Global Fund Consultation: Topic 3: Country level partnerships

Guiding Question
What are the ways the Global Fund can strengthen the effectiveness of its country-level partnerships to improve outcomes and impact for the three diseases?

Have your say! Click here


Introduction
The Global Fund to Fight AIDS, Tuberculosis and Malaria was created as a global partnership that has an operational architecture based on a series of assumptions that included the following:

- The Global Fund would not need a country presence as partners (mainly multilateral United Nations organizations and bilateral agencies) would represent the Global Fund partnership at the country level;

- The Global Fund would not need to provide a global or regional mechanism for technical assistance to countries, as other resources would be available for this support; and

- Providing long-term comprehensive support for country HIV, tuberculosis and malaria responses would remain key priorities for all of the partners involved. As part of this landscape of national and global stakeholders, the Global Fund had a very exclusive and clear mandate – the mobilization of significant additional and sustainable resources to address the three diseases. At the country level, the model was for the Global Fund to rely on its partnership model to make the funding work.

In the 10 years since its creation, there has been a growing diversity of the challenges in health, and also the number of state and non-state actors involved. Against this changing landscape, the goal of a fully complementary partnership architecture remains – in line with the 2005 Paris Declaration on Aid Effectiveness, and the 2008 Accra Agenda for Action. At the global level - this sense of shared responsibility has increased and memoranda of understanding are regularly signed to ensure clarity in global level partnership arrangements.

However – at the implementer level - countries report that they experience overlapping and sometimes conflicting messages regarding:

- The mechanisms through which sustainable, predictable funding can be accessed on a timely basis;

- Ways in which to integrate the funding priorities of partners into national planning cycles; and

- Where and how to source management and technical support.

Specific to the Global Fund, there are a small number of instances where operational agreements are currently being developed with partners at the country or regional level. These are being explored as a potential mechanism to complement the overarching collaboration frameworks that are being set in global level memoranda of understanding.

Whether it is through an expanded number of these operational country-level agreements, or some other mechanisms or approach, there appear to be a number of opportunities to strengthen the Global Fund’s partnerships and engagement model.

Without limiting the range or focus of potential strengthening measures, some of the areas of focus may include ways to:

i. Increase the level of participation and representation of implementers in Global Fund governance mechanisms – directly, or via increased engagement with other partnerships – to more effectively engage countries in a dialogue on implementation issues that adversely affect program outcomes, and the necessary Global Fund policies and strategies to address challenges arising;

ii. Improve the routine provision of coordinated management and technical assistance for implementers – with a focus on ways to stimulate the more routine inclusion of implementation support in national strategies and underlying implementation plans, and also address potential under-spending when management and technical assistance support is included in program budgets;

iii. Build or further strengthen the managerial and planning capacity of implementers through increased engagement of partnerships with proven capacity. Examples may include a strengthened engagement model with the private sector at the country level; and

iv. More clearly define the roles and responsibilities of partners, and the Global Fund’s engagement with them, both at the country and regional levels.

Further reading on this topic
Briefing Note on the role of the Global Partnership on Country Systems
http://www.oecd.org/dataoecd/19/49/45034084.pdf

Paris Declaration on Aid Effectiveness
http://www.oecd.org/document/18/0,3343,en_2649_3236398_35401554_1_1_1_1,00.html

How to Have Your Say?
You are welcome to leave your comment here. Also we encourage you to join the time-limited eForums (English, Spanish, Russian and French - for details, go to: www.aidsportal.org/web/globalfundconsult/home ).

Join the Global Fund Consultation English eForum
- send an email to: join-globalfundconsult@eforums.healthdev.org

Join the Global Fund Consultation in Spanish, Russian or French, go to:
http://www.aidsportal.org/web/globalfundconsult/home

Website here

105 comments:

  1. Garima Patel17 May, 2011

    Country-level partnerships should make sure that louder voices don't dominate - and - they are truly driven by the communities even if governments and big NGOs and donors are a part of it.

    ReplyDelete
  2. Satheesh20 May, 2011

    ISSUES AROUND COUNTRY LEVEL GOVERNANCE

    Thanks to the Global Fund Consultation Team for initiating the e-discussions. It seems to be a productive approach which will provide opportunities for people from different strata to express their views as well as to share their experience with regard to Global Fund and its programmes.

    We need to really look into the actual impact which is made by Global Fund programmes. To my view statistics are something like an interim achievement or some output which may lead to an impact.

    The existing programme management systems or programme management functions are not fully competent to facilitate the process of desired changes. I feel there are gaps both in management structures as well as the management procedures. It is better to re-look into all those things and revitalize the systems.

    There are certain key issues which affects the country level governance and management systems also.

    1. The conflict of interest - the members or their affiliates receive the funds - directly or indirectly
    2. Tokenistic participation in programme planning
    3. Incompetency in the monitoring systems
    4. Unrealistic capacity building systems

    These issues have to be addressed properly to strengthen the programmes.

    Satheesh
    www.somaindia.org
    Email: somasatheesh@yahoo.com

    ReplyDelete
  3. Dr Asomba Tobias20 May, 2011

    URGE CIVIL SOCIETY TO JOIN HANDS IN REACHING HOMES TO FIGHT MALARIA

    I can see the Ministry of Health (MOH) in Cameroon which is urging civil society organizations (CSOs) to join hands in reaching various homes as a strategy to diminish malaria.

    This should be scaled up in other countries as well.

    Dr Asomba Tobias
    Email: asombacohecf@yahoo.com

    ReplyDelete
  4. razafinjanahary20 May, 2011

    NATIONAL IMPLEMENTATION STRATEGY SHOULD FOSTER COORDINATION AND COLLABORATION OF ALL STAKEHOLDERS

    I emphasize the importance of monitoring and evaluation. As the impact is often slow to be felt, the monitoring and evaluation can reschedule time errors, or complete the missing, or to cancel what is not updated. For each program funded by the Global Fund, all proposals are developed based on the realities of the requesting country.

    I think the key to a successful financing is in the National Implementation Strategy that fosters coordination and collaboration of all stakeholders to achieve the country and where I like the Global Fund in strict management of funds, but I suggest to be less rigid in the context of the implementation of activities. Example: validation by the Global Fund of an activity planned in the proposal lost time and increases the understanding of PR and SR - the Global Fund needs to strengthen countries improve their monitoring and evaluation frameworks especially strengthen consultations with stakeholders and beneficiaries of each program and at all levels.

    Email: razafinjanahary2000@yahoo.fr

    ReplyDelete
  5. Joy Ganguly20 May, 2011

    STRENGTHEN COUNTRY OWNERSHIP

    The key issues for GFATM to focus on:

    - To strengthen country ownership in proposal development, implementation and lapses;
    - More proactive approaches to grant-making to maximize the impact;
    - Primary focus on strategic approach to strengthen M&E systems;
    - More focus on quality assurance mechanisms and long-term capacity building;
    - Improve certainty of funding to reinforce country planning processes;
    - Differentiated approaches to grant management;
    - To improve communications for better mutual understanding of roles and responsibilities.
    - Apart from that the entire performance-based funding system should be reviewed to streamline it and ensure its integrity. It is an urgent need to clearly articulated roles and responsibilities that are going beyond the MoU model, under the partnership framework and it should focus on key factors limiting scale-up and be implemented through partnership arrangement in order to strengthen the present health system.

    The most important part is to emphasize quality management approaches to build capacity for grant supervision and it is important to strengthen the civil societies role on CCMs. It should also emphasize on the need to increase resources for the provision of Technical Assistance.

    Adding to this, a better focus on cost-effective strategies is needed keeping country ownership as a key standard. There is also a need for improvement in aligning and harmonizing GFATM processes and to strengthen the linkages between programme areas.

    Joy Ganguly
    Consultant/Technical Specialist - Harm Reduction
    New Delhi, India
    Email: gangulyliani@gmail.com

    ReplyDelete
  6. The need for comprehensive responses nationally, and coordinated with international development partners, is clear and is being better understood at the strategy level. A route to value for money is better coordination. From the community level, health service civil society organisations have seen for some time that a range of accessible HIV services are needed by the same people who already attend their health clinics, or meet solo midwives, seek everyday fever management, maternity care or primary healthcare.

