What kind of data could and should be provided to the Global Fund to substantiate that a program is…

• designed to address the needs of women, girls and sexual minorities in relation to HIV/AIDS, tuberculosis and malaria?
  
  
• sound in approach, feasible, and has the potential for sustainability and impact?

Implementers need robust data to measure the success of efforts to reduce the vulnerability of women and girls to HIV/AIDS, tuberculosis and malaria, and their consequent disproportionate suffering when they or those in their care are infected. Monitoring and evaluation frameworks must take this into account and be adapted where necessary to track and measure the gender aspects of programmes.

 References:

•        The Global Fund Fact sheet: Ensuring a Gender Sensitive Approach; Page 2, section C

•        Global Fund: Round 8 Guidelines 
         Section 4.5.4, Enhancing social and gender equality. Page 30 and 31
         Section 4.8.3, Strengthening monitoring and evaluation systems, page 38

The communicable diseases are spreading just because of the lack of awareness and the illitracy. So as far as i know in India, global fund can fund the activities of the education. A good agency through the segmental studies in various part of the country can detect the diseased people and we have to relocate them. I mean to say, people with the HIV/Aids should be relocate to a place, if they wish so. Because now they are feeling nobody is there for them. if this mentality is there means, those people having the HIV infection will becoe the carriers. Becuse there will be a feeling of adding more people intheir chin. Its not always true. But according to their psychological condition this may happen. So identiy the people who is having the infection. Just relocate them. Then the other important step should be take to educate the women about the communicable diseases and aware them how these diseases are infecting. According to most of the family, women plays an important role. As far as society concern, now they are having a voice. So make them aware about the epidemic and vulnerability. They can spread the messages to a mass community. Then as far as HIV is concerned, women can control it by using the preventive measures. Earlier, we were educating them, to compell your partner to use a condom or protective measure. But now we have to educate them about the condoms available for them itself. most of the womens are unaare of these things and they are shy enought o get it from the store. This condition should be changes, there should be a free supply of the preventive measure, i mean condom. And it should be followed by the education. lets start the education from the educational institution. Actually we a group of students planned for the campaigning accross all over India, through educational institution and develop a circle with the different organizations in verious part of the country. Still we were not able to implement our project just because of the lack of funding. If somebod is funding we will be able to educate and at least a minimum part we can relocate. Thank you, Phenomon Joy feno@sify.com +919986988329

 Issues of Gender are very country specific and difficult to draw general guidlines. The Global Fund should analyse policy documents in countries and see if they establish the needed relationship between Reproductive health and gender issues. In Zimbabwe as an example there is a Women and Girls and HIV and AIDS Policy document that mainstream gender into HIV programming. Such documents come with their own M&E components wich then could be adopted by the Global Fund and be fine tuned if there is neeed.

This is very intresting, a we thinking of a seperate data farme work for women, girls and sexual minorites groups? which ever, it should be base on principle of acessibility and affordability. This groups are unique in there own, they vary in locations, urban rural, economy and geographic acessibilty a major issues. They will be happy to get in there drugs at door steps if possible, or within very short time, what data can capture this. what percentage recieve drugs , ITN free, what percentage diagnoss postive and receive drugs within very short time. The data most not be complex and user freindly.

Dear Readers,
The communicable diseases are spreading just because of the lack of awareness and the illitracy. So as far as i know in Bangladesh, global fund can fund the activities of the education. A good agency through the segmental studies in various part of the country can detect the diseased people and we have to relocate them. I mean to say, people with the HIV/Aids should be relocate to a place, if they wish so. Because now they are feeling nobody is there for them. if this mentality is there means, those people having the HIV infection will becoe the carriers. Because there will be a feeling of adding more people in their chin. Its not always true. But according to their psychological condition this may happen. So identiy the people who is having the infection. Just relocate them. Then the other important step should be take to educate the women about the communicable diseases and aware them how these diseases are infecting. According to most of the family, women plays an important role. As far as society concern, now they are having a voice. So make them aware about the epidemic and vulnerability. They can spread the messages to a mass comm
unity. Then as far as HIV is concerned, women can control it by using the preventive measures. Earlier, we were educating them, to compell your partner to use a condom or protective measure. But now we have to educate them about the condoms available for them itself. most of the womens are unaware of these things and they are shy enought to get it from the store. This condition should be changes, there should be a free supply of the preventive measure, i mean condom. And it should be followed by the education. lets start the education from the educational institution. Actually we a group of social worker planned for the campaigning accross all over Bangladesh, through educational institution and develop a circle with the different Non Government organizations who will work through Community Based Participatory Approach in verious part of the country. Still we were not able to implement our project just because of the lack of funding. If somebody is funding we will be able to educate and at least a minimum part we can relocate.Thanks to all.

