Summary of discussion, Identifying problems in grant implementation:

Representation & project implementation

1. Identify the needs from the onset by including representatives from those working at the grassroots level in the grant implementation process, ensuring that the CCM is participatory as possible.
   
2. The Global Fund should insist on a balanced technical and administrative representation from the variety of organizations represented in the CCM, rather than the representation of institutions, sectors and persons affected by a disease. Discussion would more likely be focused on the technical soundness of the proposals, rather than institutional power-play.
   
3. Project managers and independent advisors with high levels of experience and expertise are needed in the implementation of projects.

 Monitoring & Evaluation

4. Create an independent Monitoring and Evaluation (M&E) Committee, with a fulltime M&E officer to provide better support to the CCM in its overall oversight functions. This committee should have user-friendly tools, and should provide regular reviews on program implementation and report to CCM accordingly. Monitoring reports should be made available online. National M&E systems should also be considered.
   
5. There should be a CCM Governance Manual to clearly explain how CCM should carry out its oversight role.
   
6. Field monitoring should be carried out by the CCM to detect problems early on. Regular LFA reports should also provide timely identification of problems throughout the grant implementation process, which should be closely examined by CCMs.

 Communication between CCM & stakeholders

7. The Global Fund should develop a well defined capability model to improve the relationship and communication between CCMs and the stakeholders, such as PRs, LFAs, through which accountability, transparency, information-sharing should be strengthened.
   
8. Principal Recipients should report immediately to the CCM any difficulties encountered to ensure objectives and planned activities are well coordinated with all the stakeholders involved.
   
9. Give greater decision-making powers to CCMs with regards to PRs 

Capacity building

10. CCM should have a capacity building frameworks in place to provide support to stakeholders, particularly civil society. Capacity gaps should be identified at the beginning of grant implementation.
    
11. Long-term capacity building should be considered, which can provide regular contact between PRs and technical assistance providers so that problems can be resolved early and quickly.
    
12. New CCMs should undergo induction training.

Grant design flexibility

13. Programs need to be flexible enough to allow for redesign mid-term, if needed. Disease landscapes are constantly changing.

 Quicker time-frames

14. Reduce time gaps between development of proposals and grant implementation.
    
15. Avoid delays in fund transfers, which will positively impact effective implementation.

Managing cultural differences

16. There should be mechanisms in place that place more emphasis on behavioral change.

Contributors: 

English: clearconscience Najibullah Safi  mukonjia  abraham unyimeabasi Aishath Shifana  c.Ravichandran raphael.girod  Gracia Violeta Ross  reginabhebhe  Jan van Charante  ChristineOrtiz  NFORMI EDWARD KOMUSONG  Sanjeev Kumar  Abu Sayeed  jbpaikins  Javed S. Ahmad  Malini Eden  May Mahmoud Farag Ahmed  bangkit  Fenna E. Bacchus  daveapmg  Henry Nema  jaap schep  ASHISH SRIVASTAVA  jmgurnick@earthlink.net
Spanish: Alejandro Uriza  homenaje  Hugo Rolando Valladares Morales
French: stanli83  Malakona  sakhary Oumou Salamata Thiam SECK  SAKANGA MOUROUBA
Russian: Alexander Khan 

Dear Fenna,

I have never in any way suggested that you are being emotional, or that readers should consider you as such. No. Not at all. Rather, Your contributions have been appreciated to a large extent because you have been trying to expose the evil deeds of some people, especially those in authority whose bad deeds are negatively affecting the GF programs directly or indirectly.

 I only expressed my belief that there are some readers who might be tempted to think that you are being emotional, instead of accepting your contributions in good faith and giving them the needed support and attention they deserve.  

Fenna, I mean no harm. Keep it up. GF needs your contributions. 

JOSEPH B. POKOO-AIKINS/ASP

UNAMID – DARFUR, SUDAN.

My Brother Mukonjia,

You can't even hear a pin dropping from those CCM's involved. They've all gone underground because they've been busted. No matter where they go for cover they will be exposed. I hate cowards. They are not man enough to admit that they screwed up royally.

Asish, I m thankful to you for your levelheaded professional tack of things but most CCMs don't understand a fly of what you are saying and, therefore, ignore you. Asish, stealing is stealing and its just gets juicier, better and more sophisticated with each round of fund disbursement. This is the game plan that you need to understand.

The GF has "facilitated" alot of these undesirable practices by not being proactive and vigilant.

