lluberas - Mar 14, 2006

Global Fund should put more effort into providing quality integrated vector management to malaria control programs. Controlling the disease will not happen with treatment alone. It requires vector control methods to supress vector populations. This, however, will not be accomplished with mosquito net use. Unfortunately, vector management capacity is woefully inadequate in many countries and program managers tend to be medical doctors who do not fully understand the interface between human-vector and believe insecticide use for vector control is wrong. Medical doctors prescribe medicines at specific dosages and timelines with counterindications and precautions. Yet they do not understand that insecticides are also used to control specific organisms with specific timelines, limitations and counterindications.

More effort needs to be placed on field entomology. Controlling a vector-borne disease in the human population will only prolong its persistence. If the approach with AIDS was to just deal with the disease without looking at preventing its transmission there would be more people living with HIV/AIDS today.
_________________
Manuel F. LLuberas MS, IDHA
Medical Entomologist
Vector Control Systems & Program Management

Stella Attakpah - Mar 14, 2006

In addition to making available cheap affordable medication to the affected zones, the Global Fund should join in efforts of environmetal protection and primary health NGOs/organizations to impart to the people the knowledge and know-how of keeping their environment clean and free of dirty stagnant water. This could limit mosquito breeding and thereby cut down on malaria transmitting mosquitoes.

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Stella

umesh- Mar 14, 2006

Sir, I am happy to receive the Global Fund eForum news.

Price of products are not factors to be posted and discussed here.
Killing the bacteria (viruses?) is not our target, and the Global Fund should not be the source.

The Global Fund should be more than this is, the diseases should be supported (treated?) with some vital enegizers. Until then, no disease is going to be easy for the Global Fund- this procedure not only saves money but also lives.

I want more results than (achieved through) present efforts. This is a challenge to the global level (international ?) groups.

DR.VANAHALLI U.S.

STATE:KARNATAKA
INDIA

Njei Moses Timah - Mar 14, 2006

The Global Fund should identify credible manufacturers and propose long term contracts with those among them that can guarantee product quality and comfortable prices.
_________________
Njei Moses Timah
P.O Box 1443, Douala, Cameroon
Tel (237) 776 1918
Visit My website at:
http://www.njeitimah-outlook.com

Ben Karenzi - Mar 14, 2006

I believe there are lessons to be learnt from the Clinton Foundation on this matter.
Can the GFATM take this route?

Moderator: Many thanks Dr. Karenzi; we highly appreciate your helpful contributions. The Global Fund has been working closely with the Clinton Foundation, for example in the area of accessing grants for low-priced drugs. It is constantly looking for similar partnerships, and would appreciate even more ideas and messages in this regard.

Dear Members,
Please click on the below link to read more about this example of a 2004 agreement by the Government of Jamaica and the Global Fund for access to low-priced drugs and diagnostic test (kits), through funding from the Clinton Foundation. Do you know of more such examples that could work if replicated?

http://www.theglobalfund.org/en/media_center/press/pr_040518.asp

Regarding Rose Joshi's enlightening comment on financing, the final theme of this eForum, from 17 April to May 15 will deal comprehensively with the issue of financial sustainability.

Thank you all, looking forward to many more of your helpful messages and comments.

Dr. Saka Mohammed Jimoh - Mar 14, 2006

It is Good that this is a priority: Positive effect on market products i.e price reduction for the products. This will have a great impact on those with need, and will certainly reduce disease burden. One way is to have drug manufacturing companies in the poor resource settings. Tax reduction, drug subsidies and more money should be budgeted for drugs.

It think the Global Fund can re-strategise by cost reduction in some processes- for example e froum discussion is a cost reduction process, and is effective- which I believe will have a greater impact. Instead of spending a lot of money on conferences and stakeholder meetings. Therefore rebudgeting is necessary. Such money may be diverted to drugs production, distribution, subsidization and research.

More money should be spent to research on appropriate technology for drugs; some less expensive drugs but highly effective drugs can work in some settings. Also, drugs shipping cost, and a lot more.
_________________
Dr. Saka Mohammed Jimoh

Ben Karenzi - Mar 14, 2006

I believe there are lessons to be learnt from the Clinton Foundation on this matter.
Can the GFATM take this route?

rosejoshi - Mar 14, 2006

Should this be a strategic priority for the Fund? What are the critical points that are missing from the Fund's current approach? What if anything is working in terms of stimulating markets?

