PartnersGF -2005-03-28
Response to Richard Feachem's letter regarding the fifth round of funding
****************
[Mods Note: Please find Dr. Feachems letter to Communities announcing the call for proposals for the Fifth Round of funding by the Global Fund by clicking on this link: http://eforums.healthdev.org/read/messages?id=4816.]
********************
Tell Dr. Feachem that:
(I have been in Mumbai since 14 March investigating ARV access, along with Emily Bass. Article is in progress, but in the interest of getting the truth out as soon as possible, here are some key facts for Dr. Feachem (as well as interested activists) to think about as the next GFATM Board meeting approaches). Feel free to disburse widely. Please indicate source is Richard Stern and Emily Bass. Visits to key institutions mentioned below by Richard Stern and Emily Bass.)
India in general: Up to 500,000 need treatment now, according to WHO 4,500 on treatment through government funds from the National AIDS Commission throughout India.
MUMBAI FACTS: Population 16 million people
Mumbai: 1,350 on treatment at JJ Hospital in Central Mumbai with five different ARV's available, but no second line meds. ARVs and CD 4 completely free but charge of 230 rupees (about $6) for other tests (hemoglobin, liver etc.) in order to qualify for treatment. Many cannot afford this.
Number of HIV counselors to handle adherence counseling and other issues for 1,350 PLWA: two. Each one needs to see 90 people each day, to keep up with the demand, not including those who are coming in to be evaluated for treatment.
Actual cost per person lower than CIPLA best export price, about $120 per year per person.
Cap now in effect for ARV program at JJ Hospital. NO more people can begin treatment after next week. April 1st.
Estimate for Number of PLWA who need treatment in Mumbai now: 30,000 up to 50,000 2005 Cap on Treatment access through public sector: 2,800. Besides
JJ Hospital, treatment for 500 is supposed to begin sometime soon is three additional hospitals, all in the Center of Mumbai.
Of 1,350 PLWA with ARV access four sex workers on treatment in the public sector at JJ Hospital, out of estimated 8,000 who need it. Sex workers who become ill sent home to villages to die, by those who direct the brothels.
Global Fund money available since round one in April of 2002 in four different HIV grants: $255 million.
Total amount disbursed since first project approved: $4 million. The number of people receiving ARVs with Global Fund money: zero.
Plan for first Global Fund disbursement of funds related to ARV access: a new building to be built on grounds of JJ hospital where treatment is now given.
Private NGO (ACCON) to administer treatment at this program and to use a "sliding scale" to set fees for treatment.
Amount solicited by coalition of NGO's and Indian government who make up the CCM for ARV access, estimated to be less than $20 million in previous projects, but exact figure allocated for ARV access unknown to us at this moment. Remember that proposals are "country driven." The Fund did not mandate a treatment access component in previous proposals.
However, important to note the number of PLWA who could be treated with ARVs with $20 million if it were released and actually funneled into the public sector: roughly 80,000 at current prices negotiated by WHO which is procurement Agent for NACO, National AIDS commission.
Calls for proposals going out now in paid ads in the English language newspapers only, paid for by the CCM: Seeking NGO involvement to submit proposals but no mention made of ARV access programs. Or care programs either. About 5 English language papers in Mumbai and about 50 Hindi papers. Estimated amount of PLWA who can read or write in English: 3 percent. Number of NGO Directors who read and write in English: probably most. Number of NGO Directors who can afford their own treatment access privately: unknown, but very likely a significant number.
Proposal for Round 5 will apparently be a Country driven English language proposal. Estimated direct contribution to the proposal from 90% or more of 500,000 PLWA in India who need treatment now: probably none.
Amount of people with AIDS currently in the Jhoti Hospice, in North Mumbai, 72 beds occupied by 72 destitute or homeless PLWA. Amount on ARV treatment: 4 (through private donations to the hospice) Amount known to have died in the past four years in the hospice: 400, of a total of 800 admissions. Some OI medications are provided at Jhoti.
Amount of PLWA for which information is not available once they left the Jhoti hospice: 300. Number of people known to be alive: 100.
Number of children KNOWN to need treatment in Mumbai: 1,500. Number of children on ARVs through the public sector: None, --government has not purchased pediatric formulations. Children over 13 take adult formulations, younger than 13 nothing is available through the public sector.
Number of lives saved thus far by the Global Fund through ARV or OI access: none.
Current plans for Round Five Proposal. Combination of NGO's and Government, democratically determined, but NGO's who submit applications need money for staff salaries, infrastructure, etc.
Amount NACO (National AIDS commission) will ask for in Round 5 for ARV access: unknown
Amount of money available in India through other International Donor Sources: FHI, International AIDS Alliance, and up to 30-40 other donor Agencies who may be providing $1 million or more, as well as those who provide less. Probably well over $100 million, but this is a guess.
Amount of this money that goes for ARV access: less than one half of one percent. Perhaps 1,000 people on treatment through all other international donor sources in India.
Figures above do not include perhaps up to 1,000 people in Mumbai who can afford to purchase their own ARVs.
Richard Stern
AGUA BUENA
rastern@racsa.co.cr