Shahid Mallick - Feb 06, 2006

I am Shahid Mallick. As I wrote in my earlier mail, we are a very small organization. From my experience I should say the Global fund policy should change as it is not functioning properly in Bangladesh and it might be the problem other developing countres.

- goverment control should be less
- more small organization (activist) group should be involve in the implimentation
- large organization should be discouraged in the implimenation
- GOV people may not be involved in the managerial process
- Fund management should be ethically and philosophically sound
_________________
Shahid Mallick

mathur - Feb 04, 2006

this is neelima from india...would like to take up on comments made by kurt frieder and rose joshi.

the ccm concept is crucial to the operation of the global fund , which itself is an amazing concept designed for country appropriate strategies. yet, here we find ourselves again 'trapped' in issues of backdoor, out-of-sight mechanisms that defeat the very purpose of the ccm and the global fund objectives. international donor agencies make all the politically correct noises when they float calls, bids and programmes. but the fruits somehow keep reverting to the same 'groups'. this defeats the purpose of innovativeness, of fresh ideas, new methodologies of implementation. gipa still remains a paper concept. local agencies still remain far from being actually able to directly access the benefit of the ccm-global fund dynamics. if the access route remains continually linked to or routed through non-country agencies, the country programme can never be a truly country-appropriate programme.

the issue of funds imbalance is equally valid in this context. one cannot but help recalling graham hancock's book, 'lords of poverty'. it was spurned then and would be spurned today. that does not make the reality any different. more money goes out of the country than into an aids / malaria/ tb programme in the targetted country.

no point in complaining. what we need to see is how the global fund can evolve to overcome the boringly perennial north-south diatribes, which, in today's world is embarassing to even mention at a global forum.

in india specifically, the global fund may need to focus on a.r.t and non-functioning cd4 test machines even in the capital of the country.

so, moderator, maybe we can think about this as a question: how to make the global fund operate within governing frameworks but outside the clutches of existing international lobbies / vested interests.

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[Message from 'rewbdog2'

Joined: 18 Jan 2006
Posts: 2
Posted: Sun Feb 05, 2006 4:51 am Post subject: in regards to treatment and pandemics

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as a nurse and emt i deal with alot of people and it scares me to say but most of the people i speak with have no idea about aids in africa nor do they have any idea of what a pandemic is. the first way to get a point across is to educate the peaople about what is happening, pictures, articles, letters whatever it may take to give people the knowlrdge they need to understand and then maybe help out a little.

Joined: 18 Jan 2006
Posts: 2

Posted: Sun Feb 05, 2006 5:02 am Post subject: role of global fund in the future

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public awareness of the disease and suffering of others is the key to everything. i work with terminally ill children as well as autistic children for example i take my patient to the mall in a wheelchair she cant talk but makes her point known, people dont hold doors ,jump into elevators and cut in fromt of her in line, some yell because she cant walk so apparently she cany hear either. my point is if it doesnt concern them it doesnt exsist even if it is right there for them to see. the world population is not concerned with others simply because they are not aware and because it doesnt effect them now. most people dont thonk in the long term of how it will have an impact on their kids and grandkids.

Tshering - Feb 03, 2006

Global Fund certainly have been a great helpe in saving thousands of people from Malaria, TB and HIV in developing countries. Furthermore it helped in poverty reduction which is main cause of all these three diseases. However, there is still several questions need to be answered: How successful global fund have been in looking at root cause of these diseases? Has the fund been reach to those in real needs? How successful the fund have been able to address corruption, nepotism and miss-use of the funds? We are still looking and asking for more funds in order to fight these diseases, however we shouldn’t forget to analysis how the fund is used and where it is used.

There are several small projects working affectively in the grass-root levels in different part of the developing countries. The fund should give emphasis on these kinds of programmes and help them in capacity building rather than only pouring money in the country. Many of these small projects never or get less emphasis from government. There should be fund allocation for such projects that are working in grass-root level and making real difference in people lives.

Last but not the least: There is great need of fund and it need to be increased in order to fight these disease.



Thanks

Tshering Lama

Heath - Feb 03, 2006

Good evening; I'm Heath Wilder from Clearwater, Florida. First I want to say that the participants of this forum make excellent contributions, suggestions, and observations about the efforts being made to cope with and eventually overcome these diseases.