    The Global Fund has promoted community systems strengthening in past Rounds of calls for grants and in 2010 the CSS Framework document set out in the clearest terms what countries (CCMs) could request. UNAIDS and the other technical support partners to the CCMs and PRs responded to the country's enquiries and most of the approved Round 10 submissions have clear CSS components' in some countries, the CSS element was approved whilst the 'disease' part was referred for more clarifications.

    The US PEPFAR and US President's Malaria Initiative (PMI) have been significant sources of funds to be spent in a country. The level of consultation with the recipient/ host government and ministry of health has improved across all sectors since the Paris Declaration and on a country by country basis through US Partnership Frameworks. Dr Shah (USAID), in referring to the Global Health Initiative (GHI) of the US Government notes, "Our experience with GHI has made clear: our largest opportunities to improve human health do not lie in optimizing services to the 20% of people in the developing world currently reached by health systems; they lie in extending our reach to the 80% who lack access to health facilities." [http://1.usa.gov/em5y83]

    The Global Fund Partnership Forum, indeed the current and continuing work of the Global Fund to work through recipient government structures and existing in-country implementers, seems the right occasion to bring the GHI funds that will be spent outside the US to the strategic control of the recipient countries. CCMs already exist as a representative group for the health sector. Financial management can be dual control where a country's administration sector is itself the subject of international development partner support. The US move to GHI seeks to ensure a PMI medic is not working near a PEPFAR medic without knowing about each other. In country the goal now is to start at the site the community already uses, near their homes or trading centres, and coordinate through the national health planning structures to have that site host the PMI related services, the PEPFAR related services, the TB, other Malaria and other HIV services that the Global Fund supports and thereby increase accessibility for the very population that we seek to support.

    Civil Society activism to put the topic on the agenda has achieved so much - there is still more to do to clarify the priorities. Civil Society Organisations, local to the community they serve, not just of the same nationality as the community to be served, have established strengths. CSS will help them, in organisational development as well as the narrow needs of today's intervention. Follow the UN High Level Meeting and the input the recent Civil Society Hearing will have on the proceedings; contribute to #GlobalFundConsult to give the eyes on the ground a chance to pass on what they saw to the Global Fund.

    Philip, Uganda
    Email: philip@hcluganda.org

    ReplyDelete
  7. Pankaj Dev20 May, 2011

    STATE-WISE PARTNERSHIPS

    I think the Global Fund should try to build more affective state wise partnership for all the countries so that we are more focused and bring in more valuable results in terms of achieving the desire targets.

    Pankaj Dev
    Email: pankajdev73@gmail.com

    ReplyDelete
  8. Jitendra Dwivedi20 May, 2011

    --------------------
    DISTRICT PARTNERSHIPS SHOULD FEED INTO STATE, REGIONAL and NATIONAL

    Facilitating a platform for civil society on HIV, TB and Malaria or any single issue is always a challenge. For countries such as India, where state to state situation might change, it is very important to have strong district or village level partnerships which feed into state partnerships, which may set the agenda of regional or national partnerships.

    This is also about honest representation - so that every stakeholder has equal rights of participation and access to mechanism to influence the agenda.

    Jitendra Dwivedi, India
    Email: jitendraabf@gmail.com

    ReplyDelete
  9. Kiran Jaiswar20 May, 2011

    MONEY CAN THREATEN GOOD PARTNERSHIPS- DOUBLE EDGE SWORD

    The Global Fund has done commendable job over the past ten years. Even without money, voluntary partnerships of civil society or diverse stakeholders is never easy to manage - if we want to protect real values a partnership should uphold.

    With money things can become more difficult if we are not careful. It is a double edge sword.

    Kiran Jaiswar, India

    ReplyDelete
  10. Dr Fatai Wole Bello20 May, 2011

    I want to commend those who pioneered and made the Global Fund their brain-child. The recent successes as reflected in the various impacts in several countries is an indication that the journey so far is not a misplaced adventure.

    However two critical areas worthy of focus include:

    1. CCM Funding.

    Leaving CCM to source funding from the Government and unwilling partners is unhealthy. The resultant under-table transactions often lead to serious conflict of interest and compromises. Worse is the overarching influence by supporting partners whose posture affirms the adage " he who pays the pipers dictates the tune". Considering the subterranean rivalry between the old development partners and the emerging power bloc represented by the Global Fund, the CCM is often caught in the web and becomes the endangered species. As the axiom goes, " when two elephants clash, the grass will suffer". Until well defined sources of funding for the CCM are well entrenched, the principle of equality of membership will remain a challenge to CCM partnership.

    2. Attitude of Members:

    Lip-service has been paid to the remuneration of members for too long. Expecting part-time CCM members to fully apply themselves to CCM activities pro bono is a refusal to face reality. The members from Government lose their commitment once they discover that the rigor of CCM function lacks remuneration. The civil societies are even worse in developing countries. While NGOs are considered as a means of giving back to the community in the developed or high in-come countries, the CSOs in the developing or lower income countries see NGO works as a perfect opportunity to suck the society. Hence the fierce rivalry in an attempt to "have a bite of the cake". These divergent postures are often under-played. To engender strong partnership and virile CCM, the Global Fund needs to recognize the CCM Secretariat as the operational arm and the CCM board as a political entity whose responsibilities should focus on policy issues, including advocacy. This will also go a long way to reducing the frequency of their meetings and political wranglings which have characterized CCMs in recent times. It will also encourage early response to issues by the secretariat who may no longer wait endlessly for the part-time chairman to provide minute-to-minute
    direction.

    I therefore suggest strongly that the Global Fund should not only provide adequate resources for the CCM function, but should also recognize the need to strengthen the Secretariat to focus on operational issues.

    Dr Fatai Wole Bello
    Executive Secretary, CCM, Nigeria
    Email: fwbello@yahoo.com

    ReplyDelete
  11. Air Mshl Lalji K Verma20 May, 2011

    It is evident that funds released does not get properly utilized. I suggest the following:

    - Funds may be released after careful evaluation of the programme proposed,
    - Periodic inspections by the donor agency or rep (which may be one of the independent selected consultant in the country) may be carried out,
    - Post programme audit of the effectiveness of the programme may be carried out by an independent consultant/NGO

    Air Mshl Lalji K Verma AVSM (Retd)
    President ISHWM
    New Delhi, India
    Blog: laljiverma.blogspot.com
    Email: lalji.lkv2007@gmail.com

    ReplyDelete
  12. Nadeem Ahmad20 May, 2011

    GOVERNMENT SHOULD BE SUPPORTIVE FIRST OF CIVIL SOCIETY PARTNERSHIPS

    The Global Fund should ask governments to give an equal opportunity for civil society to get engaged in TB, HIV and malaria responses. In many countries, it is difficult to believe that governments will not 'control' such partnerships thereby negating all the good we want to achieve by civil society engagement.

    Nadeem Ahmad, UAE

    ReplyDelete
  13. H Joseph Kawuma20 May, 2011

    DON'T NEGLECT TB

    The Global Fund is strengthening country responses to the 3 diseases (TB, HIV and malaria) but I am concerned that even on this forum there are long texts without enough mention of TB.

    Perhaps one of the issues for country partnerships and the Global Fund to address is that of giving TB "second-class" treatment only seen as an opportunistic infection in HIV and a relatively small disease burden when compared to Malaria.

