Restrictions and risks due to social, cultural and legal norms

1.      Many decision makers hesitate to admit the existence of affected populations, so it’s difficult to get accurate data on these populations and their needs are not being met within Global Fund-supported programs.

2.      The issue of same sex relationships is seen as a 'taboo' in most African countries. As such they cannot be selected as members of the CCMs because of the criminality involved.

3.      Denial, stigma and discrimination affect some groups within affected populations more than others, depending on where they live. The stigma that surrounds diseases like TB and HIV/AIDS means that there is great reluctance to coming out openly to offer meaningful contributions.

4.      In some countries there is a risk of violence from extremists towards affected populations.

CCMs that have included APs

5.      Many CCMs have been successful in integrating affected populations into their membership. Examples are in Guinea (CCM committees and Executive Board), Nepal (CCM), Ethiopia (CCM), Tajikistan (CCM), Kyrgyzstan (ССМ) and DR Congo (CCM).

6.      In Ghana, there are some courageous but affected people who participate in preventive and educative programs to reduce stigma and educate people on how to avoid the diseases.

7.      Although in Côte d’Ivoire affected populations are not directly involved in the CCM, they can be consulted by the president.

The important role of AP participation

8.      It is essential that representatives of affected populations are members of the CCMs to contextualize the CCM processes and activities in order for them to respond to their needs. This should be in proportion to the number of total number of CCM members.

9.      Affected populations should be empowered to lead the comprehensive proposal development process and fulfil its oversight role; they can strengthen CSO advocacy at national and regional levels, monitor activities, and enforce accountability from the national entities and the CCM itself.

Closing the gap between the CCM and beneficiaries

10. Most people living with the diseases will feel free to relate with members of the CCM if they realise some of its members are also living with or affected by disease.

11. This question should be further expanded to explore other dimensions of members’ representations, e.g. religious organizations, children (through a children’s parliament), etc.

12.  Conducting a survey of patients is also a form of taking into account the interests of affected groups.

The need for organization and empowerment

13. Lack of organization among groups makes outreach difficult so they can be recognised, identified and acknowledged or be empowered.

14. The greater focus in most CCMs has been on HIV/AIDS. In South Africa, these are the only groups that are easy to identify and organize, unlike populations affected by TB and malaria.

15. Divided interests within civil society, including affected groups, do not allow them to be duly represented in the CCM.

Non-compliance and the need for stricter enforcement

16. The authorized representatives of PLWHA are not always part of the commissions on the implementation of the projects funded by the Global Fund.

Dear friends,

Participation of affected populations in the CCM, I do agree with you. A proper representation of the affected population may enrich the process of the global funds program implementation secretariat of thee global fund may direct CCM to adopt the guidelines of appointment and other representations of affected population in the CCM those PLWHA or other vulnerable diseases. If a members from these affected population feel them this is a supported services i.e., in society, in house etc. which bring them a self consciousness and confident on life specific CCM model to each CCM have to be developed as per their socio-economic structure exists in various nations. Many of countries develop uneconomic plans for implementation of global funds program. Based on the each countries economic status and national budget allocation to health related projects, secretariat of global fund have to allot the funds to implement the program to develop the health related vulnerability in developing countries.

Thank you

C.Ravichandran .

Are people from affected populations members of your CCM?


Dear Forum Members

The flat answer to this question is yes. The 33 membered CCM Nepal has some 13 representatives from civil society organisations (excluding representation from International NGOs), 11 from government agencies and rest from academic and private sectors. Of 13 members, apart from one rep from TB and one from Malaria sector all eleven in one way or other are from PLHIV, vulnerable communities and NGOs active in HIV sector.

The number equation probably works well here - but the CCM is not just the numbers and the figures. Therefore to be critical, sensible and to do the justice to CCM, the above question should be expanded further to explore other dimensions of members representations.

The decision making process, participation of each and every individual members in the CCM meetings, their understanding and application of their role as a "CCM member" within the CCM and outside, and more importantly interest and ability to understand "others" problem in order for “CCM as a institution” to be able to lead the comprehensive proposal development process and fulfilling its oversight role are some of the crucial challenges regarding representation and role of affected and vulnerable population as well as role of other members.

The overall dynamics and number equation in the CCM often does not tally. While becoming a CCM member is considered a highly dignified and responsible position, many challenges exists.

1.     For most of those representing various government agencies, process is more important than the product. And also for many “HIV is health problem” therefore their role as non health person is limited to their participating in CCM meetings.

2.     For those representing vulnerable groups or NGOs, CCM is another forum to advocate their interest, oblivious of others interest.

3.     For many, acquiring funding support to their specific constituency or NGO sector is what the CCM is expected play. Ensuring proper implementation and exercising CCM’s oversight role is secondary issue.

4.     Conflict of interest policy “should apply to other not to me” syndrome and “questionable behaviour” of some CCM member outside CCM have diluted CCM’s dignity and its influencing role.

 Thank you very much

 Mahesh Sharma

Dear friends,

Regarding the participation of affected population in the CCM, if the CCM have an affected population as a member of CCM, the planning & implementing, the program is smooth and brings successful result they think, they are not isolated from the society and they can act as a role model to the society and they can act as a role model to the others. But many of the people hesitate to come out because of the social set up. In countries like Indian, the CCM have to adhere the policy of government and there fore they have some set of rules & regulation. If CCM have members from the affected population bring some fruitful results.

Thank you,

C.Ravichadran
India