ccmindo - Apr 11, 2006

Views of Indonesia CCM and Technical Working Group Members

Remy Rohadian – AusAID Indonesia
In order to survive, GFATM might need to review the way they do business (eg from centralised to decentralised); improve M&E systems and implementation; inform the donors about the consequences of non-funding scenario for the countries in need; promote communication and program harmonisation with multilateral, bilateral and private organisations (to minimise overlap and duplication); improve efficiency, for example, the HQ overhead costs (for staff, meetings, and travels) should be reviewed to make savings so that more resources are available for country programs (including strengthening of CCM Secretariat); and set up new and realistic targets (based on absorptive capacity of particular country), and new funding is subject to accomplishment of those targets.
If GFATM had to end (in case the donors do not trust it anymore), we still have to make sure that the current programs are implemented according to the plans and benefit those who are effected and affected.

Rachel Odede – UNICEF Indonesia
Let us look at the demise of GFATM as an opportunity to do more rather than doom to HIV/AIDS response in Indonesia. This is an "opportunity in crisis". Why do I say so. Opportunity because Indonesia cannot afford to do nothing if funding from GFATM is not available - it must look internally to ensure sustainability of efforts in place. This calls for self audit to determine availability of local financial, organizational and human resources; to moving from political will to political commitment; to attract more partners (Private Sector) to leverage resources for HIV/AIDS; and to promote true engagement of communities to realize potential effect of HIV/AIDS in national development. Crisis because not enough contingency strategies/plans seem to be in place to immediate deal with the end of GFATM - no plan "b" seems to be in place or if it is there it should be brought to national agenda to ensure effective preparedness mechanisms developed. Both cases (opportunity/crisis) call for unparalleled political commitment to build the partnerships needed to raise critical financial and human resources required to bridge the gap created by the absence of GFATM contribution. And they call on all Indonesians everywhere to demonstrate their willingness to confront difficult issues around HIV/AIDS. The resources are available in the country. There are also other external resources. The challenge is to develop strategies to mobilize these local resources to help Indonesia meet its MDG goal # 6 - to halt and begin to reverse the spread of the disease by 2015. Failure to meet the goal on HIV/AIDS will adversely affect Indonesia's chances of progress on the other MDGs.
The ball is in our court - this discussion is one step forward.

Firdosi Mehta – WHO Indonesia
I would turn the topic around & pose it as "What should countries do to address issues raised by grants coming to the natural end of their phase 2 funding"?

I would think, that they should either apply for another round in advance; look for alternate funding; or ensure that the funding gap is closed by increasing local contributions to ATM programs at all levels.

What the Global fund should do is to ensure financial support, so that Funding Rounds can continue until at least the MDG's are reached for countries in need.

Firman Lubis – Coalition for Healthy Indonesia
The Global Fund has to make its best to stimulate the CCM/Secretariat especially the government representatives such as Kantor Menko Kesra, Depkes, Depdagri, Depkeu etc. to gradually take over the funding on a sliding scale mechanism. As I mentioned several times, sustainability ofthis program should be the first priority. This can be done a.o. by asking to state in the progress report how far (in percentage) co-funding from the GOI has been allocated. Another thing is to stimulate the private sector's funding contribution. This needs a good proper approach to business community/big companies. Support from high officials/celebrities in this effort is very important. Another possibility is to generate funding from community donation to combat these three diseases. With a good sympathy campaign, I think it can increase community awareness regarding these diseases and generate some funds as well. Global Fund has to end its funding gradually until sustainability is secured.

Jane Wilson – UNAIDS Indonesia
I agree as this also links with need for a fiscal strategy for reaching the MDGs. Coincidentally UNDP has it available through a regional initiative that we could link with. It also underscores the need for costed work plans for all three diseases. AIDS is not done yet nationally though I know Ministry of Health has done theirs.

N Brunet - Apr 11, 2006

I think the global fund ought to strive to source more funds on behalf of the well performing and accountable countries and groups. As a private donor, I am not surprised that there have been a few isolated cases of beneficiaries lacking in accountability. I am rather more impressed by the amount of transparency promoted by the fund. I am certain that all donors have had these problems in the past decades, which we did not hear about While I agree that non -performers must be weeded out, what impresses me most is the transparency and good speed with which the global fund has made available so much money for health in almost all developing countries. I will continue supporting it in any way I can.