    H Joseph Kawuma, Uganda
    Email: kawuma@infocom.co.ug

    ReplyDelete
  14. Beatrice Minja20 May, 2011

    IMPROVED CCMs COORDINATION & HARMONISATION ACTIVITIES

    Thanks to The Global Fund for this opportunity. May I take this opportunity to share
    with you the following recommendations for developing effective partnership at country level.

    i) Support National coordinating mechanisms to be able to conduct partnership forums for determining country real gaps for both diseases ,This will help partners support each other in dealing with the real country issues which are directed towards addressing community problems and achieving the millennium development goals. Well coordinated partners may also open up opportunities for more resources through various development agents who may choose to address certain issues through their baskets or raising funds elsewhere.

    ii) CCMs should also take their full responsibility in coordinating all partners during the Global Fund proposal developments and develop mechanisms for sharing feedback during the implementation phase... This will help partners in-countries to avoid overlap of activities and make use of scarce resources more wisely

    iii) Harmonised monitoring and evaluation (M&E) indicators for all diseases is an area that require joint partners actions and CCMs may need support to be able to do that

    iv) Increase civil society organisations' (CSOs) representation in the CCMs. Large Number of CCM members are government Officials and the CSOs efforts are given low profile and hence the entire system misses an opportunity for listening and leaning from the community or recipient of the services

    Beatrice Minja
    Coordinator: Tanzania NGOs Alliance Against Malaria Care (TaNAAM)
    Email: beatriceminja@yahoo.co.uk

    ReplyDelete
  15. Arshad Ahmad20 May, 2011

    COORDINATED RESPONSE IS A CHALLENGE
    NOT A PARTNERSHIP WHERE SOME ARE MORE EQUAL THAN OTHERS

    Partnerships exist - but to strengthen them will require a platform where all members can participate as equals - not a partnership where some are more equal than others. That is why coordinated response is a challenge - especially when dominating government agencies and their handpicked or favourite NGOs rule the show.

    Arshad Ahmad, Pakistan

    ReplyDelete
  16. Dr Shrestha20 May, 2011

    CAN WE AGREE ON THE AGENDA FOR SUCH A PARTNERSHIP?

    Without a unifying and common or shared agenda such discussions of working in partnerships and then partnerships working amongst each other will go in circles. The Global Fund should invest money in shaping such a platform where members can agree on an agenda, mobilize resources and implement effectively.

    Dr Shrestha, Nepal

    ReplyDelete
  17. Jitendra Dwivedi20 May, 2011

    PARTNERSHIPS SHOULD ENGAGE SMALL NGOs/ CBOs, SMALL CITIES

    Not only smaller NGOs and community based organizations (CBOs) are not well represented unless "hand-picked" or "selected" by bigger entities in big cities - not because of ill intention but because of lack of such a mechanism where so many people in big countries like India can participate - and represent with dignity, but also there are other issues that increase the likelihood that bigger NGOs in big cities will continue to dominate - like language. Most proceedings are in English - and even if we know English, the jargon used is less familiar for smaller partners that work in community setting.

    Jitendra Dwivedi, India
    Email: jitendraabf@gmail.com

    ReplyDelete
  18. Amir Siddiqui20 May, 2011

    GLOBAL FUND SHOULD SUPPORT SUCH PARTNERSHIPS ONLY IF THEY ARE RUN BY COMMUNITIES

    One way to make sure that the partnerships are community driven is that the Global Fund should ensure that these are not run by governments - and - get direct funding or support. We need to trust the competence of civil society - and - its ability to learn, organize and innovate when given a chance. Give it a chance.

    Amir Siddiqui, Saudi Arabia

    ReplyDelete
  19. Richard Kasesela20 May, 2011

    I am in support of Triangular partnership where as Government, Civil Society and Private sector to address the three pandemics. This should always start from planning to implementation level hence the Global Fund should always enforce this kind of partnership.

    Richard Kasesela, Tanzania
    Email: rkasesela@gmail.com

    ReplyDelete
  20. Kaji Shrestha20 May, 2011

    STOP HAND-PICKING CCM Members

    The Global Fund should initiate transparent and open process for selection of the CCM members, and stop handpicking process.

    The CCM should have ability to listen to another point of view and feedback.

    The CCM should promote local organizations rather than INGOs and big organizations only.

    At least in Nepal the whole process is promoting INGOs and local organizations are losing their capabilities because their capable staff are poached by UN agencies or other INGOs because they will pay more. That means local NGOs train the staff for the INGOs. I am not sure how the Global Fund can initiate promotion of local organizations, but it must if it wants sustainability.

    It should make mandatory for the CCM to retire after three years.

    Kaji Shrestha, WATCH, Nepal
    Email: watchftp@wlink.com.np

    ReplyDelete
  21. Ghaniur Rahman20 May, 2011

    Developing community organizations and intervention through these organizations impact of programs could be strengthened. Grassroots development organizations have direct link with target group and they can better manage resources and bring positive result in this regard.

    Besides protective measures preventive measures like health education etc could be imparted in more effective manner through community organizations.

    Ghaniur Rahman, Pakistan
    Email: ghani.economist@gmail.com

    ReplyDelete
  22. Tabrani Yunis20 May, 2011

    Partnership is a very important in campaigning or implementing program which is aimed at reaching out the poorer and the most vulnerable people in the community. Government as a stakeholders who have big responsibility to provide services of their people are not able to serve the community fairly.

    In most cases, more people complain and complain with the lack of government services. Therefore in order the Global Fund can strengthen the effectiveness of its country-level partnership to improve outcomes and impacts for the three diseases I would like to suggest as follows:

    First, build wider partnership with not only the government bodies, but also NGOs at various levels which reaches the local NGO which are very close with the sufferers.

    Second, the partnership should be designed in different levels such as policy level, and implementing level.

    Third, it must be clear what roles played by each party. The partnership must also put priority in building networking for socializing the three issues in the community worldwide.

    There must be more attention for the developing countries.

    Tabrani Yunis, Indonesia
    Director
    Center for Community Development and Education (CCDE)
    Editor of POTRET (grassroots woman magazine)
    Telp. +62 651 7428446
    Emails: ccde.aceh@gmail.com, potret.ccde@gmail.com
    Website: www.ccde.or.id

    ReplyDelete
  23. Paul Ponniah20 May, 2011

    I am of the opinion that the simplest measures should be put in place for people to have their say in such processes - as simple as possible, like travelling by bus or train.

    For the benefit of the people it is a must that the funds be utilised well. The accounting process should be simple and clean so that any NGO be able to do it satisfactorily. The scientific calculation will be by experts in data collection and analysing.

    Paul Ponniah, India
    Email: paulponniah@yahoo.in

    ReplyDelete
  24. Geetanjali20 May, 2011

    LANGUAGE AND STYLE SHOULD NOT INTIMIDATE

    Often the language and style used by big agencies is such that it intimidates smaller NGOs and community based organizations. For effective partnerships that protect small voices it is important to ensure it doesn’t happen.

    Geetanjali, India

    ReplyDelete
  25. Dr V P Gopinathan20 May, 2011

    DRUG RESISTANT MALARIA AND TB: ENGAGE DIFFERENT SPECIALITIES AND HEALTHCARE WORKERS

    There is still lack of awareness on the treatment strategy on the management of drug resistant malaria and tuberculosis with the result people are dying of these diseases. A panel discussion involving clinicians, epidemiologist, microbiologist and administrative health authorities at several centres in high burden countries will go a long way in reducing the impact. Give us opportunity to be a partner in this war against these difficult microbes.

    Dr V P Gopinathan, Trichur, India
    Jubilee Mission Medical College, Trichur
    Email: vpgopinathan@gmail.com

    ReplyDelete
  26. Gautam Sikka20 May, 2011

    ACTION IS AT STATE LEVEL

    In big countries like India, state to state issues and contexts change - so real effective and strong civil society led partnerships should be at the state level, not just national level in metropolitan cities. These state partnerships should strengthen responses to TB, HIV, malaria and other related issues supported by the Global Fund and feed into national mechanisms including those like CCMs.

    Gautam Sikka, India

    ReplyDelete
  27. Rahul Kumar20 May, 2011

    COMMUNITIES SHOULD CHOOSE THEIR REPRESENTATIVES

    Communities should choose their representatives in such national partnerships and Global Fund should see that countries are doing so. For example, why should a handful of people be selected to represent certain communities? Why cannot communities be given a right and empowered enough to select their own representatives in an open and transparent manner? Unless this happens, voices of those on the margin will continue to be faint, weak if heard at all.

    Rahul Kumar, India
    Email: contactrahullko@gmail.com

    ReplyDelete
  28. Shobha Shukla20 May, 2011

    GENDER

    The Global Fund to fight AIDS, TB and Malaria (GFATM) must ensure that these partnerships on TB, HIV and malaria have well representation of different genders. Preferably they should be led by other genders than a man. It is important to recognize and let other genders take leadership and be given such opportunities - and supported by the entire partnership when they convene.

