Sir, Jeffrey Sachs ("America should not fight Aids on its own", February 4) regrets that the US has allotted, out of its new commitment of $10bn over five years for tackling the Aids pandemic, only $1bn to the multilateral Global Fund to Fight Aids, Tuberculosis and Malaria. He calls on Europe and Japan to fill the gap in the Global Fund's immediate needs. But let us not give up on US multilateralism so quickly, nor on the clear need for the US to play a leading role in providing both funds and policy guidance to the Global Fund over the next decade.
The alternative is to call for an increase in the allocation of US money to the Global Fund that is performance-based; ie, tied to agreed measures of the fund's performance in the next couple of years. Last year, the Bush administration tied the first substantial increase of US funding for World Bank lending to the poorest countries (18 percent over three years) to evince that the resources were being used well.
The Global Fund has made an impressive start in generating and reviewing programme proposals from all over the developing world and has begun the arduous process of negotiating and signing grant agreements. Richard Feachem, its director, has recognised that only now, as money begins to be disbursed, can the evidence of the effectiveness of its bold, bottom-up approach begin to be gathered.
The US emphasis on performance is tailor-made for the Global Fund, which, if Prof Sachs is right, has every promise of being enormously effective. With Tommy Thompson, the US secretary of health and human services, set to become board chair at the fund, let's hope he and the fund management make a deal: increased US funding is linked to effective performance of the fund on the ground in the ensuing months and years.
Nancy Birdsall, President, Center for Global Development, Washington, DC 20009, US