A win-win situation: The role of the private sector

Through role-playing, the members of the Country Coordinating Mechanisms analysed the potential strategies to be developed by guaranteeing the inclusion of the private sector in the proposals.

Inform, raise awareness and avoid confrontation. These were some of the conclusions that were drawn from different work groups that participated in role-playing whose objective was to analyse the possibilities of including the private sector in the Country Coordinating Mechanisms.

In addition to demonstrating the most common mistakes made when looking at this sector, this role-playing helped to challenge certain stereotypes as each participant had to represent a sector other than the one they embodied on a daily basis.

These are some of the proposals that came out of this exercise:

- Businesses need to be informed about the work of the Global Fund, its operation, the role of the CCMs and how the projects are funded.

- It is also important to demonstrate to the representatives of the sector the advantages their business would obtain if it decides to participate in the mechanism.

- Train and raise awareness in the business but also train and raise awareness in the CCM members so that they do not approach the private sector with prejudices for the purpose of avoiding confrontation and acting with diplomacy.

- The proposals being looked at must be clear, concise and contain exact information.

- The exercise demonstrated that many times there are no clear proposals for the private sector and that, in many cases, proper communication does not exist with the representatives of the businesses. It is necessary to understand that the private sector can be added in different ways into the proposals whether through the donation of resources or as an executor of subsidies as well as a provider of goods and services and even as a CCM member.

Furthermore, technical assistance and promoting prevention and de-stigmatisation policies can be offered in the workplaces.

Therefore, it is important to work on the possibilities to incorporate this sector and to do it responsibly. Hence, it is necessary to select the CCM members who are the most capable of achieving this activity, demonstrate to them the impact that the Global Fund has on the HIV/AIDS epidemic and guide them through the positive techniques that many networks and organisation are already carrying out.

By Alejandra Ruffo
Key Correspondent Team – Asuncion, 10/12/09

Can we see the forest for the trees?

Concluding the second day of the regional meeting, some participants felt the recommendations were advancing and promoted dialogue while others felt old ideas and rhetoric were being repeated that did not necessarily result in changes and improvement.

The Executive Director of the Global Fund, Michel Kazatchkine, held a series of meetings with the different sectors in which he shared a Global Fund analysis as well as the CCMs that were very interesting from a conceptual and policy-making perspective.

“The Global Fund and its governing mechanisms (national and world-wide) put forward a concept of “Health Democracy”. A new paradigm in public health that has a plan to overcome traditional hygienist policies which are authority-based and with a slanted viewpoint” maintained Kazatchkine.

“The actual response to HIV/AIDS, Tuberculosis and Malaria require optimistic plans that promote collective responsibility and true participation by all sectors involved in the problem” he affirmed.

For political and cultural change to occur, which requires great thought into the types of governmental programmes and the national responses, it appears to necessitate different deadlines according to the urgency of these diseases.

Some of the great challenges that have existed from the minute Global Fund was founded still subsist as the years go by accompanied by a sense of frustration in both the governmental public sector as well as in civil society.

There have been strides made in terms of participation and appropriation in the countries, but there are serious bottlenecks at the time progress needs to take place for questions related to the importance of harmonisation, the need for performance supervision and communicating the advances and the results.

This has particular relevance at this time in which there are trends that question the effectiveness of international support, the exceptionability of these diseases and the need to concentrate efforts in order to quickly prevent them and treat them.

Much energy has been invested in topics related to “power”, institutional power or economic power, losing the focus on the need to more effectively coordinate the forces so that “powerful” change and improvement can occur.

Eight years ago, the international community came to the conclusion that more technical and financial resources were required in order to respond to AIDS, TB and Malaria. Comparatively speaking, the countries currently have better access to these resources which has brought to light that covering these needs was only a part of the solution.

There are still many critical areas to expose with the majority being found within the national scope. The urgency to save lives and mitigate the impact of the diseases persist. However, pressure is now added to this in order to demonstrate that we still need a great commitment from the international community to revert the impact of the epidemics. In this way, funding the efforts can continue so that health-related millennium goals can be met.

Without getting caught up in metaphors related with climatic change, it appears that we could be lost in a forest of how to find a solution to effective multisectoral participation in the Global Fund's Country Coordinating Mechanism, losing sight that perhaps we are dealing with only one tree in another large forest in which it is much more difficult to find our way out.

By Javier Hourcade Bellocq
Key Correspondent Team – Asuncion, 9/12/09

Recommendations for multisectoral participation

Representatives from all over the region debated and drafted proposals to guarantee maximum participation and representation for all sectors in the CCMs.

