The Global Fund to Fight AIDS, Tuberculosis and Malaria is marking its 10th anniversary. But celebrations have been subdued because of a lack of donations needed for future projects. The United States is being called on to lead efforts to replenish the fund, in a time of worldwide recession.

Last November, the fund's board decided to cancel its latest attempt to ask for pledges from donors. That put many planned projects in jeopardy.

"There is a crisis. The global fund is functioning, but it did not get in its donor replenishments an adequate amount of money for the period 2011 to 2014. And as a result of that, it actually suspended what they call Round 11, which was supposed to take place in 2011. And because of that, many programs in many countries are now in peril," said Jeffrey Sachs, head of The Earth Institute at Columbia University, who was among those who lobbied for the fund's creation.

Estimates say about $2 billion in pledges is needed for Round 11.

Nay to naysayers

Sachs said the global fund is a success story that needs to be championed.

"Since the financial crisis, governments have cut back in spending in general, but many have found it convenient to cut back on spending on the world's poorest people. This is of course a double tragedy. Often waste goes unattended, but because the poor don't have a voice they don't get heard," he said.

Sachs and others want the United States to lead efforts to replenish the fund. They're calling on the U.S. to propose an emergency donor meeting. If that happens, they say, Round 11 could still take place.

Sachs said the global fund has proven all the critics and naysayers wrong.

"It showed how every skeptic 10 years ago who said - you could not treat AIDS in Africa, you could not get ahead of the epidemic, you could not control malaria because bed nets would not be used and every other myth that was said - has been proved wrong," he said.

Two key donors

The fund did receive good news from the World Economic Forum in Davos, Switzerland.

"Two key donors cast votes of confidence with their checkbooks. Bill Gates announced a $750 million promissory note to the fund and urged support for the fund. And Japan, despite an earthquake, tsunami and a nuclear crisis, reconfirmed its $800 million pledge. These contributions are a strong endorsement of the fund's impact and effectiveness and a challenge to other donors to step up," said Joanne Carter, director of the RESULTS Educational Fund.

The Bill and Melinda Gates Foundation has been one of the world's biggest contributors to health-related programs. Over the past 10 years, it gave the global fund $650 million. Gates described the promissory note as an innovative funding mechanism.

"It frees up funds for (the) global fund and so they can immediately use the money and continue to save lives." He said.

Gates says the global fund can change the fortunes of the world's poorest countries. Supporters estimate the fund saves 100,000 lives every month by funding programs and projects in 150 countries.