    For example, in western UP which is a very patriarchal society, unless women are engaged in leadership roles, how else will TB, HIV and malaria programmes become gender sensitive to their needs, challenges and what works and what doesn't work with them? So is true for others in more severity like transgender populations or men who have sex with men (MSM) - these are important voices and communities know best - and only these voices can help programmes reach the unreached.

    Shobha Shukla, India
    Email: shobha1shukla@yahoo.co.in

    ReplyDelete
  29. Ritesh Arya20 May, 2011

    ONE PARTNERSHIP - ONE RESPONSE

    Civil society has been so fragmented and it is important for the Global Fund to invest in countries where different stakeholders can give up petty issues and come together as one partnership for a coordinated response in action.

    Ritesh Arya, India
    Email: ritesharya45@yahoo.com

    ReplyDelete
  30. Dr Lalji K Verma20 May, 2011

    I agree with Gautam Sikka, India that in a big country like India it would pay better dividends if the tie up is with states rather the central ministries.

    Dr Lalji K Verma, India
    Email: vermalk@bol.net.in

    ReplyDelete
  31. Anonymous20 May, 2011

    The GFATM should have provision to engage independent monitoring agencies to better hold program accountable for efficiency in spending in the area of HIV/AIDS, Tuberculosis and Malaria programs.

    By which more CSOs shall have the opportunity to emerge with a mission to reduce mal-governance in those programs and thereby maximizing the impact.

    Anonymous

    ReplyDelete
  32. Ridha Baklouti20 May, 2011

    We need to reinforce the partnerships to overcome diseases and let field experiences inform the programmes so that effective interventions can take place such as sensitizing young people to protect themselves from illnesses.

    In addition to that ,in Tunisia after the revolution of January the 14th, a very deep unity between the people and the civil society has taken shape. And in this time we must take care of local regions and this fact will be based on partnerships because "the Union makes force".

    Ridha Baklouti, CCM, Tunisia
    Email: baklouti.m@voila.fr

    ReplyDelete
  33. Richard Shilamba20 May, 2011

    Indeed, the Global Fund should support and strengthen local non-governmental organisations to be among Principal recipients of the Funds than the practice now of having only International Organisations.

    Selection of the CCM members should be more open and ensure greater involvement of organisations working for the fund priority areas.

    Richard Shilamba, Tanzania
    Executive Director
    Children Education Society(CHESO)
    Email: chesociety@yahoo.com

    ReplyDelete
  34. Soethant Aung20 May, 2011

    To enforce transparency about the terms and agreement made between the global fund and national partners. Which may explain who are intended beneficiaries, where they are and what strategy to be used and how much of the cost has been budgeted.

    It will facilitate participatory monitoring to have effective use of fund and service delivery at all level.

    Soethant Aung, Myanmar
    Email: soethant@yahoo.com

    ReplyDelete
  35. CGPVS Surguja20 May, 2011

    It's important to involve civil society because of I often see in development sector government programme performance in not satisfactory however if along with government civil society gets the proper opportunity definitely progress will be seen.

    We also have to stop thinking that civil society cannot do the work properly.

    The Global Fund should consider those organizations that are working well but lack proper knowledge, communication skill or other such tools that can be helped with. The Global Fund selection process should also be easy.

    CGPVS Surguja, India
    Email: scgpvs@yahoo.in

    ReplyDelete
  36. A Flecke20 May, 2011

    LET LOCAL PEOPLE DRIVE PARTNERSHIPS

    The Global Fund should let local people drive in-country partnerships -they know the best and solutions rest with them.

    A Flecke, Vietnam

    ReplyDelete
  37. Gurmeet Singh20 May, 2011

    MONEY MAKES IT MORE DIFFICULT TO HAVE GENUINE PARTNERSHIPS

    The Global Fund is blessed because it has the right resources to support much needed programmes and has to be careful, very careful, that money should not weaken or fragment rather strengthen in-country partnerships.

    Gurmeet Singh, India

    ReplyDelete
  38. Zafar Kidwai20 May, 2011

    COORDINATED RESPONSE WITHOUT COMMON AGENDA?

    For a coordinated response at a country level on HIV, TB and malaria it is important for the issue-specific partnerships to coordinate with each other and also directly feed into CCMs, if not drive CCMs. Without a common shared agenda for advocacy and action, it will be more difficult.

    Zafar Kidwai, Bangladesh

    ReplyDelete
  39. EXISTING NETWORKS

    In many countries already country wide networks exist - the Global Fund should invest in strengthening these for a coordinated response on health.

    T Bahn, Cambodia

    ReplyDelete
  40. Rahul Kumar20 May, 2011

    WHY SHOULD GLOBAL FUND AND OTHERS SET THE AGENDA AT LOCAL LEVEL?

    Why are we talking that local networks should talk about TB, HIV or malaria and then feed into state or national networks? It should be the local people who need to decide what are the key health issues that challenge them on day to day basis - not us! And certainly not the Global Fund. The Global Fund and other agencies should facilitate and support this process - where local people can identify their issues - and - find solutions and resources to improve programme responses on the ground. Also then truly local people will be able to have their say in regional or national networks and also drive the Global Fund's agenda.

    Rahul Kumar, India
    Email: contactrahullko@gmail.com

    ReplyDelete
  41. Saeeda Ebrahim20 May, 2011

    HOW CAN CIVIL SOCIETY HAVE RIGHTS IN HEALTH AND NOT IN GOVERNANCE?

    What about nations where civil society generally is struggling for basic rights and is expected to run democratic, ideal, equitable and just partnerships on TB, HIV or malaria? Is it because of the funding? That is why our responses on TB, HIV or malaria must accommodate programmes addressing social determinants of health.

    Saeeda Ebrahim, Afghanistan

    ReplyDelete
  42. Azim Karim20 May, 2011

    RELIGION AND HEALTH

    One effective way to strengthen civil society networks for health agencies is to work closely and effectively with religious and faith based networks. It has shown to work in many settings and at community level still binds people together.

    Azim Karim, Brunei Darussalam

    ReplyDelete
  43. Bathiudeen20 May, 2011

    RISING ABOVE ORGANIZATIONAL MANDATES

    It is important for all partnership members to rise above organizational mandates, projects and programmes and come together for an effective advocacy on an agreed issue - and the Global Fund should support this process. Unless the government agencies on HIV, TB and malaria recognise this partnership and unless civil society recognises this partnership as their platform where they too have a voice, such efforts will not bear fruits.

    Bathiudeen, Sri Lanka

    ReplyDelete
  44. D Kapadia20 May, 2011

    AGENDAS ARE DIFFERENT AND SO COORDINATION DIFFICULT

    There are so many partnerships that exist in India on a range of issues but coordination between them seems impossible. Even within them there are problems of exclusion at times. Also CCMs are very unique entities with a clear defined role at a country level and are established by the Global Fund (drawing members from within the country).

    CCMs role is well-defined but role of most civil society partnerships is broadly on advocacy. So no wonder coordination between diverse partnerships and CCMs is difficult. The Global Fund should facilitate a process to support discussions between these entities within a country to agree on ONE programme - and support this programme where different entities (CCMs, partnerships etc) take up defined responsibilities and do it well.

    D Kapadia, India

    ReplyDelete
  45. Dr Godfrey Waidubu21 May, 2011

    CCM STRUCTURE

    The Global Fund structure should continue with the CCM which should have direct contact with Global Fund and the Secretary of Health is kept informed of all reports, funding, monitoring and evaluation of the existing programs at least quarterly. CCM should be accommodate extra staff for the extra responsibilities. The CCM Global Fund must exist and remain as the major buy-in for supported programs. Too many times "correspondence" is lost through intermediary organizations.

    Dr Godfrey Waidubu
    Nauru
    Email: waidubu@gmail.com

    ReplyDelete
  46. Paul Ponniah21 May, 2011

    The Global Fund is the financial mechanism and the CCMs the machinery for implementing the project at a country level and the grass root NGO can carry the progress of the project to the most distance people both knowledge and guidance in sustainable manner. What we need is coordination between these three.