It seems to me that The Global Fund has a unique opportunity to advance its initiatives in ways that do not strictly follow the conventional ways, e.g. through layers of bureaucracy. I've read several comments about the invaluable role that the private sector contributors play. I believe that the capability to distribute relief and treatment unimpeded (or at least minimally) by the convoluted mechanisms of bureaucracy is a vantage point upon which the Fund must capitalize. (I'm not entirely naieve; I know there is red tape within almost all administrative activities. Most will agree that with less red tape things tend to happen more quickly)

Another opportunity that is unique to the Global Fund is that it has set for itself a mission that is "uncharted". We are combating microbiological pestilence as elusive to scientists as the outer galaxies are to astronomers. Unfortunately, thousands are dying every day due to these diseases. We have an opportunity, perhaps even an obligation to turn to less conventional ways of viewing this epidemiological phenomenon and brave it with creativity, please excuse the cliche, :"Let's Think Outside the Box."

Sometimes we have to dream things into reality. Where creativity and the realm of possibility spawn ideas and thoughts, is the same place, one can find a reservoir that can give rise to remedies.

To find the solution to the problems facing the Global Fund, creativity will have to be acknowledged so that we can glean from it pieces of insight that may lead us to find relief and cures. There was something mentioned earlier about a change in the paradigm. How crucial this change is! For until civilization can envision the world free of these diseases, civilization itself will not be able to identify the cures when they see them. Amazing advances have been reached in this wealthy Western World, e.g. long-term HIV/AIDs survivors, some of whom have undetectable viral loads among other things. So what then must be done to create an environment where other suffering individuals around the globe can receive the treatment and essentials needed in order to allow healing to occur?
Culture and politics, poverty and wealth, resource availability and scarcity, education and the lack thereof, are all at play in the crucible. One might even say "That's life""He's describing the world" Exactly that is indeed why we call these pandemics-- they appear not in isolation but throughout the WORLD.

In closing, the Global fund has the unique opportunity to explore both conventional and unconventional ways of resolving the afflictions of billions. The participants in this forum have certainly taken the first step towards reaching their goal and that I would say is recognition of the need and action to satisfy it. How to satisfy the need is our challenge?

Thanks for letting me contribute my thoughts on the issue this evening.

Be Well,

Heath Wilder

SABINA - Feb 02, 2006

Good evening everyone:

To me, one of the most striking attributes of the Global Fund's role is to forge down paths that have never been forged down before. If we do what we've always done, go where we've always gone, we will get what we always got.

And that has not faired well for the ones dying every three seconds of obscene stupid poverty, year after year. I'm finding that this Global Fund, and the recent commericial decision announced at the World Economics Forum (RED), as well as the ONE/MPH campaign to make poverty history, all these embrace a shift in the paradigm - a fresh alignment still to the compass bearing of due-north, yet utilizes fresh innovative callibration equipment. The activation of the private sector, a "civilian" entity if you will, adds color, depth, and dimension to the world of health and debt relief that cold government alone has never seemed to embrace.

I don't know if any any time priviously in history would government, corporate, private, and philanthropic entities be willing to come together and communicate let alone align with one another for the common good. And with a partnership based on trust and tranparency, and demanding accountability, which in itself is brilliant.

Even through the generosity of the gift of this forum, i'm not aware of any other entity of this kind that would not only consider my remarks, but welcome them, and it makes me feel a part of the larger global community. That my voice matters. And that my appreciation is felt and heard.

And I thank you for that.

Sammi Fredenburg


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Message by SABINA:

Hi Everyone,

Personally, i think that Fund's positioning lies in its nature of operation.
What do i mean here? With fund, people are not just assisted with aids, but they are also assisted with skills that would make them somebody on their own. And this is one uniqueness i see with fund's own way of giving aids.
The 2s of " Self-sufficiency and solidarity." explains better my contributions here. Fund gives consulting services to people, in order to help them start up something on theri own, at the same time they are there to support you fully.

cheers!!!

Ada

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

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Message from rosejoshi

Location: Kathmandu, Nepal, Posted: Thu Feb 02, 2006 4:50 pm Post subject: Fund for the treatment component

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How do I express my feelings!! In a diplomatic manner, or as an activist?
I would prefer to answer the questions as an activist 'coz I am an activist living with HIV(1997). My language may perhaps hurt and pinch diplomats a little bit, but reality always bites!

Involvement of the GF team as an observer in each Nation is crucial to monitoring every thing.

