Stephen Lewis has been in town. I never hesitate if he’s around – jiggle the diary, change the schedule and make the time to see him. The former Canadian ambassador to the UN, former UN special envoy on HIV/Aids to Africa, is always worth listening to. His oratorical skills and passion for what he believes in – an end to HIV/Aids (he is co-founder and co-director of an advocacy organisation called Aids-free World) and fairness for women – are unsurpassed.

The man never seems to flag, even though the UN and Wikipedia both say he was born in 1937. Unbelievable. This time he was in London to lobby for more money for the Global Fund to fight Aids, TB and Malaria, which in spite of the Millennium Development Goals summit in New York and a big fund-raising meeting soon after, has been left short of the $13 billion it needs in 2011-2013 even to meet its existing commitments – let alone scale up, as global health experts say is necessary.

Lewis believes the UK government should stump up some more. He has a good argument – when does he not? This is how it goes. The UK is the only major country that has not yet made a definite commitment. It has made a projection, but because the department for international development is reviewing all its programmes for the new coalition government, the figures are not final.

Lewis says that the UK’s projected funding is an increase from £330 million over the last three years to £384 million in the next three years – the equivalent of slightly more than $600 million. The rise is about 16%, but France and the USA and Canada have increased their promised funding by between 20 and 33%. He particularly draws attention to France, which is of a similar size and wealth to the UK and is giving $1.4 billion over the next three years.

If the UK would raise its pledge by 40-50% instead of 16%, there would be enough money in the kitty to persuade the Gates Foundation to “accelerate” part of its promised future funding – and the total would then squeeze the Global Fund past the $12 billion mark. Then the Fund could go back to the donors and pitch for more, arguing that the absolute minimum of $13 billion is within reach.

Lewis is profoundly concerned at the implications of a failure to reach even $13 billion – let alone the $17 billion or $20 billion that would allow scale-up. Here I will switch to his words:

The likelihood of the loss of human life in the last half of 2011 looms extremely large. Already there are stock-outs. Already people on the ground are worried about whether gravely-ill people will be turned away. There is a very grave concern that with Pepfar flat-lining and the Global Fund below the minimum target we are going to measure this in human life. We are going to have a carnage that may not be the same as the last decades’, but it will be absolutely indefensible.

It was a shock to everyone not only that we did not get to $20 billion or $17 billion, not only not to $13 billion which meant we could hold the line where we are, but we came in at $11.7 billion, which necessarily dooms significant numbers of people to death.

This – over a cup of coffee on the South Bank – from a man who once debated with John F. Kennedy in a university competition and, according to his supporters, lost the match but stole the show. He says it forcefully, but who – at least on the need for more money – will say he is wrong? DfID’s review will be finished around February or March. Then we will maybe hear whether they are willing to take up the Lewis challenge.

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