Michel D. Kazatchkine, executive director of the Global Fund (GF) to Fight AIDS, Tuberculosis and Malaria, arrived in India on Tuesday to get greater Indian support and funding for global health spending ahead of the United Nations Millennium Development Goals (MDG) summit in New York.

While he signed agreements with some new partners and promoted community-ownership of projects, Professor Kazatchkine's primary task is to meet top government officials and the Union Health and Finance Ministers to solicit political support in the advocacy efforts to replenish the GF.

Disease burden

India's position is perceived to be critical at two levels - as a country with a significant disease burden, and also as one being looked up to for leadership in keeping the focus on health issues.

In a telephonic interview from New Delhi, Professor Kazatchkine said: "My first objective is to ask the Indian government for political support in our advocacy effort to replenish the Global Fund.

"The replenishment conference for the Global Fund - which is seen as key to the achievement of the MDG by 2015 - will be held in October. Two weeks prior to that, world leaders will meet in New York for the MDG summit. Mrs. Sonia Gandhi will represent India.

He has also asked the Indian government to directly enhance its contribution to the GF replenishment fund.

"We are seeking to see if India, as a beneficiary of the GF with remarkable results on the ground in AIDS, TB and malaria, could support our advocacy efforts."

Professor Kazatchkine will also ask the government to directly contribute to the GF replenishment, as he did with other emerging economies - China and Brazil - earlier this year.

"It is the right time as the world moves politically from G8 to G20 [in terms of global governance] that the emerging economies also participate in a global solidarity effort," he said.

He went on to clarify: "I'm not asking for India to go from net beneficiary to net donor. Only that, while it remains a strong beneficiary, it also contributes to show its political willingness to that collective effort."

Professor Kazatchkine stressed that there could be no let-up in efforts to address the key development issues.

Matter of life and death

"I understand all of the constraints. I'm also saying this is a matter of life and death. Overall it is not big money, if you think of the wealth that is being generated everyday in just Wall Street, or the monies that go for war."

As a beneficiary, India has received up to $1.1 billion from the Global Fund, the amount being split for the three key sectors - AIDS ($800 million), TB ($200 million) and malaria ($100 million).

Targets being reached

"Overall, India is a strongly-performing portfolio for the Global Fund and targets are being reached. The Global Fund is supporting 2,60,000 people on Anti Retro Viral treatment for AIDS - a huge achievement that has happened in the last three-four years."

However, India continued to struggle with malaria, and with the current round of funding, it was proposed to scale up efforts to combat the disease, said Professor Kazatchkine.

"As the economy grows, I expect India - currently it is one of the countries with the lowest percentage of GDP for health - to put more resources into health.

"Part of the advocacy with member-nations is to increase the health component of the budget. Donors are telling me that we are ready to make larger efforts but to make sure domestic investments in health are increasing as well. It cannot be just a one-sided story," Professor Kazatchkine said.