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Global Fund Might Consider Loans for Countries That Become Too Wealthy To Qualify for Grants, Executive Director Says

The Global Fund To Fight HIV/AIDS, Tuberculosis and Malaria might begin extending loans to countries that become too wealthy to qualify for grants, Executive Director Michel Kazatchkine said Sunday at an HIV/AIDS conference in Moscow, Reuters reports. Kazatchkine said that by including a loan repayment program in its mandate, the Global Fund could help increasingly wealthy countries that do not yet have the infrastructure to effectively fight HIV/AIDS, TB and malaria. "To us it's important that when the world's money for aid is being distributed, it not only takes into account economic factors but also, for example, burden of disease,"(in this respect Russia is #1) Kazatchkine said.

The Global Fund has committed $1.2 billion to Eastern Europe and Central Asia through to 2010, about 55% of which is going to fight HIV/AIDS. Ten countries from the regions -- including Kazakhstan, Russia and Turkey -- will not be eligible for Global Fund grants by the end of 2009 because they will be classified as upper-income countries, Reuters reports.

Kazatchkine said there has been significant progress in developing nongovernmental organizations in the two regions. However, some advocates worry that without Global Fund financing, NGOs could be marginalized by governments, Reuters reports. "These are societies" in which the "relationship between public sector and the nongovernmental sectors haven't been established and do not run as smoothly as Western societies," Kazatchkine said.

According to Kazatchkine, Russia set the precedent for the possibility of including loans in the Global Fund's work. The country in 2006 pledged to repay 80% of its $320 million Global Fund grant. "What I'm saying is that with the Russian example, we may find ways of basically a free loan that would allow these countries to access resources now but also behave as a donor," Kazatchkine said.

Kazatchkine also said that Kazakhstan could benefit from a Global Fund loan. The country's economy has grown rapidly during the last 10 years, but it still is experiencing an increase in HIV/AIDS cases. Kazakhstan has received more than $67 million in Global Fund grants in previous years. "The challenge for Kazakhstan is how to manage in the future," Kazatchkine said, adding, "I wonder whether we couldn't consider, as an international community, whether Kazakhstan instead of not being eligible at all in the future could potentially be eligible but then commit to reimburse by 2015 or 2020 or whatever."

According to Reuters, the annual number of new HIV/AIDS cases in the Eastern Europe and Central Asia regions has declined from 210,000 in 2001 to about 150,000 in 2007 (Kilner, Reuters, 5/4).