The participants in the South American Regional Meeting of the Country Coordinating Mechanisms and the Regional Coordinating Mechanisms participated in an exercise in which a debate took place on the need for inclusion, participation and representation of all the sectors in the CCMs. The groups prepared proposals and action plans to achieve advances against these obstacles.

Selection of CCM members from the non-governmental sector

The CCM members acknowledged three common problems: A lack of rotation, a lack of representation and the existence of necessary but poorly organised sectors. To resolve these problems, they proposed to apply existing policies and they comply with the election process every two years and with only one mandate extension.

They also suggested that the balance between Civil Society and Government be maintained and that it works in response to the agendas of the sectors and not according to persons or institutions. Lastly, they recognised that s common effort needs to be made in order to guarantee the participation of the less-organised sectors with the support of international cooperation.

Roles and responsibilities of the different sectors in CCM operations

The participants concluded there was a need for capacity building in order to fulfil the roles of the participants. Hence, a greater commitment is needed from the members, the policy-making role of the CCM needs to be boosted and dialogue and advocacy needs to be put into writing in order to prepare national strategies.

They also considered it important to ensure that all sectors participate from the beginning of the proposal preparation and to avoid fragmentation.

Active representation by the CCM members of the interests of the sector they represent

In this last point, the participants identified three precise challenges: Capacity building, achieving effective communication and including baselines in the preparation of the proposals. In the presentation of their conclusions, the group stated that it is fundamental to “strengthen the capacities of each member so that they can effectively participate and represent their sectors”.

To achieve this, they suggested, amongst other action plans, preparing a Web page which includes all the information about the CCM.

The conclusions of all the teams demonstrated that the theory was clear. The problems are identified and there are effective proposals to resolve them. Now, all that remains is to put them into practice to see if they can successfully overcome the conflicts and the differences so that these ideas can truly come into fruition.

By Alejandra Ruffo
Key Correspondent Team – Asuncion, 9/12/09

Contribution of regional networks in CCM

Representatives from different regional networks gave their opinion on the participation of key populations in the CCMs.

The Latin American and Caribbean Network of Women Sex Workers (Redtrasex), the International Community of Positive Women (ICW), the Latin American and Caribbean Network of Transgender Persons (Redlactrans), the Association of Men Having Sex with Men (ASICAL) and the Latin American and Caribbean Network of Organisations with HIV/AIDS Services (LACCASO); noted a greater participation and inclusion of diverse populations within the Country Coordinating Mechanisms.

“There are prejudices surrounding women sex workers for managing large sums of money”, complained Elena Reynaga of Redtrasex who stated that if there were actually women sex workers in the CCMs, it was because Redtrasex trained women so they could participate.

In turn, Arely Cano, Secretary General of the Latin ICW, maintained: The CCM must allow women to participate and not just by sitting quietly in a chair, but rather by allowing their voices to be heard. In addition he added that one of the challenges is also “to allow the voices of women living with HIV/AIDS to be heard in the different venues".

Marcela Romero, Regional Coordinator of the RedLacTrans, mentioned that the inclusion of the trans populations in the CCMs was an important milestone as their needs and problems are very different from the other populations. “We would like to take our rightful place in order to have access to prevention, universal access and human rights” demanded Romero.

Finally, Orlando Montoya, General Coordinator of ASICAL stated that it was “very difficult to ensure that all the needs are represented" and acknowledged that the networks are part of a very important tool".

All these testimonies are a sample of the work carried out by the networks in order to have a place in the different CCMs, although they also demonstrate that though the participation has increase, there is still not sufficient numbers to provide an effective and organised regional response to the problem of HIV/AIDS.

By Mirta Ruiz
Key Correspondent Team – Asuncion, 9/12/09

Global Fund ED visits Paraguay

Michel Kazatchkine, Executive Director of the Global Fund, travelled to Paraguay to attend the regional meeting and sign a new agreement for €3.5 million in order to fund HIV/AIDS programmes.

Amongst many acknowledgements of gratitude and providing a balance of the Global Fund in the region, its Executive Director, Professor Michel Kazatchkine, participated in a round of questions and answers with the participants at the Regional Meeting.

Following the presentation he met with Paraguay’s Minster of Health, Esperanza Martinez, to sign a new agreement for €3.5 million that is designated to fund programmes for prevention, diagnosing and treatment of HIV/AIDS.

“We have seen an extraordinary change in terms of health world-wide. The key factor was understanding the unacceptable gaps between the North and South countries”, stated Kazatchkine at the beginning of his presentation, in which he gave an analysis of the panorama in the region related to HIV/AIDS, tuberculosis and malaria.

In his analysis he said that 2010 “will be an absolutely critical year” as in addition to presenting the new structure, it will be a year of transition in which the Global Fund will become an autonomous institution. In reference to these changes Kazatchkine assured that the CCMs will occupy a very important place in advocacy.

