An uneasy sensation, of the pit-of-the-stomach kind, spread among the activists and donors supporting the fight against AIDS this week.
The Global Fund, the international partnership that channels money to fight AIDS, TB and malaria, announced it has been forced to delay applications for new programmes due to insufficient funding from donors. Instead it will have to focus its efforts on maintaining the current programmes.
After a decade of huge leaps forward in the fight against AIDS, it is hugely concerning that progress may stall.
New figures from UNAIDS this week showed that in just one year we have added 1.4 million people to treatment.
In 2003 only 100,000 people had access to life-saving antiretroviral treatment, now more than 6.6 million people do. This is in large part thanks to the work of the Global Fund, which is responsible for a sizeable chunk of the global response to HIV and AIDS.
Despite this progress, nearly 8 million others are still waiting for life saving drugs and the number of new HIV infections remains high. And while effective treatment to prevent mothers passing on the virus to their babies is available, less than half of HIV positive women have access to it. A major push is still needed in order to turn the corner in this epidemic.
This year, for the first time, evidence shows us that it is possible to end AIDS within a generation. New research found that an HIV-positive individual on antiretroviral treatment is up to 96% less likely to transmit the virus to others.
This news should give us reason to be more hopeful than ever that the fight against AIDS is one we can win. But this hope is being undermined by donors who are not meeting their promises to the Global Fund.
In the past all pledges made to the donor fund have been delivered, but now this record is slipping. Some donors are not keeping their promises and others are delaying pledges. Now is the worst possible time for delays and broken promises.
There have been concerns about the Global Fund. It is true that they identified a very small proportion of funds being lost. But the Global Fund has a zero tolerance policy for corruption.
Suspected corruption is pursued aggressively, corrupt officials go to jail, steps are taken to reclaim funds and new safeguards are put in place. The Global Fund has also introduced a pro-active plan of action to address any remaining issues.
The openness of the Global Fund and its commitment to deal with concerns head-on is something worth celebrating. And reforms agreed this week will make the Global Fund not just a life-saving global health institution, but also a leading example of smart aid and transparency in practise.
If donors had doubts, they should now have confidence.
Germany has responded to this development by releasing a commitment of $100m to support the Global Fund.
Other donors now need to follow. And donors must commit to serious planning for an ambitious scale-up of efforts over the next couple of years, to ensure the Global Fund can reach many more people who need its help. We cannot afford to lose ground just when the beginning of the end of AIDS is in sight.
When the Global Fund was first established Kofi Annan said "the war on AIDS will not be won without a war chest". That is still true today. The world needs the Global Fund and we need to fund it. This would be the worst time to falter.
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