    Paul Ponniah, India
    Email: paulponniah@yahoo.in

    ReplyDelete
  47. Roger Kamugasha21 May, 2011

    The Global Fund country mechanisms are still running like parallel entities, the CCM will have a different agenda while the Ministry of Finance and other Line Ministries concerned are also having an agenda of their own. In the due process we have the President's Office the political strong arm for Uganda and most of the GFATM beneficiary countries, also fronting its political interests.

    To be able to strengthen country partnerships we need to have a central mechanism that brings all the stakeholders to one platform of planning, budgeting and implementation phases for the 3 diseases.

    The tendency of isolating the Civil Society in due process leaves this whole exercise in checks; the transparency of the whole process remains questionable; since Civil Society is the most reliable linkage to grassroots communities, the impact on the 3 diseases is not visible. Total lack of cohesion.

    Roger Kamugasha, Uganda
    Email: rogerkamugashas@yahoo.com

    ReplyDelete
  48. Jitendra Dwivedi21 May, 2011

    PRINCIPLES OF EQUITY

    People who are doing the service provision on the frontlines are least remunerated - and those sitting on top of HIV, TB and malaria responses either at the state, country or global level, are heavily remunerated - compare the remuneration please. That is why healthcare workers on the frontlines in developing countries want to move to greener pastures. This inequity has to stop in the development sector and let us have some balance and the Global Fund should step in to ensure that equity is upheld while strengthening country responses to HIV, TB and malaria.

    Jitendra Dwivedi, India
    Email: Jitendraabf@gmail.com

    ReplyDelete
  49. Brajesh Kumar21 May, 2011

    CCM COMMUNITY REPS SHOULD COME FROM NATIONAL PARTNERSHIPS

    One suggestion is to let national partnerships of civil society on TB, HIV and malaria select their own community representatives at CCM. CCM has to work in coordination with the national partnerships (and through these national partnerships be connected to state or district level network).

    Brajesh Kumar, Singapore

    ReplyDelete
  50. Bal Krishna Sedai23 May, 2011

    Since couple of weeks I have been reading various opinion in for and against the current Global fund partnership modalities. In my opinion, ultimately this fund also a one way to assist in the implementation of national health programmes for low resource countries. In this connection, we need to see the global fund's impact in overall national programme. For this, the Global Fund programme should be implemented by improving existing government mechanism with an appropriate partnership with strong and community based civil society organizations rather partnership with so called international organization (in the name of technical capabilities).

    The global fund partnership modality should be flexible and country specific. In case of Nepal, we have very good impact on TB component, because there is strong partnership with existing government programme and civil society where as the implementation of rest two components are not seen satisfactory. Thus, there must be transparent and sustainable partnership with government and local civil society organizations.

    Bal Krishna Sedai, Nepal
    Email: bksedai@gmail.com

    ReplyDelete
  51. Joseph N Ngunju23 May, 2011

    PARTNERSHIP AMONG THE CCMs, CIVIL SOCIETY AND GOVERNMENT AGENCIES AT COUNTRY LEVEL

    All partnerships require the stakeholders active participation and inclusion, clear responsibilities, right, obligations and mutual understanding with conflict resolution mechanisms. The government representatives and the CCM must practice, stick to guidelines objectives and policies in their original mandate.

    The gaps between CCMs, Civil societies and the implementing government agencies need to be harmonized, do their work in a free and transparent manner without duplications of responsibilities while remaining focused on the objectives of their original mandate.

    CCMs must be empowered to name and a shame corrupt public personalities who abuse and misuse public resources recklessly without prosecution. A code of conduct and vetting for those aspiring to join CCMs ought to be put in place for best practices.

    The CCMs and Civil societies need to be strengthened to also prosecute all those who shamelessly embezzle funds intended for treatment and prevention of the three diseases. Monitoring and evaluation is not enough, we must now walk the talk.

    Integrity and self sacrifice to speak out without fear or favor is a critical ingredient in any leadership.

    Joseph N Ngunju
    Policy and Advocacy Officer
    Ambassadors of Change NGO
    Nakuru, Kenya
    Email: ngunjujoseph@yahoo.com

    ReplyDelete
  52. Dr Asomba Tobias23 May, 2011

    The Global Fund need to liaise with CSOs, Quarter heads and involve family heads in its program to effectively diminish the three diseases.

    Dr Asomba Tobias, Cameroon
    Email: asombacohecf@yahoo.com

    ReplyDelete
  53. Annah Irungu23 May, 2011

    It is important for GFATM to create mechanisms for monitoring and evaluating CCM's performance outcomes at country levels for quality, accountability and effectiveness. This will ensure equitable distribution of resources and optimum impact posted towards fighting the three diseases. Targets should be given for country level performance which will be scorecard by which CCM's effectiveness will be evaluated on, if performing encouraged and if not, changes effected.

    Annah Irungu, Kenya
    T-plus CBO - Kariobangi
    Email: tiplus.org@gmail.com

    ReplyDelete
  54. Dr Saka Mohammed Jimoh23 May, 2011

    Global Fund worldwide well done we will get to the destinations. CCM country office should be giving the opportunities to expand and limited autonomy to provide oversight function. It is important in granting the government of a country, managed by the government and decision of material support from Global fund is politicise. CCMs be discipline to section any organisation not performing.

    Where are new NGOs let the grassroots, competent, result oriented NGOs have the opportunity to impact in the community.

    Dr Saka Mohammed Jimoh, Nigeria
    Consultant Health Systems
    Email: sakamj1@yahoo.com

    ReplyDelete
  55. Isaac Kireti23 May, 2011

    It's true that NGOs and civil society should be given more power, role and authority to act on pandemic than now.

    Isaac Kireti, Tanzania
    Director, Civil Society
    Moshi-Kilimanjaro
    Email: kili-heritage@email.com

    ReplyDelete
  56. Manu S Mishra23 May, 2011

    Participating in partnerships should be part of the terms of reference of the Global Fund grant recipients and also other mechanisms like CCMs. If left self-regulatory then these partnerships will lack teeth to hold agencies accountable.

    Manu S Mishra, India
    Email: contactmanushresth@gmail.com

    ReplyDelete
  57. GK Bansal23 May, 2011

    Unless we have a national policy that mandates coordination between TB, HIV or malaria programmes it will be difficult to achieve a coordinated response supported by strong national partnerships.

    GK Bansal, India

    ReplyDelete
  58. CCMs and NATIONAL CIVIL SOCIETY PARTNERSHIPS

    The Global Fund should go back to drawing board so as to ensure that CCMs have to engage national civil society partnerships on issues or of most at risk populations - and - let these partnerships chose their representatives.

    Rashi, Nepal

    ReplyDelete
  59. Rahul Pandey23 May, 2011

    I support the suggestion to monitor and evaluate partnerships and CCMs as part of the Global Fund grant.

    Rahul Pandey, India

    ReplyDelete
  60. Dr K Suresh24 May, 2011

    Improve the routine provision of coordinated management and technical assistance for implementers with a focus on ways to stimulate the more routine inclusion of implementation support in national strategies and underlying implementation plans, and also address potential under-spending when management and technical assistance support is included in program budgets;

    To improve the coordinated management one need cultivate a habit among the development partners and different vertical program leaders at state and district level to go in for integrate planning by analyzing implementation bottlenecks and possible local solutions in consultation with local peers. Appropriate funding for such initiatives also be provided.

    iii. Build or further strengthen the managerial and planning capacity of implementers through increased engagement of partnerships with proven capacity. Examples may include a strengthened engagement model with the private sector at the country level; and

    Strengthening planning, managing, monitoring and facilitating capacities of the field level manager will be key for better outcomes. This where involving civil societies, private and NGO sector comes hand.

    The partnership building should discourage nominal or sympathetic lip service or outsourcing of some mundane activities. Involvement of Private sector, Professional Groups and NGO country level is an enigma. There is no such huge organized set up in either of these sectors (though some representatives may be involved in strategic planning too) for facilitating or taking part in implementation and ensuring outcomes. Such role is better envisaged at district/sub-district level. We are talking of sailing or sinking together groups and not advisors and evaluators (fault finders only.)

    iv. More clearly define the roles and responsibilities of partners, and the Global Fund's engagement with them, both at the country and regional levels.

