Politics and Policy of HIV/AIDS

The United States has declined to join the vaccine plan. Bush administration officials could not be reached for comment Thursday night, but said earlier this year that the long-term commitment to raise money through the bond market is not consistent with the annual appropriations process in Congress. The United States provides $60 million to $70 million a year to the alliance.

The pact marks the first time rich nations have used pledges of increased aid to back government bonds as a means of financing a major development program. This so-called international finance facility is the brainchild of Gordon Brown, Britain’s chancellor of the exchequer.

Under the plan, income from the sale of the bonds would be provided to the global vaccine alliance to pay for vaccinations over a period of 10 years. The five participating nations would pay off the bonds over 20 years. The two largest donors are Britain, which has pledged to cover 35 percent of the cost, and France, which is covering a quarter.

The money will be used to purchase vaccines and bicycles to transport them, as well as to rehabilitate health clinics and pay health workers to do the immunizing in remote areas.