Shah Tasadduque Ali Khan
Community Participation for Health and Development(CPHD)
Tel: 880-2-8951897
Mobile: 01819902589
E-mail:stakhan1973@yahoo.com

This is a remarkable initiative by the global fund.But i will suggest something more different from what you are expecting.Why not do it this way;Invite abstracts from individuals,organization,medical professionals,universities and the youths,possible from the rural populations.You may reach to receive more than 1000 abstracts.Then you may proceed to organising workshops in each beneffiting countries on this topic.By so doing ,you will have a full graps on which datas could be the best and how to best handle the whole thing.Please, iam appealing to other members of this forum to say something similar to my idea.

I quite agreed with learning from present and past what work well what not well. Why don't we look and access this data from past conferences ICASA and other international conferences etc. this may be cost effective. What can we learn from organisations with strenght on M and E e.g Measure.

The global fund doesn't know how many people - whether male OR female have AIDS, malaria, etc. The most critical information the Global Fund needs to monitor and evaluate ANY of its programs is good starting point information. The VERY FIRST STEP in solving any problem is, of course, to understand the true scope and nature of it. If you don't know what you're up against, how can you address it? How can you be sure you’re targeting the right areas or measure the effectiveness of your efforts if you don't have a good baseline to measure success or failure? How can you ever figure out whether the rate of illness and death is decreasing if you don't know how many are sick or dying right now before the program begins?

"Accurate and timely data on deaths and causes of death are essential. . . But for more than a quarter of the world’s population – largely in Africa, South-East Asia and the Middle East – there are no recent data available. . .The quality of the information suffers as proper systems for death registration operate in only 29 of 115 countries that report such statistics to WHO. These systems represent less than 13 % of the world population. In the remaining countries, mortality statistics suffer from incomplete registration of births and deaths, and incorrect reporting of the cause of death and age. (World Health Organization, 10/05/07)"

"Without reliable vital registration systems to track even the existence of births or deaths, naturally the data for the medical circumstances of those births or deaths—or the lives in between—are unreliable" (Attaran A, 2005).

The amount of money it's been estimated to finally get this BASIC data on the world population, by setting up demographic surveillance sites in the poorest countries, is about 40 million dollars a year. (http://medicine.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pmed.0020318&ct=1 ) That is a TINY portion of what the Global Fund has access to. It's also only 0.1 percent of the global foreign aid budget. We should not be relying on computer modeling or guessing, but on real data instead. Let's make this happen yesterday.

Once we have real data on the development of humanity, you know, its life, death and health (and how shocking and shameful it is that in 2008 the world is still in the dark and doesn't have valid data about the very state of humanity), then it would be easy for the Global Fund to monitor and evaluate programs targeted to women or any other group or disease for that matter.

It seems to me that this is the most obvious and necessary step to making progress against the most pressing problems facing humanity. What happens when such vital data is unreliable? I'll give you the AIDS example of which the Global Fund should be very familiar. Statistics concerning AIDS are notoriously unreliable. ("The United Nations’ AIDS-fighting agency plans to issue a report today acknowledging that it overestimated the size of the epidemic . . . Some epidemiologists have criticized for years the way estimates were made, and new surveys of thousands of households in several countries have borne them out. . ." (New York Times, 11/20/07) Such mistakes and reliance on non-empirically based data can have grave results. Here's an example:

"[F]aced with UNAids’ warning in the nineties that their teachers were about to be decimated by AIDS, several African governments responded by training armies of replacements. The result, according to UK researcher Paul Bennell, is millions wasted and a glut of unemployed teacher trainees in countries like Botswana and Swaziland. Meanwhile, the poor continue to die of ordinary diseases that could be cured for a few cents if medicines were available." (See Rian Milan & also P. Bennell, The Impact of the AIDS Epidemic on Schooling in Sub-Saharan Africa at http://www.eldis.org/fulltext/impactofaidsonschooling.pdf)

Here's another from The Washington Post from 1/18/08:

"In the two decades since AIDS began sweeping the globe, it has often been labeled as the biggest threat to international health. But with revised numbers downsizing the pandemic... AIDS experts are now wondering if it might be wise to shift some of the billions of dollars of AIDS money to basic health problems like clean water, family planning or diarrhea... The world invests about $8 billion to $10 billion in AIDS every year, more than 100 times what it spends on water projects in developing countries. Yet more than 2 billion people do not have access to adequate sanitation, and about 1 billion lack clean water."