    Yes, This is the need of the hour. Defining the roles and responsibilities and accountability for outcome. The implementers do not need advisors. They need onsite hand holders and facilitators. They need more facilitating environment to implement innovative ideas ( as generally these get shot saying there is no provision or not included in national/state guidelines)

    Dr K Suresh
    Public Health Consultant
    New Delhi, India
    Email: ksuresh@airtelmail.in

    ReplyDelete
  61. Zafar Kidwai24 May, 2011

    CCMS and NATIONAL PARTNERSHIPS

    The country coordinating mechanisms (CCMs) and national partnerships on TB, HIV and malaria must be connected with each other.

    Zafar Kidwai, Pakistan

    ReplyDelete
  62. Amir Siddiqui24 May, 2011

    ALIGNMENT

    Until there is one plan at country level - for health and human rights, and other partnerships, networks like CCMs align accordingly, how can a coordinated response become a reality?

    Amir Siddiqui, Bangladesh

    ReplyDelete
  63. Jitendra Dwivedi24 May, 2011

    GENDER

    I agree with Shobha Shukla that country level partnerships should be gender sensitive and one way to ensure that is to let women, MSM, transgender people or other most at risk populations lead it.

    Jitendra Dwivedi, India
    Email: jitendraabf@gmail.com

    ReplyDelete
  64. Latif Al24 May, 2011

    MONITOR AND EVALUATE CCMs

    Monitoring and evaluating CCMs should also be a part of the rigorous process the Global Fund adopts.

    Latif Al, Jordan

    ReplyDelete
  65. Kiran Jaiswar24 May, 2011

    WOMEN

    Let local partnerships have equitable representation from most at risk communities including women and the difference in terms of gender sensitivity and human rights will become obvious.

    Kiran Jaiswar, India
    Email: indopakpeacemarch@yahoo.co.uk

    ReplyDelete
  66. Shobha Shukla24 May, 2011

    HUMAN RIGHTS FRAMEWORK

    Why cannot the human rights framework be taken up at the country level and the Global Fund should influence governments to do so.

    Shobha Shukla, India
    Email: shobha1shukla@yahoo.co.in

    ReplyDelete
  67. Rahul Kumar24 May, 2011

    DALITS

    Most at risk populations are different for different health conditions and one of the socially ostracized and marginalized communities in India are of dalits - please do involve them genuinely to reach the unreached.

    Rahul Kumar, India
    Email: contactrahullko@gmail.com

    ReplyDelete
  68. Ritesh Arya24 May, 2011

    STRONG PARTNERSHIPS AT LOCAL LEVEL

    If strong partnerships on health exist at local level, the programme performance will improve. If these feed into national ones and guide plus inform CCMs then further beneficial outcomes will be seen.

    Ritesh Arya, India
    Email: ritesharya45@yahoo.com

    ReplyDelete
  69. Anand Pathak24 May, 2011

    TRANSGENDER AND HIJRA POPULATIONS

    Although the Global Fund has done commendable job in supporting men who have sex with men (MSM) but a lot more needs to be done for transgender and Hijra populations.

    Anand Pathak, India

    ReplyDelete
  70. Eric Joshua Oluwakayode25 May, 2011

    IMPROVING COUNTRY LEVEL PARTNERSHIPS AND ALIGNMENT

    Below are my suggestions on how The Global fund can improve on country strengthen level:
    1. Review both MOU and Budget submitted by each partners from each country,

    2. Remind each partners about their MOU and budget and let each of them compile and do accordingly,

    3. Let OIG team review, investigate and ensure compliance of each partners so that there will be VALUE FOR MONEY

    4. Let this be a quarterly review so that no partners will do otherwise.

    5. Let each partners embark on more awareness in their country

    6. The Global fund should welcome more partners from any country so that the work can spread to the nooks and craning of countries

    Eric Joshua Oluwakayode, Nigeria
    Email: ericjossy2003@yahoo.com

    ReplyDelete
  71. Ainsley Reid25 May, 2011

    HIV and AIDS response programming is EVERYBODIES BUSINESS! I think that we need more (additional) and new partners in the response to HIV/AIDS to engage all in reaching the aspire vision of UNAIDS - Zero new infections, zero AIDS-deaths, and zero stigma and discrimination. Over the past 19 years of my personal experience with HIV,I have seen the deaths and associated problems of the early phase of the epidemic, I became very hopeful about how the Global Fund for AIDS TB and Malaria sought to mobilise new and non traditional stakeholders for their engagement in the responses, However, I would like to suggest that decision-makers on the fund's architecture look again at how it enables the creation and application of concepts of relating to social capital at (geographic) community levels.

    The responses right now has too many national level stakeholders who have totally or partially disregard how they impact the situations and perspectives at the grassroots-levels. As a result we can measure the impact of GFATM assistance at national levels but leaving many communities struggling to address issues of social vulnerability, stigma, discrimination, marginalisation, and unable to mitigate HIV related risk as individuals or collectively.

    For example, in the small country village where I am from the local organisations have been thinking about developing programmes to help the people socially and economically since the young people (many of whom are HIV+) are unemployed, at home and frustrated. The Society is plagued by so many challenges which include poor community infrastructure such as road, the spread of HIV etc. They wonder how can GFATM and local decision-makers can help them to help their community. I would considered agents like the Benevolent Societies ideal for outreach and making the kind of impact that would move us closer to the UNAIDS vision.

    We need a kind of partnership that will help local people to be involve in the solution and realise results in (geographic) communities. I am anxious to see how we empower people with HIV to help with this.

    Ainsley Reid
    GIPA Coordinator
    National HIV/STI Programme (NHP)
    Ministry of Health
    Kingston, Jamaica
    Email: akrinja@yahoo.com

    ReplyDelete
  72. Isaac Kireti Moshi-Kilimanjaro25 May, 2011

    Central process is best method in execution of the Global Fund initiative away from political hands, that's why we forced civil society like ours, to help redress what govt fails.

    Isaac Kireti Moshi-Kilimanjaro, Tanzania
    Email: kili-heritage@email.com

    ReplyDelete
  73. Josephine Abgo25 May, 2011

    I have monitored closely what other people are saying concerning the improvement of country level partnerships and alignments and I have few comments to make. There is strength in partnerships and coordination and this is for the success of anything. This fund is meant to support governments in the area of health and for countries to really feel the impact this impact of the Global Fund, government mechanisms and structures must be greatly improved in this course. Partnerships should be flexible and transparent as well as sustainable. However, to strengthen effectiveness with country specific, there should be strong civil society partnerships - after all it is the CSOs who are at the grass root level doing the work and reaching the unreachable. It is the CSOs who work tirelessly to achieve country results. CSOs capacities are not built and they need on the job training to perform magic where the global fund is concerned. Again, flow of funds is very slow and coordination is not strong and these are areas that need strong improvement for the global fund. Much has been done but there is still more to do.I also support the suggestion to monitor and evaluate CCMs.

    Josephine Abgo, Ghana
    Email: jossyagbo@yahoo.com

    ReplyDelete
  74. Paul Ponniah25 May, 2011

    I noted that every funding organisation is under observation for the following things is noted:
    - Once grant is given to the agency then the work is not maintained as on records.

    - Every applicant should be numbered and the application should be well processed and notified to the NGO organisation as how the needed correction is to be effected to gain grants.

    - The system of transparency and accountability should be easy.

    Paul Ponniah, India
    Email: paulponniah@yahoo.in

    ReplyDelete
  75. Arif Clinton25 May, 2011

    India has major health challenges like TB, malaria, dengue, kala-azar, diabetes, and others. We need a comprehensive healthcare approach through a wide network of local community health centres.

    Arif Clinton, India
    Email: arif.clinton@gmail.com

    ReplyDelete
  76. Air Mshl Lalji K Verma AVSM25 May, 2011

    PLAN and EXECUTION

    There have been plenty of well researched detailed plans but implementation has been woefully lacking and in this case as well! It is required that implementation strategies be developed and ensured. Close monitoring and concurrent financial and administrative audit should be carried out periodically by independent organisation/ NGO.

