G8 increases aid to Africa but moves little on climate change
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《英国医生杂志》
Health expenditure in Africa, especially cash to fight AIDS, malaria, and poliomyelitis, should grow exponentially in the next five years as a result of decisions taken by leaders of the G8 industrial nations at their disrupted summit in Gleneagles, Scotland. The G8 agreed to increase overseas aid by $50bn (￡28bn; 41bn) by 2010 compared with 2004, with half the rise dedicated to sub-Saharan Africa.
Tony Blair asked each individual G8 leader to sign as G8 leaders have a long track record of failing to keep their summit commitments. The rotating presidency and lack of permanent G8 bureaucracy allows leaders to escape most come-back.
Mr Blair, helped by the lobbying of pop singers Bono and Bob Geldof in the grounds of the Gleneagles Hotel, spent his limited time at the summit negotiating extra cash injections from the Japanese and the Germans. This ensured that he was able to say he had met the commitment set out in the Commission for Africa report to double aid to Africa by 2010 ( BMJ 2005;330: 622, 19 March).
Many of the development agencies, less enthused by the outcome than the effusive Mr Geldof, said that much of the cash would not arrive until 2010, and almost half the money had already been pledged by governments.
Prime minister Tony Blair chairs a meeting of the G8. With him (left to right) are Presidents George Bush and Jacques Chirac
Credit: PATRICK KOVARIK/AP/EMPICS
The G8, largely because of opposition from the United States and Canada, also failed collectively to agree to boost spending to 0.7% of gross domestic product or to the novel financing plan, the international finance facility, first set out by Gordon Brown, the UK chancellor.
Roughly four fifths of the aid will come from the European Union, even though the gross domestic product of the EU represents only two fifths of the collective gross domestic product of the G8 countries.
The announcement does not specify how the extra cash will be spent, or the mechanisms that might be used, such as the African Development Bank, but it does set out some broad goals and targets. The G8 itself does not have the authority to direct governments to spend cash in a particular way. The US tends to be prescriptive with aid, and the United Kingdom tends to let individual governments set their priorities.
In its single most specific target, the announcement embraces the goal of saving 600 000 children's lives a year by 2015 by tackling malaria by reaching 85% of vulnerable populations. The G8 adjudged that this will require an additional $1.5bn a year to ensure access to antimalaria insecticide treated mosquito nets; adequate and sustainable supplies of combination therapies, including artemisinin; presumptive treatment for pregnant women and babies; and household spraying. The G8 also proposed that everyone in Africa should "as close as possible" have access to AIDS treatment by 2010. This will require fuller commitments to the United Nations' Global Fund.
Mr Brown also won support for his plan for advance purchase commitments to encourage the development of vaccines, microbicides, and drugs for AIDS, malaria, tuberculosis, and other neglected diseases. The idea is for governments to give a commitment to buy a fixed number of vaccines in advance to ensure that drug companies will have guaranteed markets. A proposal for an International Centre for Genetic Engineering and Biotechnology centre in Africa to help research into vaccines is also supported, but little detail was provided. The announcement also contains a commitment "to eradicate polio and keep it eradicated" through continuing or increasing the G8's own contributions toward the required $829m. The UK pledged ￡60m to complete the eradication of polio this year.
The announcement also proposes, in line with the millennium development goals set by the UN in 2002, to ensure access to basic health care (free wherever countries choose to provide this) to reduce mortality among those most at risk from dying from preventable causes. Extra spending on water sanitation is proposed but again without specifics.
A working group will also look at the French proposal to see if the proceeds from a special airport levy could be dedicated to health, but a series of technical difficulties, not least opposition from the airlines and airports, leaves the project as a prototype.
Mr Blair is adjudged to have made less progress on climate change, the second chosen topic of Britain's G8, but he has set in train a forum or dialogue that could see China, India, the US, and the EU discussing whether they can reach agreement on a future emissions trading regime.
A new dialogue may seem inadequate to the scale and urgency of the deemed crisis, but Mr Blair thinks that by taking the US and the EU out of their respective trenches, he may have discovered a way of increasing cooperation on climate change, including technology transfer and the spread of carbon trading into the US.
