We Americans can’t seem to get enough of our movie stars, rock stars, super models and flashy politicians. And they, in turn, live for the limelight. So when one or two high-profile individuals back a cause, they automatically raise awareness about that disease or condition. In recent years, many of these luminaries are doing much more than just adding their name to a worthy endeavor, however: These folks are actively involved in their crusades.

Whether it’s adopting orphans a là Angelina Jolie and Brad Pitt or producing a compelling documentary about the perils of global warming a là Al Gore, star power does the trick. And U2 front man Bono’s various campaigns, including the end of third world debt, were significant enough to place him on the front cover of TIME Magazine in December 2005 – where he shared the honor of person of the year with Bill and Melinda Gates.

Former U.S. President Bill Clinton is in there pitching, too: The Clinton Foundation HIV/AIDS Initiative has been helping to implement AIDS treatment and prevention programs in 20 countries in Africa, the Caribbean and Asia since 2002. The Foundation negotiates with drug makers and health ministries to bring down the cost of drugs and tests. In January this year, Clinton announced that the Foundation had worked out a deal for cheaper antiretroviral drugs efavirenz and abacavir (to be made by three Indian companies and one from South Africa), which will be priced about 30 percent less than current market rates. As well, the Foundation lined up four other companies to provide rapid HIV tests at a 50 percent savings. These products will be available to the Foundation’s Procurement Consortium, which includes 58 developing countries.

Among its latest accomplishments, Clinton’s HIV/AIDS Initiative reached an agreement with the Irish government, which will contribute 70 million Euros (about $88.6 million) to fund critical care, treatment and prevention programs in Mozambique and Lesotho.


In an era where AIDS, malaria and tuberculosis continue to devastate millions upon millions of individuals, global aid programs need all the money they can get their hands on. Already, the incredibly influential Bill & Melinda Gates Foundation has contributed massive amounts of money to aid in the creation and/or delivery of low-cost medicines to those who can least afford them – including a relatively modest grant of $750,000 to the Clinton Foundation, which it will use to investigate the best way to expand patients’ access to HIV/AIDS drugs. (For historical details of global efforts to improve world health, see the Signals articles, “North-South Alliances: Abolishing Pandemics” and “Who’s Going To Pay For Global Health?”)

In June 2006, billionaire investor Warren Buffett joined the game – and he upped the ante substantially. Buffett gifted the Gates Foundation with $31 billion, essentially doubling its assets. The donation will be made in the form of Berkshire Hathaway Inc. stock, transferred in increments over the years (with about $1.5 billion in 2006). But there’s a catch: Buffett wants his money distributed in the same year it’s donated, not stockpiled for future use. It’s apparently not at all easy to spend that amount of money well, nor to make sure it gets into the right hands. Therein lies the real challenge.

In many respects, though, current philanthropic efforts pave the way for future directions. Although not meant to provide a comprehensive accounting of all donations by all parties, foundations or initiatives to global campaigns, the following list should give you an idea of some of the larger funding deals that occurred in 2006 – especially those aimed at AIDS, malaria and tuberculosis.

n In January, Microsoft Corp. chairman and founder Bill Gates announced that his foundation will triple its funding for battling tuberculosis (TB) by 2015 – from $300 million to $900 million.
n In March, the Global Alliance for TB Drug Development (TB Alliance) announced that it had received $14 million from the British, Dutch and Irish governments to accelerate the development of new TB drugs.
n In late May, the TB Alliance received another cash infusion – this one worth $104 million over five years – from the Gates Foundation to develop its pipeline of nearly a dozen new drug candidates.
n In November, the Dutch Ministry of Foreign Affairs invested about 30 million Euros ($38.5 million) in three non-profit partnerships (The TB Alliance, Aeras Global TB Vaccine Foundation, and the Foundation for Innovative New Diagnostics) that are developing drugs, vaccines and diagnostics for TB.

