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End of an Era – A High-Water Mark in AIDS funding?

The pending Wall Street bailout reminds us that the buoyant global economy of recent years created permissive conditions for international altruism on global health and development. With America’s economy staggering, the effects are being felt further afield among other major industrialized economies, the UK included. Prime Minister Gordon Brown, who has for more than a decade, been one of the stalwart supporters of funding for global development now faces economic troubles at home and a political crisis. Under the Labour Party, UK foreign assistance soared.

In 2007, the UK surpassed the United States as the largest donor to IDA, the World Bank’s wing for the poorest countries in the world. The UK has also shouldered a disproportionate share o funding for global AIDS efforts. Should Brown be ousted in a leadership competition or if the Conservatives win, will Brown’s successor be as pro-development? Will Britain even be able to sustain its contributions at the level it has over the past decade? Donors haven’t come close to meeting their pledges of an additional $50bn per year by 2010. With advanced industrialized country economies struggling, campaigners should be worried that foreign assistance funds may subject to much greater fiscal discipline by donors and AIDS funding may be subject to donor fatigue.

Given the variety of demands from advocates, competition for those funds will likely increase, and campaigners in the public health arena need to be thinking about political priorities — sustained and/or deepened provision of ARV’s, more support for health systems, a turn towards other health priorities like maternal health and child survival, a focus on other issues like climate change and education, etc. These are critical times for the global economy and could signal a turning point in the political effectiveness of the development advocacy in coming years.

Postscript: We may be poised to be entering a global recession or at least a downturn among the world’s advanced economies. One of the most prescient and clear voices on the global economy, Nouriel Roubini, had this to say this morning in the FT:

The real economic side of this financial crisis will be a severe US recession. Financial contagion, the strong euro, falling US imports, the bursting of European housing bubbles, high oil prices and a hawkish European Central Bank will lead to a recession in the eurozone, the UK and most advanced economies.

Even if foreign assistance constitutes a small proportion of donor budgets, aid and development circles are worried their concerns are among the most vulnerable to cuts, or at the very least, stagnant budgets.

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