    Air Mshl Lalji K Verma AVSM (Retd)
    President ISHWM
    New Delhi, India
    Skype: lkv2007
    Blog: laljiverma.blogspot.com
    Email: lalji.lkv2007@gmail.com

    ReplyDelete
  77. Pastor Phainos Muhindi25 May, 2011

    The Global Fund can be strengthened the effectiveness of its country level partnerships to work together as representative partnership at the country, to compliment the strengthen and give access ideas. Multilateral united nations organizations and bilateral agencies will also allow to share different feature and increase impact in the country level partnerships. As a part of strengthening, it may identify key partner organizations with who partnership could work, through an additional brain-storming exercise, even more potential partners may be identified.

    Pastor Phainos Muhindi, Kenya
    Email: phinosmuhidi@yahoo.com

    ReplyDelete
  78. Dr Renier Sefularo25 May, 2011

    SUPPORT LOCAL ACTION

    The Global Fund should support mechanisms that truly engage local communities, build their capacities so that they can deliver services with integrity and efficacy.

    Dr Renier Sefularo, South Africa

    ReplyDelete
  79. I Katali25 May, 2011

    MARPs SHOULD DRIVE CCMs

    The country coordinating mechanisms (CCMs) should be driven by most at risk populations (MARPs) in disease context

    I Katali, Namibia

    ReplyDelete
  80. Marco Gomes25 May, 2011

    To improve country level partnerships and alignment of the Global Fund within the wider architecture of international aid the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) must remain a funding institution and not become a technical agency. But work with in-country technical assistant agencies, whether it be UN Agencies, multilateral and bilateral agencies that are mandated and funded to work on technical capacity, assessment and health strategy planning at country level to align Global Fund support programmes with the overall National Health Strategy.

    This presupposes that:

    (i) the strategies prepared by individual countries and adopted to combat the three diseases are relevant and that the funded initiatives are both effective and efficient, and

    (ii) the partnership with the United Nations agencies (the technical benchmark for the diseases), the stakeholders within individual countries and the development aid agencies, is working for the benefit of delivering the Fund's programs.

    In addition the Global Fund must develop a communications strategy that conveys a clearer understanding of its principles and mechanisms among those approached to support its work. Finally, the Global Fund must never lose key objective within Global Health Initiatives. That is to mobilize resources as well as promote multi-partner engagement in government-led programming.

    The Global Fund faces an insurmountable number of challenges to create harmonized country-level partnerships, which include:

    - Countries struggling to absorb partnerships resources given disparate rules, procedures, and expectations of each partnership.

    - The need for enhanced coordination of partners and countries involved in a given partnership to deliver and impact positively on health outcomes.

    - Country coordination mechanisms and forums proliferating each specific to a given Partnership.

    - Performance-based funding may not function in the Global Fund model. Although a positive development, leading to long term uncertainty of funding flows.

    - Partnerships bypassing and undermining existing country plans and processes, often by insisting on new rules and/or leading uncoordinated multiple processes.

    - Distorting effects of uncoordinated funding flows and engagement by Partnerships at country level as they typically favour individual diseases or aspects of the health system.

    (Citation Reference: 4th Global Meeting of Heads of WHO Country Offices with
    DG and RDs. Partnership for Health Development)

    Marco Gomes
    Policy Advisor, Health and HIV
    Centre for Health Policy and Innovation (CHPI)
    Emails: marcogomes.healthpolicy@gmx.com, mgomes.chpi@gmx.com
    Skype:marcogomes.chpi

    ReplyDelete
  81. Ghani Ur Rahman25 May, 2011

    The Global Fund should focus on preventive measures which are cost effective, sustainable and beneficial for people living both in developed and developing countries of the world. If preventive measures are taken like giving health education regarding AIDS, TB and Malaria 90% decrease in these disease can be made without spending too much on expensive medicines for these fatal diseases.

    In making health policy more focus should be made on preventive measures and environmental pollution need to be reduced which also help in decrease of may diseases.

    Ghani Ur Rahman, Pakistan
    Email: ghani.economist@gmail.com

    ReplyDelete
  82. S Roger Paul Kamugasha25 May, 2011

    For Uganda when it come to Human rights in health initiatives, we are reminded of Dr Mathew Lukwiya who succumbed to "Ebola" a deadly disease that had hit the Northern region. Mathew died because of his humanitarian commitment to save lives of helpless citizens. Protective Measures should be put in place by governments to save the health provider

    S Roger Paul Kamugasha, Uganda
    Email: rogerkamugashas@yahoo.com

    ReplyDelete
  83. Lala Oluwatobi25 May, 2011

    I believe the Global Fund should critically review its country level partnerships as regards rules of procedure and modalities of implementation.

    In my opinion, the Global Fund should allow countries to develop indigenous solutions to the problems of these diseases while providing policy framework, guidance and technical as well as financial assistance.

    Yes, we have run the program for ten years now; we have seen areas of shortcomings of the program. It is time for us to adapt the program to suit the peculiar challenges of our societies.

    I have seen in my experience that while the Global Fund approach may be producing good results, an indigenous adaptation may provide better results.

    Lala Oluwatobi, Nigeria
    Email: call4biggy@yahoo.com

    ReplyDelete
  84. Prasanta Kumar Hota25 May, 2011

    I feel strongly that, Global fund has to move forward to reach every corner of the country by simplifying its modalities of receiving proposal from grassroots NGOs in India.

    First it has to organise regional (Sub-State specific information dissemination workshop for NGO leaders) before their each RFP session - for at least about next five years; so that they can get good hard working committed NGOs to work with. Because good development workers seldom get time to do lobby for fund raising hence goes out of the reach of donor agencies like Global funds.

    Prasanta Kumar Hota
    Executive Director
    Solidarity for Social Equality (SSE)
    (Human Rights Centre)
    Balangir, Odisha, India
    Emails: ssehrc@gmail.com, ssesonepur@rediffmail.com, prasantahota@yahoo.co.in
    Website: www.humanrights-orissa.org

    ReplyDelete
  85. Fred Mwansa25 May, 2011

    To have the right people on the CCM and who are well informed about the three diseases. They should also coordinate with the civil society that are directly involved in the fighting against these diseases. Political will is one of the cardinal thing, politicians should show commitment and safeguard the well being in the society.

    Fred Mwansa, Zambia
    Email: fredmwansa@yahoo.ca

    ReplyDelete
  86. Sandra Jaclyn Kiapi25 May, 2011

    In countries like Uganda where there is a Global Fund Secretariat, there is no CSO representation at the Secretariat. It is therefore no wonder that information flow to CSOs has been very poor-- the CSOs representatives on CCMs have not been effective in channelling back to the CSOs in the Constituencies they represent. The idea of having CSO representation at the country level GF Secretariat will be helpful in terms of information flow to CSO partners. CSO focal points should also be tasked to ensure that information flow is nationwide and not limited to specific regions taking into account hard to reach areas.

    Although CSOs have been largely involved in service delivery, their accountability role within the partnership framework should be strengthened. In fact, some CSOs should be facilitated to play the accountability role as a watch dog so as to minimise the conflict of interest that comes with a dual role as a service provider and as watchdog.

    Sandra Jaclyn Kiapi, Uganda
    Advocate and Human Rights Specialist
    Kampala, Uganda.

    ReplyDelete
  87. The country coordinating mechanism (CCM) has developed over the years of the Global Fund. In its membership and generally through its operations, it draws together the views of small civil society organisations, government policy managers, development partners, medical and other technical implementers and representatives of affected populations. It often appears to offer greater representation than did the sector-wide approach committees.

    Country-level partnerships at the level of planning and prioritising would appear to be in place. The implementation, particularly holding the development partners to their commitment to country ownership and host-country determination of what they need could also be chaired through the CCM. However, the role of civil society implementers and drawing on in-country experience of past and continuing implementers could be a simple form of country-level partnership that aid transparency and strengthen implementation. Encouraging recipient countries to require their development partners to recognise the CCM and accept CCM determinations of what is to be funded, would help inter-donor coordination for the good of the population of the recipient country.

    Philip, Uganda
    Email: philip@hcluganda.org

    ReplyDelete
  88. Paul Ponniah25 May, 2011

    I will like to comment to the response from Dr V P Gopinathan, Trichur, India. There is still lack of awareness on the treatment strategy on the management of drug resistant malaria and tuberculosis with the result people are dying of these
    diseases. A panel discussion involving clinicians, epidemiologist, microbiologist and administrative health authorities - this is what Dr Gopinathan had said and I support it. This is the secondary level of prevention where the expert team get involved to control, cure, and defeat the disease.