n In July, the Gates Foundation awarded 16 grants – totaling $287 million – to create an international network of collaborative research consortia to accelerate the pace of HIV vaccine development.
n In August, the Gates Foundation came through again, granting $500 million over five years to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) – which provides AIDS assistance in poor countries.
n In November, The Global Fund granted $70 million to the government of Kenya to back programs that provide antiretroviral drugs to HIV-infected individuals.

n In May, the Novartis Institute for Tropical Diseases forged a new private-public partnership to discover next-generation drugs for malaria. The partnership’s other members -- the Wellcome Trust, the Singapore Economic Development Board, and Medicines for Malaria Venture – will provide $20 million to fund the research project.
n In September, pharma giant Pfizer Inc. pledged $15 million through Clinton’s Global Initiative to help develop and strengthen programs for the treatment and management of malaria.

Although the spotlight has been focused on the three diseases cited above, there are plenty more to tackle.

n On June 1, The Carter Center received the 2006 Gates Award for Global Health, a $1 million prize that honors the center, led by former U.S. President Jimmy Carter and his wife, for its pioneering work against neglected diseases such as Guinea worm, river blindness, trachoma, schistosomiasis, and lymphatic filariasis.
n In mid-September, the Infectious Disease Research Institute received a $32 million grant from the Gates Foundation to develop a therapeutic vaccine for leishmaniasis, a parasitic disease that affects more than 12 million people, predominantly in India, Africa and Latin America.
n A Gates Foundation grant of $21.3 million was awarded to the University of North Carolina to develop drugs for leishmaniasis and trypanosomiasis.
n About the same time, the Gates Foundation also granted $13.8 million to the Sabin Vaccine Institute for work on a vaccine for hookworm, another tropical parasitic disease that affects millions.
n In late September, the U.S. Agency for International Development announced a $100 million award to RTI International (a non-profit organization) to implement and integrate existing disease-specific programs for the diseases mentioned above, as well as other tropical neglected diseases.


Is it too soon to determine whether all the money being poured into the many projects underway to devise new, more effective drugs to treat pandemics has had any effect?

Well, yes and no.

In late March, the U.S.’s Centers for Disease Control and Prevention (CDC) reported that a new drug-resistant strain of TB (XDR-TB) has emerged around the world – and it’s nearly impossible to treat because it resists all known TB drugs. But the CDC did add a glimmer of hope, saying that six new TB drugs will be tested in humans in the near future: Perhaps one of them will work against XDR-TB.

In May, the World Health Organization (WHO) announced that 13 drug companies had agreed to phase out malaria medicines containing only artemisinin, a powerful drug that works against all parasitic strains so far. The WHO fears that this monotherapy approach will increase the rate of drug resistance among the blood parasites, however, so the companies agreed to shift their production to combination therapies containing older malaria medicines, as well.

Most recently, the WHO reported that the global AIDS epidemic is still growing – adding to the United Nations AIDS Report in June, which said that the spread of the disease has slowed in about 10 countries but continues to rise in others. According to the WHO, as of late November, about 39.5 million people are living with HIV infection, including 4.3 million new infections. However, its data also had a bright spot: Apparently, declines in HIV infection rates are being seen in some countries. New data also show that increased HIV prevention programs that are focused on reaching the highest risk individuals are making some inroads.

According to the U.N.’s data, the 2001 U.N. meeting turned out to be a turning point for AIDS financing: That year, countries around the world spent $1.6 billion on AIDS; in 2005, they spent $8.3 billion. Commenting on the data, Peter Piot, the executive director of UNAIDS, said, “We are seeing the impact… It’s about time.”

We’re now 25 years into the AIDS epidemic, but despite these inklings of hope, the fight is far from over. Even now, not all infected individuals are receiving help, and more contract the virus each year. The only way to really eradicate the scourge, according to the Gates in their speech at the 16th International AIDS Conference, is to prevent infection in the first place.