TB Monitor International-Wanted: New donors for TB global plan
Taking a think-big approach
A document intended to attract money — in particular, money from new donors — is in the works, as members of the newly formed Global Alliance for TB Drug Development begin creating the agenda outlined at the conference on TB drug development held in Capetown in February.
Potential donors browsing through the document, dubbed the Global Investment Plan (GIP), won't find any technical jargon or arguments about DOTS-Plus, says Jim Yong Kim, MD, PhD, executive director of Partners in Health (PIH). "What we're trying to develop is a consensus document," Kim says. "We're drawing on the expertise of as many people as possible and casting our net as widely as possible, listing goals that we can all agree on."
A new vaccine; new diagnostic and therapeutic tools; expansion of directly observed therapy, short-course (DOTS) coverage to meet targeted goals by the year 2005; and effective responses to the twin threats of multidrug-resistant TB and HIV-related TB should all make it onto the agenda, according to a preliminary outline of the plan.
After all, Kim says, if ever there was a time to think big, this is it. "We're living at a unique moment in history, and it's important to take advantage of it. There's so much money in the hands of newly rich people, yet TB is still being poorly managed. That's why we have to think big."
What all that thought will cost is still under debate, but estimates place the price tag at somewhere between $600 million and a billion dollars, he adds. "I think if we could get a handle on TB for a billion dollars a year, that would be one of the best bargains imaginable."
George Soros' Open Society Institute commissioned PIH, along with members of the international STOP-TB coalition, to write the investment plan, which is due out sometime in early summer. Before next fall, when a donors' conference is due to convene, the plan will have gone out to key players in the donor community, and at least some commitments will have been secured, Kim says.
One important feature of the plan is that it will list at least 10 ways donors and countries can take part, he says. There's always cash, of course, as well as a variety of much-needed in-kind investments rich countries can supply, such as lab services, which the Massachusetts State Laboratory already supplies free of charge for projects in Peru and Haiti.
There also are debt-for-health swaps, Kim says, which work like this: Suppose a poor country owes a billion dollars but has little chance of repaying it. A donor could offer to buy the debt at a reduced rate. In exchange for that, the poor country could repay its debt by obligating itself to invest an equal amount of money in health care.
Though Kim and others at PIH are doing the actual labor of putting the document together, Kim take pains to stress that the GIP isn't going to reflect only the aims of "Americans and Europeans."
"We have [input] everywhere in the world, certainly from lots of high-burden countries," he says. "We've reached out, and we want people to read this document and respond."
Drafts of the plan are being posted on the STOP-TB Web site, www.stoptb.org.
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