I've restrained myself for a very long time and innocent Africans suffered so badly and died.

I've been far too polite with my submissions. Mukonjia, I was trying to be too polished and polite with the King's English. Then ofcourse the cute word "professionalism"...but you know what? The language has to become rough and tumble in the boxing ring. Someone needs to  publicly shame and disgrace these "elements".

The story was like a festering wound full of gallons of exudate (pus). It is so smelly that I am sick to my stomach. It is still oozing smelly pus and I'm absolutely not letting up because this is knowledge in the public domain and this made the headlines. When the story broke in various news media internationally it was the most perfect timing to make a landing in the region. I've been watching with bated breathe how the scandal was unfolding and how those "elements" have been running for cover. I hope the GF sacks all of them and changes the Bylaws because that will curb corruption if each CCM is officially interviewed and selected by a panel. Currently, the CCM composition is a scattered one where certain members are privy to the secret meetings at the dark of night. The CCM composition represents the dominant ethnicity of the "President" and also the ruling party. This is absolute breeding and fertile ground for wide spread corruption.

Some of them held emergency meetings around the clock trying to explain the sudden madness that has hit the GF to deny them round 8 from the honey pot. Then they ran to certain national meetings of AIDS Control Council and those on HIV and STDs, National Bartender Conferences on Sexual Violence only to find that the person they committed the crimes against (illegal removal from the Board or the CCM at the middle of the night and altering the Board Minutes and putting their name instead), was face-to-face in body watching them. Those "elements" were dumbfound and thought this was a ghost. This was quite a spectacle, but the high drama was missing as I watched from a distance. 

Now the GF made a landing as a landing in this beautiful capital and it was a lady from the top of the GF. It was hurry scurry for the "elements". It is so scandalous that no CCM's are talking to defend themselves in the countries where this is taking place. The information I submitted for the past 48 hours was brought to my attention months ago, but I had to wait to let the cat out of the bag at the right time when the underwears are down to the ankles. 
 
And this according to commentator Andy Rooney "was the rest of the story".
 
Fenna

Dear GF brothers and sisters,

Fenna E. Bacchus, in her contributions, might be considered emotional by many readers. Her contributions are very interesting and must be studied carefully and given the needed attention.

However, I advice my good and leaned friend, Fenna, to go the extra distance to bring to light more solutions to assist the Global Fund improve on its functions and also offer better services to improve the plight of the sick, the needy and the unfortunate ones in hopeless situations.

I am a peace officer and such I wouldn’t like to delve into politics. But some people in many countries can make or unmake the GF. They can use or exploit the GF to achieve their wicked desires, fame and ambitions. This should never happen. It should be prevented from happening.

Let us together, in the name of God, offer our best to alleviate the plight of the sick, the needy and those in hopeless situations.

 
J.B. POKOO-AIKINS/ASP

UNAMID – DARFUR, SUDAN.

To CCM-FORUM,

Received reminder.I am sending e-FORUM discussion 2008 for
development of possible mechanism & identification of problem
during grant implementation.This discussion is based upon
product concept including product simplicity,promotional mix,
optimum utilization,integration of independent variable&
social adaptability of goods/services in less GNP& developing
countries.
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The GF Secretariat could provide vital mechanism for (Community-
System Strengthening - Affected population,grassroot solution,
social factors i.e. labour migration,unhygienic conditions,
literacy level,gender disparity factors attributed specific
diseases & integrated approaches.
The GF Secretariat should develop appropriate measures with
inclusion of strategic intervention to overcome oversight problems
in implementation of GF process.
In developing Asian & African countries, product mix,projects &
grants relationship,mobilizing resources are vital issues in
implementation of GF process.In the above process,GF Secretariat
should develop specific product based economic model& procurement
of effective,less expensive products for fulfill socio-economic
expectation of countries.For formation of economic model,GF Secretariat could interact with GF stakeholders in the form of
Public,Private,Govt,economical& financial institutions,research&
development for effective implementation of GF process.
These institutions should ensure product's simplicity,product mix,
promotional mix,hedging,optimum utilization,& integration of
independent variable/participant/channels for mobilization of
resources& grant consolidation.GF Secretariat could develop business
models with inclusion of expertise variable & organisation e.g.
Industry,sales,enterprize resources planning,medical attentive
services. Discussion , requirement of an organisation could give
specific priority of GF Secretariat for mobilization of resources,
integrated approaches& grant making process.
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Thanking you

ASHISH SRIVASTAVA
EX-International Marketing
&e-Forum 2008(SEAR-INDIA)

Dear Javed and Jaap,

I've the deepest regard for you for understanding the mammoth challenge the GF is facing with especially African countries.
 
