“HAS THERE EVER BEEN A GREATER INJUSTICE IN THIS WORLD?”Amy, Morgan, and Steve

“The promises are never met…”

The UN is ineffectual, difficult to navigate, and values process over results. There is a tendency to praise the UN for increasing resources

for Africa, when this amount is nowhere near what is needed. The UN acquired $8.3B from all sources in 2005, but

needed a minimum of $15B for 2006, $18B for 2007, and $22B for 2008.

Diplomacy yields concerns about “stepping on the toes” of the UN in addressing these shortfalls.

Power players set the bar low, and fail to clear even that modest hurdle. The G8 meeting in Gleneagles in July 2005 promised to

contribute $7.1B to meet Africa’s needs in 2006/2007, but only came up with $3.8B.

“Incestuous” meetings, presentations fail to produce visible results. “We’ll never close the gap by endless contemplation of

figures, as though we were in some permanent actuarial trance.” (203)

Huge amounts spent on travel, accommodations, and logistics of meetings, money that could’ve been saving lives…

“…all sound and fury signifying so very little…" Organizations lack a sense

of emergency “…every minute delayed

is another life lost…” (p.204)

Absence of leadership despite available human resources

“Three by Five” considered successful, WHO adopted “to hell with the obstacles, just get on with the job” attitude “Three by Five” put 1.3

million people in treatment-a success despite falling short of its goal

Individual lives are marginalized Perceived trade-off

between treatment and prevention “…the pandemic has

come down to saving a child, to rescuing that mother’s future, to putting the highest value on individual lives.” (p.204)

Goal is to save lives, whatever it takes “…with treatment

comes hope, and with hope comes testing, and with testing comes prevention, so that what we have now, country after country, is the single minded-pursuit of keeping people alive…” (p.199)

Forgive the national debts Enslaved by the debt

“owed” the rest of the world Disables progress

Focus on women and orphans Eliminate school fees to

ensure education “We need a powerful

international women’s agency more than we need any other institutional arrangement” (p.205)

“A continued swamp of economic malaise…”

“Three by Five” paving the way for universal access

Smaller organizations appear more efficient: MSF, The Clinton Foundation, etc.

DFID improved conditions and training to keep healthcare workers in Malawi

UNICEF has potential progress for children Some debt relief…but it’s not complete

“Phenomenal Resilience…”

“An abject failure…very little has changed” Developed nations refuse to write off debt, so that African nations

pay bills instead of feeding the hungry, treating the sick, and educating the future

Barely 20% of the ill are receiving treatment Africa lacks human capital and capacity; all the young people are

dying Funding/Aid organizations are top heavy and fractured, and there is

no real central or organized leadership to streamline identification of need, deployment of resources, and follow-up on progress UN, UNAIDS WHO, G8, Global Fund, IFF World Bank, IMF, UNICEF,

ADF, MDG…and on and on… Wealthy, developed nations do not have an urgent sense of

responsibility for helping halt this pandemic There is no true sense of corporate responsibility to halt the

pandemic either (The Gates Foundation is one exception). “Corporate welfare bums.”

Women and children disproportionately affected

Continued… Agricultural subsidies place Africa at an

economic disadvantage. G8 failing in its 0.7% of GNP promise. Continued competition between

treatment and prevention.

Recommendations/Solutions Be real

Stop self-congratulatory pomp in the face of suffering

Replenishment Conference in 2005: Global Fund asked for $7.1B, received $3.8B

“…the large gap ‘twixt cup and lip’…” (p.195)

Better accountability standards for UN Member States Goals set but never

reached Don’t make promises

you never intend to keep

Treatment and prevention are not a trade-off, both must be given priority There must be funding for

both Elevate the status of women

and orphans through education

Assist orphans Improve capacity

DFID in Malawi (p.202) Reattach the human

element The purpose of all of this

is to save lives Forget the figures; get on

the ground, do the job

Rec/Solutions Con’t A visible “integrator”

Financial streamlining? Better support of bottom-up efforts

Greater community health focus

“Searching for hope,” Our Reflections

Renewed assault on school fees by UNICEF?

Debt forgiveness? Out of sight, out of mind “What continues to be

lacking is a sense of emergency, the fire of effective leadership, the consuming passion to cut through the cerebral doldrums and save lives, save lives, save lives.”

Facilitate constructive criticism… In the absence of that, reduce the taboo of

criticism between nations. Do not ignore progress…

“Three by Five” Goal: 3 million in treatment. Actual: 1.5 million in treatment, opened the

door for “universal access.” Four pronged plan by UNICEF: “Unite for

Children, Unite Against AIDS.” Treatment of infected children. Prevention of Mother-to-Child transmission. Care of orphans. Attention to adolescents and youth.

Think on a global scale (The UN) and act locally (communities)… Get on the ground! Use the UN to empower localities.

Conclusions

“There should not

be disciplinary action for telling the truth…”

“…an unlovely

pattern of Pavlovian

obeisance to the United States…”

Questions How do we build

grassroots/community based delivery systems?

Is it possible to create an “integrator” for such a diverse range of cultures and delivery systems?

What’s the best way to reduce fragmentation?

If you contributed funds, where would you send them?

How do we spread the urgency of smaller organizations?