An ambiguity remains at the heart of the agreement. The EU and most of the developing world think the current cap and trade regime set out in the Kyoto treaty should be continued after 2012, when the treaty comes up for renewal. The US does not. It only favours targets to reduce carbon intensity, the amount of carbon used for a unit of production. The dialogue will have to be intensive for this gap to be bridged. (See News Extra on bmj.com.)(Patrick Wintour, chief political corresp)
Tony Blair asked each individual G8 leader to sign as G8 leaders have a long track record of failing to keep their summit commitments. The rotating presidency and lack of permanent G8 bureaucracy allows leaders to escape most come-back.
Mr Blair, helped by the lobbying of pop singers Bono and Bob Geldof in the grounds of the Gleneagles Hotel, spent his limited time at the summit negotiating extra cash injections from the Japanese and the Germans. This ensured that he was able to say he had met the commitment set out in the Commission for Africa report to double aid to Africa by 2010 ( BMJ 2005;330: 622, 19 March).
Many of the development agencies, less enthused by the outcome than the effusive Mr Geldof, said that much of the cash would not arrive until 2010, and almost half the money had already been pledged by governments.
Prime minister Tony Blair chairs a meeting of the G8. With him (left to right) are Presidents George Bush and Jacques Chirac
Credit: PATRICK KOVARIK/AP/EMPICS
The G8, largely because of opposition from the United States and Canada, also failed collectively to agree to boost spending to 0.7% of gross domestic product or to the novel financing plan, the international finance facility, first set out by Gordon Brown, the UK chancellor.
Roughly four fifths of the aid will come from the European Union, even though the gross domestic product of the EU represents only two fifths of the collective gross domestic product of the G8 countries.
The announcement does not specify how the extra cash will be spent, or the mechanisms that might be used, such as the African Development Bank, but it does set out some broad goals and targets. The G8 itself does not have the authority to direct governments to spend cash in a particular way. The US tends to be prescriptive with aid, and the United Kingdom tends to let individual governments set their priorities.
In its single most specific target, the announcement embraces the goal of saving 600 000 children's lives a year by 2015 by tackling malaria by reaching 85% of vulnerable populations. The G8 adjudged that this will require an additional $1.5bn a year to ensure access to antimalaria insecticide treated mosquito nets; adequate and sustainable supplies of combination therapies, including artemisinin; presumptive treatment for pregnant women and babies; and household spraying. The G8 also proposed that everyone in Africa should "as close as possible" have access to AIDS treatment by 2010. This will require fuller commitments to the United Nations' Global Fund.
Mr Brown also won support for his plan for advance purchase commitments to encourage the development of vaccines, microbicides, and drugs for AIDS, malaria, tuberculosis, and other neglected diseases. The idea is for governments to give a commitment to buy a fixed number of vaccines in advance to ensure that drug companies will have guaranteed markets. A proposal for an International Centre for Genetic Engineering and Biotechnology centre in Africa to help research into vaccines is also supported, but little detail was provided. The announcement also contains a commitment "to eradicate polio and keep it eradicated" through continuing or increasing the G8's own contributions toward the required $829m. The UK pledged ￡60m to complete the eradication of polio this year.
The announcement also proposes, in line with the millennium development goals set by the UN in 2002, to ensure access to basic health care (free wherever countries choose to provide this) to reduce mortality among those most at risk from dying from preventable causes. Extra spending on water sanitation is proposed but again without specifics.
A working group will also look at the French proposal to see if the proceeds from a special airport levy could be dedicated to health, but a series of technical difficulties, not least opposition from the airlines and airports, leaves the project as a prototype.
Mr Blair is adjudged to have made less progress on climate change, the second chosen topic of Britain's G8, but he has set in train a forum or dialogue that could see China, India, the US, and the EU discussing whether they can reach agreement on a future emissions trading regime.
A new dialogue may seem inadequate to the scale and urgency of the deemed crisis, but Mr Blair thinks that by taking the US and the EU out of their respective trenches, he may have discovered a way of increasing cooperation on climate change, including technology transfer and the spread of carbon trading into the US.
An ambiguity remains at the heart of the agreement. The EU and most of the developing world think the current cap and trade regime set out in the Kyoto treaty should be continued after 2012, when the treaty comes up for renewal. The US does not. It only favours targets to reduce carbon intensity, the amount of carbon used for a unit of production. The dialogue will have to be intensive for this gap to be bridged. (See News Extra on bmj.com.)(Patrick Wintour, chief political corresp)