High level telephone conferences and in person meetings with African high officials outside of the African continent revealed that there is absolutely no urgency for African Presidents, Ministers of Health and top strategic policy makers (leaders) to eradicate HIV/AIDS, TB and Malaria. It has been their custom to give lipservice at high level UN meetings, regional meetings and to leave the impression that they are working hard to eradicate these menaces.
 
In reality I was personally warned not to push for a cure or anything in any African country receiving GF and other donor funding because this is the biggest honey pot of free for all money for all participating African governments. They have guaranteed and unrestricted access to GF money and do not feel they need to give any accountability to anyone. If we press for eradication or solving the problems by bringing in a cure for the above diseases we will simply stop the flow of free money in the honey pot and mess up the leadership that has generously benefited from corruption, theft, diversion, kleptomania and misappropriation.
 
Things are so much out of control that fraudulous midterm, progress reports and program evaluations are submitted by the CCM to the GF, while the funds are misappropriated, the sick clients never saw the medicines or were visited by health care providers for drug distribution and education. If they were given drugs they were banned substances such as the Malaria drugs I mentioned in an earlier submission.

Who is verifying the validity of all these reports? This is were Quality Assurance,Risk Management, a Retrospective Utilization Review and Fraud detection comes in. It is mandatory that if the GF means business that they make an concerted effort to know avail themselves of credible knowledge how their funds have been spent and that they take CCM reports with a grain of salt before disbursing any more funds. An "inspector" of Western origin, non-native or non-regional origin that knows the political culture, worldview and country well, must verify the content of these reports and match this with accounts given individuals...not goverment leaders, talk to CBO's and churches randomly and the truth will come out. Many of the CCM reports submitted lack credibility. The proof again is that Kenya doesn't know how many of its citizens are on ARV's.... This firmly justifies an immediate formal programme audit of all the previous reports going back years and put them into question. There are too many gaping holes and I don't feel comfortable with the PEPFAR and Bill & Melinda Gates Funds paying for things which are not hard facts but just a figment of one's imagination.     
 
African governments have no intent to investigate any fraud or theft unless they are forced to and sack their innocent ministers and assistant ministers of health who are not the ones that have stolen GF monies....so why are we even in Africa and what is the GF doing? The problem is also if the funds pass through the President's Office, his wife has unrestricted access to it before the Ministry knows what has come.
 
More interesting is that in a certain country the President, under duress forced the Minister of Health to sign the checks for him to cash to run elections against his opponent. Then the President's wife, his brother and the Minister of Foreign Affairs ate from the money and ran agains the opponent and all won seats. When the GF and IG reads this they will know which country it is also.
 
Worse yet, some communities wrote through their representatives on this e-forum that they have gone to these communities mentioned in the GF reports to verify whether indeed HIV drugs were distributed and the communities never saw a single person. For example cases in Nigeria and the Congo.
 
How can we on this e-forum have a conscience, eat and drink while our poor disenfranchized people are dying like flies left, right and center because of such unethical practices??? We should not sidelines these issues otherwise we become accomplices. We should stand in unison and take drastic action without further disenfranchizing the poor and give them dignity to die without pain and hardship. Im a hospice nurse and I grief about our people dying without dignity. I wish I can take their pain and agony on my shoulders and carry it for them. They don't deserve the pain they are going through.
 
Fenna

Both Jaap and Fenna have hit on the nail on the issues. Unlike other major donor international organizations, Global Fund made a heroic effort to ensure ownership of the programs by the countries, via CCM. However, good intentions are not always enough. I believe when so much free money is involved, anything that can go wrong, will.  It is not surprising that in such situations, highest political offices want to have their say on how the funds are distributed (to serve their constituencies, hiring their recommended personnel, and so on). Jaap's suggestion of  introducing stricter rules and procedures for the use of funds is certainly critical. May be Forum can discuss what are the tried and tested methods that ensure better accountability and efficient management of such funds.
 
As Fenna said there are good CCMs that implement programs in the spirit of helping their people. And then there are others.
 