Answer: In my point of view this sounds like nothing is working
I must say flexibility is missing from the Global fund and its current approach to individual countries. According to its need through out using sixth round from the global fund (But how and when??). Earlier I have mentioned that somehow it look as if/ sounds discouraging for an individual country (for those who work from the bottom/ grassroots) such as I am from Nepal. In the case of Nepal Global Fund for HIV, TB and Malaria has given its notice to Nepal's failed CCM to fulfill the ambitious requirements by 15 of April 2006, one of which to reform CCM itself with a democratic process, otherwise, the Global Fund said, "the FUND is bound to take its money back from Nepal". Nepal has received the second round grant for HIV (4,365,996 US$) and it took ages-es to get the money to the ground and recently Nepal was able to receive and disburse the first phase (1,981,053 US$ so far disbursed since 2003), of the second round money from Global Fund ( now through UNDP MSA) for ART and other important prevention, care and support programs in Nepal. PLWHA (people living with HIV/AIDS) are in ART because of this fund, other PLWHAs are receiving care, support, Hospice facilities, and prevention work in such districts where hardly any other programs are ongoing because of the country's conflict (www.nepalnews.com). And recent news is that 2006 could be the first year in Global Fund history that a new round (Sixth round) of grants is not launched and funded, setting a dangerous precedent- then what topics do we use for this forum and why?? No words what shall I say or how would I respect this forum- please note that reality always bites. My intension isn't to hurt the Global Fund, only to bring out the issues that are affecting our daily programs and lives in Nepal.
_________________
With Love and Hug
Rose Joshi

Don_Pedro - Mar 13, 2006

I know it sounds a bit ambitious, but it will however put the right issues on the agenda for various producers of the needed medicine, if The Global Fund used some of it's fundings to buy stocks in these companies.

From my experience (e.g. from insulin producer Novo in Denmark) it is possible to produce effective drugs at a lower price, but the companies are often afraid of creating a differentiated price on the global market. Scaring as it is.

Yet, many of the drug companies have a signed politic for Corporate Social Responsability - but do they live up to their own standards?
Would it not be possible to donate/sell medicin to poor countries at a fair price and still make money??

As a shareholder The Global Fund - perhaps represented by local volunteers - could participate in the annual shareholder congress and put the political/critical questions to the board?!

Furthermore, I'm sure that the global councils for these matters already put pressure on the companies - but when will the doctors and professors, who take part in the making and testing of new products, demand a clear CSR politic focusing on the human benefits of poor countries.

LPPrayas - Mar 13, 2006

I live in the Easten part of India. In this area is a free zone for Malaria, T.B and HIV/AIDS. I , with my Organization (Lotus Park Prayas), have been fighting against these evils for about ten years. So I think if our organization gets the support from The Global Fund then we can make our programme a great success.

Thanking you,

Pinaki Mukherjee
Secretary,
Lotus Park Prayas


Moderator:

Dear Pinaki,

Many thanks for your message to the eForum. In the course of your work in Eastern India with Lotus Park Prayas, what challenges have you encountered in obtaining medical drugs, mosquito nets , or other essential health products, and what, in your opinion were the causes of these challenges? Finally, we would be delighted to receive your opinion on what the Global Fund, working as a financing mechanism, could or should do to solve or correct some of these issues that your organization has faced.

For more on the Global Fund's current grant-making process, please click here: http://www.theglobalfund.org/en/apply/call/

We would also be delighted to receive the responses of other eForum members, including those who had submitted their thoughts regarding this topic during the previous weeks.

Thank You,

Your eForum Moderators.

Mar 12, 2006

At its founding, it was expected by some that the Global Fund would take active steps to exert a positive effect on the markets for essential health products in order to achieve lower prices and more sustainable supply. To date, despite the Global Fund having a number of particular features – such as its global visibility, financial size, as well as its share of the global financing for the purchasing of specific health products – that position it well to have a strong influence on markets for essential health products, this has not happened in a systematic, strategic way. What needs to change in the way the Global Fund positions and promotes itself so that it can fulfill expectations of its impact on markets for essential health products? Should this be a strategic priority for the Fund? What are the critical points that are missing from the Fund's current approach? What if anything is working in terms of stimulating markets?

Question: In your opinion, what should the Global Fund do to have a positive effect (i.e. lower prices, more sustainable supply, etc.) on the markets for essential health products (e.g. ARVs, bed nets, diagnostic tests) used for the prevention, treatment and care of HIV/AIDS, TB and malaria?