Theme: The Global Fund’s successes, challenges and suggested topics

Background:

The first week’s contributors to the online discussion forum represented all regions except Latin America: They also represented various sectors, different structural relationships with the Global Fund, and demonstrated varying levels of knowledge about the Global Fund and its roles.

LEAD CONTRIBUTORS: WEEK 0NE- Jan16, 2006- Jan 22, 2006

Sylivia N. –Uganda, Gennady Roshchupkin- Russia (Independent Expert), C.O. -Kenya (Community Based Organization in Kibera Slums), Sammi Fredenburg -USA, (Development Volunteer),Grace Mulei- Kenya (Orphan Care Volunteer),Edward Ayanbiola- USA (Pharmacist),Mercy- Ghana (Member of CCM),Rose Joshi- Nepal (Private Sector, ICT),Onesmus M.- Kenya (Project Coordinator, Aga Khan Foundation),Ada- Ghana,Zhang Mingrui-China (Youth)


The main points of discussion for the week were the Global Fund’s successes and challenges as experienced by the online forum participants at the national and international level. The contributors were further invited to suggest themes for online discussion. Following is a summary of the week’s discussions.

A. The Global Fund’s Successes:

1. Reduction of stigma: The Global Fund was credited several times with facilitating the reduction of stigma against people living with HIV/AIDS, particularly in East Africa; partly due to its financing of the effort to provide affordable Antiretroviral drugs (ARVs) and treatment, since all People Living with HIV/AIDS (PLWA) could live healthy lives.
2. Giving hope and prolonging life: The Fund has given hope to the infected and prolonged life by financing the provision of medicines, mosquito nets, etc.
3. Standards of living: In Uganda, the Fund was credited with facilitating an improved standard of living for some beneficiaries.
4. Reduction of infection rates: In Kenya, the coordinator of an organization for youth living with HIV/AIDS credited the Fund with the reduction of infection rates, as witnessed by the country in recent years.
5. Dramatic increase in country health budgets.
6. Increased awareness and recognition of the existence of HIV/AIDS and behavioral factors that increase vulnerability to infection. The Early Alert and Response System (EARS) was credited with facilitating a regional overview to healthcare and financing.
7. Revitalization of the fight against AIDS, e.g. in Russia.

B. Challenges Experienced by the Global Fund

1. Government bureaucracy, corruption, poor accountability and political interference were cited as challenges by several contributors, who urged that funds be channeled through independent institutions, suggesting that the local private sector’s current and potential role in the amelioration of material and service provision should be recognized.
2. Poor local accountability and monitoring structures: A contributor from Uganda cited poor accountability and monitoring structures, as a local challenge.
3. Inadequate transparency of the funding process at the local level in some countries. Some contributors state that recipients sometimes obtain funding through varying manifestations of influence.
4. Lack of technical resources by otherwise worthy organizations promotes a cycle of technical bias in obtaining funding, leading to larger organizations e.g. Non-Governmental Organizations (NGOs) having an upper hand over CBOs, despite the latter possessing the advantage of direct community reach, and in some cases, better potential to ensure effective outcomes and achieve impact.
5. ‘Crowding Out effect’: Apparent favoritism towards organizations that originally obtained funding during the earlier funding rounds in Kenya (Rounds 1 and 2), hence crowding out other organizations from the funding process.
6. Lack of awareness at the ‘grassroots’ about the criteria used by funding agencies in selecting groups that receive funding during each round.
7. Insufficient funding in some countries, e.g. Ghana, does not allow for both the purchase of ARVs and the purchase of adequate nutrition to boost diet.
8. The Russian Government agencies, NGOs and experts working in the area of HIV/AIDS may lack the technical and logistical capacity to manage the increased Global Fund and federal government financing. However, more organizations are taking up the fight against AIDS. There is need for a multi-sectoral coordination mechanism that:
a. Ensures coverage of targeted beneficiaries in all geographical areas;
b. Creates a national system of communication between the existing system of government, civil society and experts and the swiftly growing number of new organizations and individuals with an interest in HIV/AIDS work;
c. Facilitates coordination at a local or decentralized level.
9. Challenges occasioned by special situations: (a) Encumbrance of support activities for orphans and the elderly during emergency situations e.g. natural disasters, and poor documentation and mapping of orphans. (b) A contributor from Nepal cited political instability as a cause for failure by the country to obtain Round 5 funding.

C. Suggested themes for further discussion:

1. Recognizing and supporting the private sector's contribution to the fight against the three diseases and extreme poverty, both internationally and locally.
2. Recognizing the role of training institutions in capacity building to reduce HIV incidence, and promote HIV Counseling and Testing (HCT)
3. Promotion of Prevention of Mother to Child Transmission of HIV/AIDS (PMTCT) programmes, and recognition of their benefits.
4. The possibility of funding Human Resource Development for health professionals in Africa and other parts of the developing world through facilitating the reversal of ‘Brain drain’ amongst health personnel.
5. The prospect of establishing a special CCM or a special organ within the CCM to support Remote Rural Communities and coordinate funding during disasters, monitor use of funding, or perform research on vulnerable populations.
6. The possibility of borrowing from their models, and working with private sector partnerships in the areas of
(a) Philanthropy (e.g. Clinton foundation: www.clintonglobalinitiative.org, &
(b) Information Technology (Massachusetts Institute of Technology Media Lab 4’s One Laptop per Child (OLPC) initiative: http://laptop.media.mit.edu