I agree with Jaap that independent, experienced and qualified technical persons should be engaged by the Global Fund to work with CCMs and LFAs. While LFAs can ensure if procdures were being followed, Technical experts can ensure that project designs are technically sound and program objectives are attainable, among other things. The resources spent on technical oversight will eventually pay off by reduction of redundancy and wastage. If all other donor organizations use technical officers and consultants, there must be a cogent reason for it.

 

Regards.

Dear Dr
 
I've been associating with the top medical experts in the world and none has given me a cure for kleptomania, theft, fraud, misappropriation, diversion of funds but I do have the cure ....and I am telling you it will work like a charm...
 
Yes CCM behaves like God the maker, creator and ruler of all living human beings and that ultimate power needs to be taken away. They all need to be sacked with the greatest urgency. There is too much conflict of interest.

It's hightime that the GF becomes directly involved with NGO's/CBO's on the country level by posting an advert in the news paper that they are coming to establish a CCM. This will require amendments of the Bylaws. We need an unbiased CCM and that is presently is not the case on the country level hence the corruption. People put themselves there and kick others out. The GF has to send representation and literally have an interviewing panel in place that is ethnically balanced because as we see the majority of CCM is a reflection of the ethnic heritage/Political Party of the President. This is where we must break the back of tribalism once and for all.

If you do a survey of CCM in especially African countries you may come to some shocking and startling revelation:

1. male to female ratio
2. ruling party association
3. ethnicity
4. professional expertise and credentialing
5. what their understanding is of the MDGs for TB, Malaria and HIV/AIDS
6. whether or not they feel they are achieving the MDG's and explain how they have done so
7. what self evaluation mechanism they have in place to ensure that their performance is of a high standard
8. How many of them are running their own NGO's (conflict of interest) or have it someone else's name (they will not answer that coz then we understand how to start tracing the missing funds)

The GF needs to be able to track the originators of the proposals submitted by putting an advert in the national news papers and ask each CBO/NGO to come forward with the proposals submitted in the most contentious Round 8. Then the GF will be able to compare the original proposals submitted to the CCM and what the CCM says it received versus what they submitted for funding. We will also have confirmations which proposals were altered in the middle of the night without telling those poor CBO's and NGO's that paid so much money to develop their proposals. This has been going on year after year round after round. We need to see justice for the hardworking people that have been raped and disenfranchized by the CCM. This is the only way to catch the CCM in the act of corruption where it starts at the root and kick the culprits out.

It is so interesting how a Principal Recipient can just divert a massive chunk of  funds allocated for a completely different project and thought to get away with it ...this time they were caught with their underwears down to the ankles in a certain country. It made national headlines when the GF hierarchy visited and spoke on TV...and now its no longer a secret...its a disgrace to have allowed this to happen to poor innocent Africans that need medicine. I was right here when the big mess unfolded and how they scrambled for cover and tried to accuse one another. It was the popular enclave of 5 that is now keeping quiet. They can't look their collegues in the eye because they know what they have done. I have no mercy on them because they have no conscience, no backbone and deserve no respect from me or this e-forum. I dare them to answer me from wherever they went in hiding. I have every right to speak my mind on this e-forum because US tax payers dollars and US donors are making huge contributions to the GF and its also my money that has been abused. The US Senate Foreign Relations committee needs to know how our tax payers dollars are abused by kleptomaniacs that seek to enrich themselves on the backs of poor innocent people.

If we think behavioural change will work with kleptomaniacs...we need to revisit this topic because they have a way coming on board in another form and aliases. The GF needs to have a copy of their national ID on file and also which bankaccounts they have hidden the funds and under what aliases and companies...

DOOMS DAY HAS COME FOR THE CCM AND WE NEED TO STOP JOKING WITH THEM. FOR THOSE CCM'S THAT ARE HONEST AND FORTHRIGHT LET US CONGRATULATE THEM TO CONTINUE SETTING AN EXAMPLE, DO THEIR COUNTRY PROUD, THEIR FAMILY AND PROFESSIONAL ASSOCIATIONS. THOSE THAT HAVE BEEN A DISGRACE NEED TO BE XD AND PUBLICLY SHAMED FOR THE ONGOING CORRUPTION. THEY NEED TO BE ON THE INTERNATIONAL LISTING OF SHAMEFUL AND DISGRACED ELEMENTS. I'M FED UP WITH THEM BECAUSE THEY HAVE COMMITTED CRIMES AGAINST INNOCENT ILLITERATE AND SEMILITERATE HUMAN BEINGS THAT DESERVE LOVE AND CARE.

Fenna E. Bacchus