Global Fund Replenishment Conference in Berlin
CIVIL SOCIETY CALL TO ACTION
on the occasion of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF)
Replenishment Conference, 26-28 September 2007 in Berlin
We recognise the Global Fund (GF) as an innovative and effective new financing mechanism. Since its establishment in 2002, the Global Fund has funded programmes that have already saved more than 1.8 million lives around the world. Although the mechanisms of the GF continue to become more effective, its development remains work in progress.
We welcome that Germany and the other G8 Heads of State committed themselves at the recent G8 summit in Heiligendamm to increasing their annual support to the GF by between 6 and 8 billion US-Dollars through 2010. We appeal to the German Government as the host of the Global Fund’s Replenishment Conference on 26-28 September 2007 in Berlin, to live up to its financial promises and encourages an in-depth discussion on how to improve Global Fund’s effectiveness and accountability.
We appreciate the fact that the German government enriched the conference’s programme beyond its mere financing purpose by organising side events which cover a wide range of topics including the importance of integrating Sexual and Reproductive Health (SRH) with HIV/AIDS.
However, we see need for action in the following fields:
Improving Civil Society Involvement
In principle, the GF grants civil society an important role on both global and national level - from governance to programme implementation - by stipulating that at least 40% of the members in the Country Coordinating Mechanisms (CCMs) should come from the civil society sector. This confidence is well placed: recent studies document that those GF projects in which the Principal Recipient (PR) is not a government entity show better results than government-led projects.
Civil society inclusion, however, varies greatly from country to country and is not sufficient overall. First of all, there is a lack of enforcement of the stipulation to involve civil society on the CCMs. The lack of CS participation may be due to the weakness of civil society in some recipient countries as well as to a lack of information amongst non-governmental organisations (NGOs). Equally problematic is the lack of transparency and involvement of NGOs and other civil society organisations (CSOs) in the preparation and submission of proposals to the GF and their implementation. Under this year’s Round 7 Call NGOs and CSOs in Kenya and Uganda e.g. were given one week to provide input to the CCM.
Therefore, we demand supporting measures in the fields of CSO capacity building and information sharing in order to enable civil society to live up to its designated role of serving as a “bridge-builder” and watchdog within the Global Fund’s architecture.
Demanding Gender-Sensitive Programming
Because of the greater vulnerability of women - both socio-economically and biologically - to infection, the HIV/AIDS-pandemic in developing countries has an increasingly (adolescent) female face. We welcome the fact that this need for a more “gender-sensitive response” to the pandemic and in the work of the Global Fund was reflected in the G8 final communiqué from Heiligendamm.
We support the international initiative to encourage more explicit recognition of the direct links between gender inequity and risk of HIV-infection at all levels in the work of the GF. In this context, we endorse the introduction of a "gender mainstreaming"-approach which can be an effective part of ensuring more and better gender-sensitive programmes.
Linking SRH and HIV/AIDS
The primary mode of HIV/AIDS-transmission in developing countries remains heterosexual activity, and those at risk for HIV/AIDS are also at risk for other sexually transmitted infections, unwanted pregnancy, and the resultant socioeconomic consequences. Bridging the gap between family planning and distributing contraceptives is an important starting point in HIV/AIDS-prevention, treatment and care.
Unfortunately, the GF insufficiently addresses the reality of HIV/AIDS as a SRH-issue. Calls for Proposals do not explicitly link HIV/AIDS with SRH, thereby implicitly or explicitly discouraging submission of proposals to address both causes and consequences of unsafe sex. The possibility to provide HIV-prevention in the context of SRH-services and vice versa remains thus often unused. Furthermore, the availability of SRH-commodities and supplies is widely recognised as an important aspect (and measure) of health systems strengthening.
We urge the GF to use its considerable resources and political leverage to work towards ensuring an improved linkage between SRH and HIV/AIDS as well as a sufficient supply of SRH-commodities, including human resources. As an important step in achieving the above, we consider the representation of SRH-experts within the CCMs and their continued representation in the Technical Review Panel (TRP).
Fighting Malaria Effectively
Currently, almost 26 % of the GF’s financial means are contributed to the fight against malaria. According to a recent study, malaria projects in general do not perform as well as projects with a focus on HIV/AIDS and tuberculosis. The reason for this poor performance might be partly due to the switch to artemisinin-based combination therapy (ACT) for drug resistant malaria in 2004, which slowed implementation and added to costs.
The most vulnerable to the severe consequences of malaria are pregnant women and children under the age of five. Providing comprehensive health services to these most vulnerable groups of patients constitutes a significant opportunity to make more efficient and effective use of available resources, including distribution mechanisms.
We strongly encourage the Global Fund to actively support the merging of all efforts in providing comprehensive health services to the two most vulnerable groups by recognising that intensified cooperation and partnership between Malaria-, SRH- and HIV/AIDS-organisations is the key to a comprehensive global health approach. Furthermore, we call upon the GF to renew its commitment to efforts to accelerate the use of ACTs and the free distribution of insecticide-treated nets (ITNs).
Finally, we appeal to all participants at the GF´s Replenishment Conference to carefully consider the need for action in all the fields mentioned above when defining future financial and programmatic strategies in order to improve GF´s effectiveness and accountability.
Download the Call for Action as PDF file (247 KB) here.