“Five of the eight Millennium Development Goals are directly or indirectly related to health”, he maintained and assured that currently the Global Fund "has become the most important global funder" in terms of health.

“The model is very attractive because of its pillars and you are the ones who implement your proposals”, he explained. Thus, he persistently asked the representatives from the CCMs to make a commitment to successfully achieve the goals. “Keep working, manifesting, expressing your needs and be an advocate. The Global Fund is making a difference and this saves lives. And the Global Fund is you”, he expressed.

In the signing of the agreement with Paraguay, Kazatchkine insisted on a request for greater commitment from the regional CCMs in order to successfully reach the millennium goals linked to health: “With this signing, I have no doubts that the millennium objectives will be achieved by Paraguay. And they must be achieved for all countries in all of Latin America because they have potential”.

By Alejandra Ruffo
Key Correspondents Team – Asuncion, 9/12/09

The Global Fund and Paraguay sign a new agreement

The Global Fund pledges €3.5 million for the prevention, diagnosis and treatment of HIV and AIDS in Paraguay.

The Global Fund to fight AIDS, Tuberculosis and Malaria and the Centre for Information and Resource Development signed an agreement today for €3.5 million over two years to support HIV and AIDS programmes.

This grant will allow Paraguay to increase its care and treatment interventions for persons living with HIV in six of its health regions.

“I am pleased to be joined by Dr. Agustin Carrizosa, Executive Director of the CIRD to sign Paraguay’s Round 8 agreement with the Global Fund,” said Professor Michel Kazatchkine, Executive Director of the Global Fund, who travelled to Asuncion to attend the Regional Meeting of the Global Fund and to sign the agreement with Paraguay.

“This agreement reflects the strengths of Paraguay to expand access to HIV and AIDS prevention and treatment and their continued efforts to fight against this epidemic,” he added.

Paraguay is a country of 6 million inhabitants, in which 21,000 are living with HIV/AIDS. Its HIV prevalence rate is 0.6 percent. Paraguay has another grant from the Global Fund that began in 2007 and that successfully provided ARV treatment to 1,857 persons.

The grant that was signed today is for a total of €12 million over five years and will be implemented by the CIRD Foundation. The programmes supported by the Global Fund and covered by this grant will include treatment services for HIV and AIDS, treatment for Sexually Transmitted Infections, Information on Behaviour Changes, an increase in community-based participation in the national response, amongst others.

Currently, the Global Fund has approved grants for $16.1 million world-wide in 140 countries since its creation in 2002. The Global Fund actually provides one fourth of all international funding for AIDS as well as two-thirds of the funding for tuberculosis and malaria.

The Global Fund supports programmes that provide services to hundreds of millions of people. As a result, more than 4 million lives have been saved to date all over the world. 3,000 deaths have been prevented every day. The general results of the programmes supported by the Global Fund world-wide include:

· 2.3 million people currently under antiretroviral treatment (ARV)
· 5.4 million people currently under effective treatment against tuberculosis
· 88 insecticide treated nets distributed to protect families against malaria
· 79 million people who were provided with HIV counselling and who underwent HIV testing
· 537,000 seropositive pregnant women who were provided prophylaxis treatment to prevent Mother-to-Child Transmission of HIV
· 110 million people who were provided with community-based information services
· 3.7 million orphans who received basic support

Global Fund press release
Key Correspondents Team – Asuncion, 9/12/09

The new structure of the Global Fund

David Kim, of the Global Fund’s Strategy Team, gave a presentation on the new organisational structure that will be implemented from 2010.

The Global Fund presented its new structure for 2010 on the first day of the Latin American Regional Meeting of the Country Coordinating Mechanisms.

“The new structure will work on harmonisation, alignment and the secretariat. This will give the CCMs a major role, strengthening and helping them in their governance and management” explained David Kim, of the Global Fund’s Strategy Team.

The Global Fund structure currently in force was designed at the time of its creation and has continued improving over time. “This structure has favoured the achievement of impressive results”, acknowledged Kim.

The new structure is going to introduce simpler formats for the purpose of encouraging and facilitating information that the preceding rounds already had in the approved proposals. In addition, there will be two calls for proposals per year and each country can choose when they would like to present their proposal.

“We are hopeful that there will be more money for the Country Coordinating Mechanisms", mentioned Kim, who also added, in reference to performance management, that there needs to be more programmatic supervision in each country.

The new structure will be launched in May 2010 with new requests and in 2011 periodic supervision is going to be introduced.

By Mirta Ruiz
Key Correspondents Team – Asuncion, 8/12/09