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The World's Best Investment: The Global Fund

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You may not have heard the siren over the earsplitting clatter of the economic crash in America and the ominous emergence of swine flu, but there's an urgent crisis involving Africa and other parts of the developing world that rely on our donor dollars for public health. The Global Fund to Fight AIDS, Tuberculosis and Malaria, a multi-national organization that's been channeling financial assistance to 136 of the world's poorest countries since 2002, is facing a funding shortfall totaling about $2 billion. It's a shortfall that must be made up. Like many of the pressing hardships Americans now face, this is really about money: a paltry sum in view of US financial bailouts, but resources that, if made available, will save millions of lives.

Here's why: years of dramatic results and sustained due diligence demonstrate the effectiveness of the Global Fund. 2 million people living with HIV have received life-saving, antiretroviral treatment; 4.6 million people stricken by tuberculosis, the leading cause of death among HIV sufferers, have so far been put on effective TB drugs; and in the fight against malaria, 70 million insecticide-treated bed nets have been delivered to families at risk of contracting the disease. I dare you to name a hedge fund, start-up, or mutual fund that has delivered better results in the past 7 years.

Where the Global Fund differs from traditional mechanisms is in its mission to provide financing to organizations and governments to conduct the programs they wish to implement. There are no outsiders foisting their ideologies on resource-needy nations -- just Ministries of Health and active non-governmental organizations working to get the job done. The metrics are clear and funding disappears when corruption or bad management appears.

Presently, the United States contributes nearly half of the Global Fund's budget -- for fiscal 2009, that came to more than $900 million -- and from my ringside seat in Rwanda, I see the tremendously positive effect this has had. I also see the opportunities that could be realized if America builds upon its commitment to fighting crippling global disease. But the fact is, FY 2010's commitment is no greater than this year's, and need has grown, leaving a shortfall of $2 billion.

The Obama administration must now step in and fill the Global Fund's fiscal gap, not only to save lives, but also for the financial leverage such a step would have. In the past, whenever America has raised its level of support to the Global Fund, the rest of the world has followed suit.

This support could be an investment that would yield great returns. Tax dollars spent on global health today will pay dividends for decades to come in more productive populations, increased political and health security, and burgeoning new markets for US goods and services. Conversely, failure to invest would be a disaster. Poor health drags poor people even further down the economic ladder and wreaks havoc on their nations' output. By contrast, healthy people are naturally more productive and capable, and that can go a long way in lessening the impact of the economic crisis all around the world.

The recession may have altered the order of things concerning spending in Washington. Banks, car manufactures and investment firms have jumped to the head of the line, while poor people -- even those in America -- have been pushed even further to the margins. This arrangement clearly needs to change.

Unlike the emergencies of most Federal bailout recipients, the Global Fund's wasn't created from mismanagement, nor is it linked to the worldwide market meltdown. In fact, this deficit is the result of the fund's proven success. Years ago, Global Fund directors pledged that they would provide the financing recipient countries needed to scale up efforts to combat disease if the demand was there. The programs put into place have worked very well, and, ultimately, beneficiary nations outperformed expectations. That success needs to be supported and followed up. Now, however, the fund doesn't have enough dollars in the bank to meet the demand.

Bringing Global Fund reserves up to the needed level must be part of a larger effort. Recent Obama-appointed Global AIDS Coordinator Eric Goosby should help lead a careful evaluation of how the US can bolster the Global Fund. The Fund, after all, has outperformed the global markets since giving its first grant. It has delivered its intended results, avoided corruption, and saved lives.

That's ample and clear evidence that while critiques of development aid abound, there's plenty of good aid worth financing. When you look at the money being thrown around Washington right now for various projects and bailouts, $2 billion to save millions of lives should be an easy choice. Investing that amount in the Global Fund makes a lot more sense -- and brings a higher return -- than using taxpayer dollars to fund bonus checks.