To view the list of supporters of this call to action, please click here.
on the occasion of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF)
Replenishment Conference, 26-28 September 2007 in Berlin
We recognise the Global Fund (GF) as an innovative and effective new financing mechanism. Since its establishment in 2002, the Global Fund has funded programmes that have already saved more than 1.8 million lives around the world. Although the mechanisms of the GF continue to become more effective, its development remains work in progress.
We welcome that Germany and the other G8 Heads of State committed themselves at the recent G8 summit in Heiligendamm to increasing their annual support to the GF by between 6 and 8 billion US-Dollars through 2010. We appeal to the German Government as the host of the Global Fund’s Replenishment Conference on 26-28 September 2007 in Berlin, to live up to its financial promises and encourages an in-depth discussion on how to improve Global Fund’s effectiveness and accountability.
We appreciate the fact that the German government enriched the conference’s programme beyond its mere financing purpose by organising side events which cover a wide range of topics including the importance of integrating Sexual and Reproductive Health (SRH) with HIV/AIDS.
However, we see need for action in the following fields:
Improving Civil Society Involvement
In principle, the GF grants civil society an important role on both global and national level - from governance to programme implementation - by stipulating that at least 40% of the members in the Country Coordinating Mechanisms (CCMs) should come from the civil society sector. This confidence is well placed: recent studies document that those GF projects in which the Principal Recipient (PR) is not a government entity show better results than government-led projects.
Civil society inclusion, however, varies greatly from country to country and is not sufficient overall. First of all, there is a lack of enforcement of the stipulation to involve civil society on the CCMs. The lack of CS participation may be due to the weakness of civil society in some recipient countries as well as to a lack of information amongst non-governmental organisations (NGOs). Equally problematic is the lack of transparency and involvement of NGOs and other civil society organisations (CSOs) in the preparation and submission of proposals to the GF and their implementation. Under this year’s Round 7 Call NGOs and CSOs in Kenya and Uganda e.g. were given one week to provide input to the CCM.
Therefore, we demand supporting measures in the fields of CSO capacity building and information sharing in order to enable civil society to live up to its designated role of serving as a “bridge-builder” and watchdog within the Global Fund’s architecture.
Demanding Gender-Sensitive Programming
Because of the greater vulnerability of women - both socio-economically and biologically - to infection, the HIV/AIDS-pandemic in developing countries has an increasingly (adolescent) female face. We welcome the fact that this need for a more “gender-sensitive response” to the pandemic and in the work of the Global Fund was reflected in the G8 final communiqué from Heiligendamm.
We support the international initiative to encourage more explicit recognition of the direct links between gender inequity and risk of HIV-infection at all levels in the work of the GF. In this context, we endorse the introduction of a "gender mainstreaming"-approach which can be an effective part of ensuring more and better gender-sensitive programmes.
Linking SRH and HIV/AIDS
The primary mode of HIV/AIDS-transmission in developing countries remains heterosexual activity, and those at risk for HIV/AIDS are also at risk for other sexually transmitted infections, unwanted pregnancy, and the resultant socioeconomic consequences. Bridging the gap between family planning and distributing contraceptives is an important starting point in HIV/AIDS-prevention, treatment and care.
Unfortunately, the GF insufficiently addresses the reality of HIV/AIDS as a SRH-issue. Calls for Proposals do not explicitly link HIV/AIDS with SRH, thereby implicitly or explicitly discouraging submission of proposals to address both causes and consequences of unsafe sex. The possibility to provide HIV-prevention in the context of SRH-services and vice versa remains thus often unused. Furthermore, the availability of SRH-commodities and supplies is widely recognised as an important aspect (and measure) of health systems strengthening.
We urge the GF to use its considerable resources and political leverage to work towards ensuring an improved linkage between SRH and HIV/AIDS as well as a sufficient supply of SRH-commodities, including human resources. As an important step in achieving the above, we consider the representation of SRH-experts within the CCMs and their continued representation in the Technical Review Panel (TRP).
Fighting Malaria Effectively
Currently, almost 26 % of the GF’s financial means are contributed to the fight against malaria. According to a recent study, malaria projects in general do not perform as well as projects with a focus on HIV/AIDS and tuberculosis. The reason for this poor performance might be partly due to the switch to artemisinin-based combination therapy (ACT) for drug resistant malaria in 2004, which slowed implementation and added to costs.
The most vulnerable to the severe consequences of malaria are pregnant women and children under the age of five. Providing comprehensive health services to these most vulnerable groups of patients constitutes a significant opportunity to make more efficient and effective use of available resources, including distribution mechanisms.
We strongly encourage the Global Fund to actively support the merging of all efforts in providing comprehensive health services to the two most vulnerable groups by recognising that intensified cooperation and partnership between Malaria-, SRH- and HIV/AIDS-organisations is the key to a comprehensive global health approach. Furthermore, we call upon the GF to renew its commitment to efforts to accelerate the use of ACTs and the free distribution of insecticide-treated nets (ITNs).
Finally, we appeal to all participants at the GF´s Replenishment Conference to carefully consider the need for action in all the fields mentioned above when defining future financial and programmatic strategies in order to improve GF´s effectiveness and accountability.
Download the Call for Action as PDF file (247 KB) here.
To view the list of supporters of this call to action, please click here.