If I may express my opinion in a direct way, then the reality is that the role of the Fund is undermined by what goes on in my country (Nepal) , e.g a lot of money is spent on consultants or monitoring budgets, and whoever is close to the system or embraces its corrupt ways. Which is the real experience based on the ground level for us (In Nepal).

Such as: Four different RRF (Rapid Response Fund) announced with the total amount for 5,000 dollars each and total 20,000 dollars for which donors usually unnecessarily spend 80,000 dollars over the consultants and monitoring for the four different RRF programs.

My Perspective:
People living with disease must be given priority and treated with respect at all levels. Their representation from the grassroots is a major factor and they could play a vital role in mobilising funds/ monitor the fund. My country Nepal, which is renowned as the birth place of Lord Buddha, Highest Mountains in the World Mt. Everest, with fascinating culture, has become a famous global tourist destination. Currently, it is facing political problems due to the internal conflict between Maoists, who control a huge part of the country, and the government. Political conflict has diverted the government's attention from the fight against these diseases. Each month we have new leaders and each month we have to teach them the old topics related to disease. I wonder if I would have been born in Europe or some where in America at least I could have received proper treatment.

As a part of the International level they (International Team) must decide the composition of each National based team, and who to fund like in the case of Thailand. We are fed up of our country's politics, which leads to changes of the CCM chairmen and National AIDS Directors.

There is great need for a strong institutional mechanism with the involvement of International efforts to define whether the funds are misused or for people to know how funds are being used.

As a part of the HIV/AIDS work in Nepal, there are a maximum of 35 support groups run by and for People Living with HIV, whose numbers could be expanded in the near future because of the impact of the HIV epidemic overall in the country. We (Nepal) have no support group for people with Malaria or T.B. All the resources related with these two diseases are being mobilized through negotiations with government hospitals, which have a tendency to manipulate.


HIV/AIDS ultimately runs the risk of being thought of from a business point of view by everyone except people with disease, so a unique thing that the GF would do is to engage the private sector with the purpose of educating the world to improve the quality of knowledge available around the world (Prevention is better then cure). The most improtant dream for people living with diseases are adequate diagnosis centers with proper equipments and good technicians. Obviously, drugs are important in improving the quality of life and maintaining respect, which are the fundamental needs of people with diseases. Still, the Global Fund alone cannot manage to put all these in place, if I am not wrong.

In Nepal, the Global Fund may have to nominate its own sub committee at the National Level with the involvement of people living with disease from grass roots to the national level, since the country is undergoing political conflict and connot utilise the GF money properly. Besides that, GF should have to think to reintegrate its own strategy for resource-poor settings in different countries, where people with diseases can provide services widely using the Fund's resources. Different bilateral agencies' involvement in terms of encouraging local organizations to build up and strengthening their capacity with proper, up to date supervision with the purpose of creating an enabling environment for all people living with diseases at all level, and by lobbying the government to formulate legislation to re-enforce the right of people living with disease to be treated with dignity.
_________________


With Love and Hug
Rose Joshi

Dr Benjamin Udodigbo - Jan 25, 2006

My name is Dr Benjamin Udodigbo.We use our organisation,Madonna Foundation which shares resources with Madonna Clinic in Ibillo,Nigeria to reach out to and cater to the needs of the many people who are living with the HIV in our community.We were initially not going to be bothered by the HIV/AIDS slogan until we started encountering so many seropositive cases.
Unfortunately,our situation was made difficult by the fact that our clients did not even understand what we were talking about let alone accepting it.We have had to limit our activities to awareness creation,advocacy against stigma and discrimination and limited ARV donation.

We are grateful to the Global Fund for adopting and insisting on universal access to ARVs,even though countries like Nigeria made it difficult in the past by insisting on counterpart patient funding.Gratefully,the President has just given approval for zero patient payment.
We think that the CCM platform for fund release and utilisation is ordinarily a wonderful strategy since it allows each candidate country a free and unfettered access to funds without interfering in the use of such funds.Regretably,the experience in countries like Nigeria makes it neccessary to think deeper.Governmental interference and bureaucracy have hindered the smooth transmission of funds to the civil society for response escalation.This is primarily responsible for the inability of Nigeria to make any appreciable progress with the 3 x 5 initiative.

We think it will be plausible to relate directly with the civil society in order to escalate response especially for those of us working in very rural communities.