Knowing this, the Global Fund should be at the forefront of the effort to gather actually reliable data on AIDS and the other diseases it wants to target, but of course to do that, one needs valid health/life/death data on all of humanity. With that in hand, one could sort that data any which way you want - by pulling out data on women only so we can examine the impact of program A on women, or advise us of how many children for program B. I hope others will encourage the Global Fund to be just that, at the forefront of gathering what we shamefully still do not have, the most important information that humanity needs - accurate data on the very state of humanity. With that data, the Global Fund can more specifically tailor its relief to those suffering from AIDs, Malaria, and TB and properly evaluate such relief efforts, the only way something can be properly evaluated, with real, empirical data. This is affordable and CAN happen immediately. Humanity needs nothing less. We all deserve to be counted.

Angie www.WhatNewsShouldBe.org

(b) Accessibility of women and girls to free or subsidised health care services

(c) Infant mortality rate

(d) The number and availablity of health service personnels, with consideration to the number of female health care providers available per rural area

(f) Constitutional rights of the female gender within given regions, how much power is given to the female gender and how much can the female gender express. The culture, norms, religious beliefs within a defined region, and how they affect the female gender.

For feasibilty and potential of gender driven programmes, data's to be provided to global fund from implementers to measure success is highlighted as follows;

(a) A concise methodology/approach  of enlightening the female gender, clearly elaborated within a given local precinct

(b) Total number of health care personnels and knowledge capacity of health care providers. Also, available and quality of health facilities

(c) Managerial principles to be applied by implementers, in managing health care providers and health facilities.

(d) Highlighted basic limitation/obstacles expected (as in cultural and religious limitations) how implementers are to tackle the said limitations/obstacles in a given rural region  

Thank you GLOBALFUND to give me a scope to participate in your e-forum network. The main feature to initiate a design the data and information to campaign to bring public attention of the growing incidence of stigma and discrimination faced by the women, gils with HIV/AIDS, TB and Malaria. To campaign for the Causes of infection, preventive measures and treatment. The structures of socio-economic factors that i.e. Gender inequality, human rights violation, discrimination that increase peoples vulnerability to the infection on HIV/AIDS, TB or in the case of Malaria. To campaign the alarming growth of HIV positive throughout the world and it's required tools of preventive strategy, realization and use. To design how the measures can be adopted to reduce the growth rate of infection from HIV/AIDS, TB and Malaria. The initiative of an integrated and balance approach to prevent and treat of the diseases like HIV/AIDS, Malaria and TB through social and community development and public and private partnership dedication in the large scale financing. It is required a massive expansion of social involvement to fight this social evils not only by a mere 'will' or financing, but by the dedication to fight against these threat of infection of the pandemics. Aisma Chakraborty General Secretary The Organization for Peace Environment and Human Rights [TOPER] Kolkata, India Email: toperac@gmail.com

The question of data is clearly a central one. Recently, there have been increasing calls to "know your epidemic" as a cornerstone of any country's national AIDS response. And, as many comments have noted, "knowing your epidemic" requires data that is fully disaggregated. And to "know your epidemic in gender terms" means that data must be disaggregated by sex and age, at the very least. It also means that this data must be disaggregated across the board. For example, rather than assuming that all sex workers are female, we need data that tells us how many are female, how many are male and how many are transgender. Similarly with injecting drug users, where the assumption is that IDUs are male. Guidance to help "know your epidemic in gender terms" exists in a variety of forms and is now being more fully developed - with attention to women and girls, men and boys, and sexual minorities. The methodologies and tools for integrating issues of gender and sexual minorities into national AIDS responses still needs to be more fully developed so that it becomes a guide for use by a wide variety of actors -- AND it will help to develop more finely articulated information about the local context of HIV. Some key steps might include -- building stronger and more sustainable linkages between HIV and gender Ministries, identifying national experts in gender and HIV, including those with expertise in sexual minority and HIV issues, and developing more robust tools for understanding the impact of HIV interventions on gender equality issues and the impact of gender equality interventions on HIV. - Susana T. Fried, Gender Advisor, UNDP/HIV Group