Sammi Fredenburg - Apr 10, 2006

i'm thinking transaction costs are going to be somewhat necessary in the accountability process, however properly monitored and regulated. my concern is where so many are saying that the most grassroots level operations are being overlooked. it's one thing to get the aid to the area. . . . .it seems to be quite another to get it properly and efficiently to the caregivers on the ground for disbursement, yet that's the intention. is proper consideration given to infrastructure for this? roads, vehicles, planes, these sort of capital projects, are they considered when grants are given? or are they items that can be coordinated with the governments? knowing these matters are in the works or are being taken care of can be factors of consideration when dealing with Phase II funding.

sammi

tarigwafa - Apr 08, 2006

Hello; pleased to meet you again.

My contribution for this week will bring me back to several weeks ago. The only way to guarantee the success of such Global Fund programmes is to bridge the way directly to the grassroots. I'm saying this because from the experience of my country, only those who work in TB, HIV/AIDS and Malaria Programs are aware about the Global Fund, in addition to the Minister, undersecretary and some of the directors of the general directorates at the federal level.

Dr.Tarig Dafallah
HIV/AIDS State Coordinator
SUDAN
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Tarig Dafallah

ogenkemakolam - Apr 08, 2006

The Global Fund should continue with the ongoing grants coming to the natural end of the phase 2 funding because it is effective for accessing the extents of performances before awarding any further funds.It will make for accountability and project and financial resposibility on the part of the funded and the funder.
The GF should look at ways to fund NGOs directly while the CCM supervises.
If there is any real need for improvement it should be to increase the phase 2 funding to phase 3 and then instead of a 2 years assessment period it will now be reduced to 1 year.

from
Oge Franklyn Nkemakolam
ANTI MALARIA & AIDS INITIATIVE NIGERIA
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LETS HELP MAKE AFRICA FREE FROM DISEASES AND POVERTY ULTIMATELY SHOWING CONCERN FOR HUMANITY

Apr 07, 2006

Wishing you all a Happy World Health Day !

Thank you all for your excellent and very useful suggestions. Some specific issues have come up regarding the Phase 2 grants in question. What more should the Global Fund do to:

1. Find and secure funding to continue programs started via the expiring Global Fund grant if the program desires to continue?;
2. Effectively direct funds which were earlier used for infrastructure development, into reaching more people?;
3. Ensure that a gap in services does not occur from when the Global Fund grant term ends to when new funding becomes available?;
4. Develop ways to smoothly transition out of programs reaching the end of their funding periods (e.g. closing clinics and prevention centers, helping workers to find other jobs, etc.) ?

We would be even more delighted to receive more of your very useful responses to these issues.

Darren Fast - Apr 07, 2006

I agree with the spirit of the postings so far that state that if project objectives are being achieved, the funding should continue. It is obviously important to have clearly stated goals and deliverables for both phases of funding. It is also important to remember that by definition, projects should have end dates (that might not conveniently fall into 2 or 5 year chunks) and definitely have limits on resources available.

Perhaps there should be a process where successful projects could be applying for the next round of funding after the phase I review so that as they become ongoing programs with a periodic review process (yearly, biyearly etc), preferably with a goal of becoming self sufficient or at least less dependent on external funding, they can continue to deliver what the local situation requires. This way, for the successful programs there would not be a gap in funding while approval was being obtained.

I would suggest that as groups apply for new project funding, they apply with the assumption that funds will not continue past the first grant (ie end of phase II) without a new application. By ensuring that a new proposal must be prepared, there is room to reevaluate projects and perhaps choose a better project given the current environment than simply a continuation. If projects are anticipated to extend greater than 5 years, perhaps a different type of process should be considered.

Amadougalo - Apr 06, 2006

Dear member,

Good evening and thank you very much for your wonderful contributions.
In my opinion, what the Global Fund should do to address the issues raised by grants coming to the natural end of their phase 2 funding is to strengthen the spirit of ownership and partnership so as to ensure the sustainable funding of ongoing programmes/interventions. Partners should be made to honour their pledges on time to ensure timely disbursement of funds. Also, I think it is high time that a common plan of action taking onboard needs of target countries is put in place.

Best wishes,
Amadou

Dr. Saka Mohammed Jimoh - Apr 06, 2006

We can not just put an end to problems of HIV/AIDS, TB and malaria. I think GF should categorise the partners based on performace score Grades 1 green, 2 yellow and grade 3 Red. The analysis of factors (both internal and external) for success, failure and possiblity of these factors for continuation where Funds are available. Some might have overcome their internal and external factors for failure, while some may not be able to proceed futher. However, those in green can be supported to scale up and expand, while those in 2 and 3 can be merged or put in mechanisms for internal capactity building for them to move on.

Rember that GF has done a lot with those partners (Accountabilty, programmatic, leadership and management etc). It is beter to source for funds for continuation rather looking for new partners or otherwise, it is waste on costs.
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Dr. Saka Mohammed Jimoh

Apr 05, 2006

Message from J Vinod

Involvement of PLWHAs Organisation / Networks should be compulsorily done in the intervention programs.

