PHA-Exchange> Fw: Global Fund -from Dorothy

[Aviva]

From: <pamzinkin at gn.apc.org>

> Dear All,
> I have attached an update about the working of the Global health
> Fund from a recent meeting in London which Medact attended. As you can see
> there are a lot of problems with the Fund as it stands, not the least is
that
> they are not listening to NGOs working with HIV/AIDS or at grassroots
> development level.
>
> Perhaps someone could forward this around the PHM AIDS group and other PHM
> groups? Thanks Dorothy Logie
>
>
> The Global Health Fund  an update
>   Save the Children, Dfid, Medact, MSF. Notes of meeting held on 07/07/02
>
> The Fund is still in its infancy.  It was created by the G8 two years ago
> as a “gap filler” to attempt to reimburse country -wide projects quickly.
> Richard Feachem is managing director and heads the 17-member Board with
> reps from southern and northern NGOs  (Peter Poore ex-STC is UK rep). All
> meetings are in Geneva. Many Board members do not have expertise on
> development issues. The projects have been divided up into HIV/AIDS (by
far
> the biggest slice), TB and malaria and they have been considered
> separately: next year, “cross-cutting “projects will be considered The
Fund
> is unwilling to subsidise health staff salaries.   92% of the first
> disbursement went to poor countries (LDCs). Though a second round of
> applications is in process, no money, so far, has been disbursed to the
> successful projects from the first round (problems about whom in-country
> should receive it?). There is no transparency about
> how the successful projects were chosen.
>
>
> The Fund is hugely weighted to pay for ARVs and drug firms are represented
> on the Fund’s Board. The “procurement working group” meets in Washington
> DC. There is confusion on many issues of procurement (e.g. generic versus
> brand name drugs) and  links with in-country drug procurement policies are
> weak or non-existant.  The country co-ordinating mechanism is also weak
and
> time-consuming. There is too much “ vertical thinking”.  The assessment of
> proposals is undertaken  by a technical review body and is very scientific
> with little recognition of wider development issues. Communication from
the
> Fund so far has been very poor.
>
> The donated money (US $2billion) has come from governments and not from
> private donors (except Gates Foundation) who are waiting to see how things
> go. UK has donated $200 million so far from existing aid budget,
>
>
> NHO concerns about the GHF
>
> ·       It has shown lack of transparency so far
> ·       How are Board members chosen and will the voice of  health
> professionals working in very poor countries be heard in decision-making?
> Especially around the supply of ARVs.
> ·       Is the GHF taking money from other health projects?
> ·       Is it a distraction from government’s own health agenda? Will the
> transaction costs for developing countries take staff away from other
> essential work
> ·       Will the Fund build on PRSPs or SWAPS? If so how?
> ·       What about countries with complex emergencies like Rwanda?
> ·       What are the roles of UNAIDS, WHO or DFID?
> ·       Will the Fund co-ordinate with Stop-TB or with GAVI?
> ·       How will it link to the Commission for Macroeconomics and Health?
> ·       What is the Fund’s long-term objective?
> ·       Does it acknowledge that many countries are bankrupt?
> ·       Are the voices of people working with HIV/AIDS  being heard?
>
> Role for NGOs
>
> To collate the voices of “ reality” (those working in the field) and to
put
> together suggestions on improving the working of the Board and the Fund.
> The prize at the end of the day could be better co-ordination for everyone
> (including private sector) in the fight against AIDS, TB and malaria.
>
>
> Dr Dorothy Logie (Medact)