Global Fund - a view from an NGO's perspective
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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.
Claudio Schuftan
Hanoi, Vietnam
mailto:aviva@netnam.vn
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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 cho-
sen.
The Fund is hugely weighted to pay for ARVs and drug firms are repre-
sented 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 pro-
curement policies are weak or non-existent. The country co-ordinating
mechanism is also weak and time-consuming. There is too much "verti-
cal thinking". The assessment of proposals is undertaken by a techni-
cal 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$ 2 billion) has come from governments and not
from private donors (except Gates Foundation) who are waiting to see
how things go. UK has donated US$ 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 profess-
sionals 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)
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