mechanisms of the Global Fund to Fight AIDS, Tuberculosis and Malaria, 19 September 2011, http://www.aidspan.org/documents/aidspan/HLP-Report-Layer-5.pdf
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