Dr Benjamin Udodigbo
Madonna Foundation
Madonna Clinic Ibillo,Edo State,Nigeria

chandap - Jan 25, 2006

The GFATM unique role comes from the fact that they allow countires to work out their own priorities without inteference and live up to timely disbursement of funds hence allowing for better implementation of relevant activities. If all aprtners worked like this we are sure to achieve the desirable targets.

Pascalina Chanda, National Malaria Control Programme, Zambia

Kurt Frieder - Jan 24, 2006

From my point of view, the most strategic value that the Global Fund adds to all other efforts confronting the epidemic is that it was created with a great international consensus with the specific purpose of financing national efforts that have a broad coverage from assistance and supply of ARV´s to territorial prevention programs.
The problem arises when the officers of the Fund or the local PR and/or CCM members start patronizing and intervening in the strategic plan of the countries trying to impose their own view about the strategies that should be followed.

Jeremy - Jan 24, 2006

I'm a Clinical Officer from Kenya,working with the Walter Reed Project,which has been doing a survey of malaria drug resistance patterns across the country.

The global fund is the best thing that could have happened to humankind in the 21st century,the solidarity,the emotions and loss(years&people) that came about this trio diseases galvanised the Human beings alive today.

The fund however will throw all these efforts in the pit;if Global fund can not differentiate between:

The people who water flows to from those who follow water.
The people who dream of holidays from those unaware of the next meals
The people with tummy;s from those of thin skin
The people with wings from those of a "leather shoe"

Just to cut short the poem,as Marcela P. Montero (From India) pointed out-this has to be without too much beuracracy and politics.

Its a matter of seeing the forest and the trees and avoiding chi squares and logarithims-in finding out who is begging for what.

It is disappointing that this fund drains most of money to Governemnts and "NGO'S" I invite you to come to our district-you will not need stata to find out that less than 1 % PLWD Know not where their Salvation is coming from: These are the people who need Global Fund.

On the policy,I wish Global fund strengthens its policy of empowering PLWD Ecomically(Through individuals in groups or localities,visa drug handouts,food or out of pocket).This alongside the lobby that has seen ART's for example come down from 1,000 USD to 1.4 USD will ensure man cares man-Whats the motto of Global Fund?

Jeremiah Kiponda
Kenya
_________________
Jeremy
CO
Chairman-MPEA

Marcella P. Montero - Jan 24, 2006

Hi, I am a program assistant working for the GFATM project in the Philippines
I am new in my job but I can see how the Global Fund can really make a difference by providing universal access and quality service delivery to various remote areas in the country.
A unique structure to the GFATM is the CCM wherein stakeholders from a multi-sectoral representation come together to meet, assess and discuss the implementation of the project. We have the government, the non-government, the faith based, the private, multi-lateral and bilateral agencies and at present the active participation of the PWDs (People Living with Disease). This healthy mix of representatives can hopefully raise the standards of health care and the quality service delivery in our country despite the onslaught of rising poverty and a fast declining doctor to patient ratio due to their exodus overseas for higher paying jobs.
The CCM can be a very potent instrument in making quality health programs with the inputs of all the representatives. However, it can also be a double edged sword especially if there is too much bureaucracy, red tape and politics involved. In the end, it becomes a hindrance instead of an ally.

Luc Comhaire - Jan 24, 2006

I will send strategic positioning to INTERNATIONAL CLASSIFICATION
OF FUNCTIONING DISABILITY & HEALTH on above topic.
Please consider for GLOBAL FUND's strategic positioning.


ASHISH SRIVASTAVA
EX- International marketing
& C.C.M(SEAR-INDIA)
81237

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Regarding TB we experience in several countries where DFB provides a support to the National TB control Programme that the time and efforts needed for fulfilling the administrative requirements related to the Global Fund's support are disproportionate to the time and efforts the programme staff still has for ensuring the operational activities of the TB control programme itself. This may lead to a diversion of attention from operational aspects towards administration and is influencing the progress of the TB control programme.
_________________
Luc Comhaire
Project Manager
Damien Foundation (Belgium)
Boulevard Léopold II, 263
1081 Brussels
Belgium

In your opinion, what are some of the unique or different roles that the fund has played thus far, in relation to other programme funders ? What roles has the fund played well, and which has it played less well? What is the value added by the fund, to the fight against AIDS, Tuberculosis and Malaria?