Vinod

NKP+

Apr 05, 2006

Message from Jumoke Owoola (Nigeria)

What Global Fund need to do is to get closer to the grassroots people and speak the languages they will understand. Most of our stakeholders just sit down in one boardroom and dictates whatever they feel from their own personal minds. ... Let Global Fund get closer to the rural people and see what will happen. Humility,total concern , and willingness to serve are their toga. Once they believe in you; they will go to extra lenght to help as well as adhere to instructons...There should be need for partners to work closely with each other. There should be prorities especially after a thorough reseach on the real need.

First of all there must be proper awareness in local languages. Making use of drama, music and media no matter at what level. Either local, international or national. Carry them along and let them feel important and concerned.i e(Not until icasa2005 and scandal that rocked NACA:most journalists in Nigeria were not aware of anything called GLOBAL FUND). If this category of people supposing to be information carriers are not aware; how will grassroots people be aware?
GLOBAL FUND should not sponsor only Federal Government projects alone, they should look forth to other organisations


Jumoke

Njei Moses Timah - Apr 05, 2006

Any project that is well managed and has yielded positive results to the recipient communities should not be discontinued at the end of phase 2. Funds should instead be diverted from badly managed projects to support the the succesful ones. The global fund should make it loud and clear to recipient governments/communities that there is a heavy price to pay for mismanagement. Good management of resources is a sure incentive for continued donor support.
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Sammi Fredenburg - Apr 05, 2006

These funds truly are granted with a degree of trust and faith in the organization and individuals that they will do what they said they will do to the best of their future abilities. Benchmarks and milestones, though necessary and look good in spreadsheet and report form, can be cold and may not accurately or graciously reflect the impact on individuals and communities they were spent on. Like our youth, sometimes when given a dollar or a chore, their response can be yes I did as I should whereon our assessment may find major differences in expectations. But the only way to know that as a parent is to peek in on it ouselves. To correct the matter we can either hold to the standard or find a suitable compromise, but either way we mentor and parent the case. Both learn. All win.

Those with a love and heart and gift for those in dire need of these meds and services are not always the most talented in accountability or record keeping and report writing. I'm willing to bet most have not even written their own grant proposals even. Yet precious dollars and hours are spent on these matters when they'd rather be in the wards, thankfully, taking care of the human targets of these funds.

Perhaps something comparable to say a Global Health Fund ISO team, which has become a high-standard form of Good Housekeeping Seal for corporations worldwide, or on a smaller scale some other audit team to visit the site and themselves assess the progress? How were the misuse of funds in Uganda discovered? We shouldn't need a whistle blown to visit and be demanding of the progress of these precious funds. Yes it would take a portion of Global Health Funding to finance a team of this sorts, yet when company's coming the house is tidied and books are in order. . . . . and with the amount of dollars and lives we are dealing with, this may be a way to make sure the children and the communities are indeed benefitting and that misuse is not tolerated. Teams could peak under the beds in the cupboards and in the checkbooks and should there be any raised eyebrows remind them from where their funds come from. We all need recallibration due north from time to time.

Thank you everyone of you who are in these countries taking care of these dying people. You are much appreciated.

Sammi

SABINA - Apr 04, 2006

Personally I think I buy the contribution of "Indra" above.
When the initial funding was released, it was meant to achieve a particular set milestone. Now to help make conclusions on whether to release the 2nd phase will depend on the tracking of the activities that the initial fund was meant to realize. And this tracking and reporting should commemnce immediately, in order to discover the successes and probably the challenges faced in realizing this milestone. This I believe will help to make a rational decision.

But in a situation where there is no basis for effective utilization of the initial funding, then it could be tranferred to another focus area. This will help it give most countries a chance to prove their potential. And probably carry on a review and assessment exercise on the initial fund channelled area/country, and see how much they could still be given another chance.
Thank you very much Global fund. This opportunity makes one feel good.

AdaB
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Do what you can, when you can, where you can and how you can.
SEA

Rishi - Apr 04, 2006

I am not up to scratch on The Global Funds procedures, but in reading the question wouldnt it be suitable to assess outcomes of project, establish its feasability, research the model of development put into practice, if succesful use this as a model of best practice, continue to support the agency of delivery, but build in resources that will enable them to assist with the development of similiar agencies. Therefore funding becomes organic and enables for the replication of succesful projects to continue. therefore enabling the 'original' agency to become the hub of change, thus preventing reinventing the wheel. In addition similiar projects applying to the fund must be assisted to communicate and learn from similiar succesful projects (training and development) in doing this it would hopefully enable the reduction of costs in the long run to the fund as support networks will be formed connected to an experienced 'hub'
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