    The primary level is to prevent the breading of mosquitoes, the nutrition for the TB with the therapy, and the comfort for the AIDS and HIV patients with comfort for their relatives and nutrition requirements is to be given prime responsibility.

    Paul Ponniah, India
    Email: paulponniah@yahoo.in

    ReplyDelete
  89. Ainsley Reid25 May, 2011

    GLOBAL FUND SHOULD IMPROVE HOW IT PARTNERS FOR GREATER IMPACT AND RESULTS

    HIV and AIDS response programming is EVERYBODIES BUSINESS! I think that we need more (additional) and new partners in the response to HIV/AIDS to engage all in reaching the aspire vision of UNAIDS - Zero new infections, zero AIDS-deaths, and zero stigma and discrimination. Over the past 19 years of living with HIV and experiencing the deaths and mayhem of the early phase of the epidemic, I became very hopeful about how the Global Fund for AIDS TB and Malaria sought to mobilise new and non traditional stakeholders for their engagement in the responses, However, I would like to suggest that decision-makers on the fund's architecture look again at how it enables the creation and application of concepts of relating to social capital at (geographic) community levels.

    The responses right now has too many national level stakeholders who have to
    tally or partially disregard how they impact the situations and perspective
    s at the grassroots-levels. As a result we can measure the impact of GLOBAL FUND assistance at national levels but leaving many communities struggling to address issues of social vulnerability, stigma, discrimination, marginalisation, and unable to mitigate HIV related risk as individuals or collectively.

    For example, in the small country village where I am from in St, Mary, Jamaica, the Benevolent Society have been thinking about developing programmes to help the people socially and economically since the young people (many of whom are HIV+) are unemployed, at home and frustrated. The Society is plagued by so many challenges which include poor community infrastructure such as road, the spread of HIV etc. They wonder how can GLOBAL FUND and local decision-makers can help them to help their community. I would considered agents like the Benevolent Societies ideal for outreach and making the kind of impact that would move us closer to the UNAIDS vision.

    We need a kind of partnership that will help us to realise results in geographic communities. I am anxious to see how we empower people with HIV to help with this.

    Ainsley Reid
    GIPA Coordinator
    National HIV/STI Programme (NHP)
    Ministry of Health
    Kingston, Jamaica
    Email: akrinja@yahoo.com

    ReplyDelete
  90. Amungwa Athanasius Nche25 May, 2011

    PARTENSHIPING AT LOCAL LEVELS

    I believe that effective partnerships at local levels for GFAMT action is one of the most important strategy in the planning, intervening, monitoring, supervising and evaluating action within the framework of HIV, Malaria, TB prevention, treatment, care and support continuum but unfortunately it looks to me as if it is the weakest link in programme implementation. I believe that partnership analysis using the SWOT approach before creating a partnership pool for a particular project is highly appreciable if we want projects to yield the intended cost beneficial and effective outcomes.

    When a thorough partnership analysis is done then it would be guaranteed that programme action would be executed, monitored, supervised and evaluated within the spirit of a united whole working in amazing cohesion to achieve the mandates reflected in the relationships.

    I am wondering what the GLOBAL FUND system can do to ensure that all GLOBAL FUND action against AIDS, malaria and tuberculosis is carried out within a partnership network in which all the actors coalesce their expertise, efforts and best practices to produce results that would impact locally and help to significantly scale down HIV, malaria and tuberculosis.

    Amungwa Athanasius Nche
    Health and Development Certified Training Professional
    Bamenda, North West Region, Cameroon
    Email: athanestherhaw@gmail.com

    ReplyDelete
  91. Pastor Phainos Muhindi25 May, 2011

    The most common way to strengthen effectiveness in country- level partnerships
    And their assessment is to undertake a SWOT analysis looking at both external and internal issues.
    Swot stand for:
    *S-strength
    *W-weakness
    *O-opportunities
    *T-threats
    In a SWOT analysis, it will improve partnerships to identify, first, the strengths and weaknesses of the projects, [which are internal] and then the opportunities and threats that they see [which are external].

    Pastor Phainos Muhindi
    Eldoret, Kenya
    Email: phinosmuhidi@yahoo.com

    ReplyDelete
  92. Jitendra Dwivedi25 May, 2011

    LOCAL PARTNERSHIPS

    Even in one city it is so difficult to establish an ideal partnerships based on agreed values that can support a coordinated response to health. That is why it is so essential to begin strengthening local partnerships - and then establish mechanisms that it may feed into national or global ones.

    Jitendra Dwivedi, India
    Email: jitendraabf@gmail.com

    ReplyDelete
  93. Rahul Kumar25 May, 2011

    COMMUNICATION IS KEY

    I will like to highlight that open, simple and practical communication solutions is also a key in making partnerships work at all levels.

    Rahul Kumar, India
    Email: contactrahullko@gmail.com

    ReplyDelete
  94. Sandeep Kumar25 May, 2011

    GREEING ON A COMMON GOOD Vs ORGANISATIONAL AGENDAS

    Partnerships work only when members agree on a common agenda rising above and beyond their organisational agendas at times. If we limit ourselves to our organisational mandates only, then partnerships are likely to suffer. For example, if an AIDS NGO sees nutrition as a key issue affecting people's lives in the community, then it should support rising beyond its organisational mandate and likewise for nutritional or food security groups to support AIDS response if communities need that.

    Sandeep Kumar, India
    Email: sandeep.napm@yahoo.com

    ReplyDelete
  95. Dr G Shrestha25 May, 2011

    LET COMMUNITIES LEAD

    Partnerships do exist at local level - come to a village and see it. They might not be ideal partnerships given the power dynamics that a range of factors govern - so the challenge is to improve these local partnerships so that they can truly serve local needs in an accountable, transparent and equitable manner without any prejudice or discrimination - and are rooted in human rights framework.

    Dr G Shrestha, Nepal

    ReplyDelete
  96. Isaac Kireti27 May, 2011

    I agree with the comment that good partnership, accountability, are among the key factors to improve the programme outcomes of the Global Fund supported initiatives.

    Isaac Kireti, Tanzania
    Email: kili-heritage@email.com

    ReplyDelete
  97. Dr PS Sarma27 May, 2011

    Country level Partnership is required for effective functioning of any programme. One has to identify the correct Partner - the ideal partner /committed partner and need to have a tie up for strengthening and continuing their action plan. The Global Fund is doing excellent service in supporting various countries in their work for AIDS /TB / MALARIA.

    I am associated with RNTCP [Government of India's national TB programme] PPM project in India since 2007; which is being supported by the Global Fund. Because of their support only thousands of Private Practitioners has the opportunity of learning about RNTCP and also involving themselves in the PPM project. Likewise it is needless to emphasize the necessity to get involved with as many ACTIVE NGOs as possible and give them a helping hand for better performance.

    Dr PS Sarma
    Technical Consultant
    Revised National TB Control Programme (RNTCP)
    Ministry of Health and Family Welfare
    Government of India
    Email: drpappuss@yahoo.co.in

    ReplyDelete
  98. Fred Mwansa27 May, 2011

    The Global Fund can allocate more money to organizations dealing with most at risk populations by empowering them. This will also help people have more access to information and other resources and understand issues surrounding them.

    Fred Mwansa, Zambia
    Email: fredmwansa@yahoo.ca

    ReplyDelete
  99. Dileep Sharma27 May, 2011

    PARTNERSHIPS ARE SO NECESSARY YET A CHALLENGE

    Even government ministries and departments struggle for inter-sectoral collaboration - it is not so easy to facilitate a multi-stakeholder partnerships and hope for a horizontal approach. Unless at policy level inter-sectoral collaboration is laid down with indicators to monitor and evaluate it, it will be a long road ahead.

    Dileep Sharma, India

    ReplyDelete
  100. Jatin Arora27 May, 2011

    LOCAL PARTNERSHIPS

    Real action if any has, and will, come at local level. That is where a partnership can make a real difference.

    Jatin Arora, India

    ReplyDelete
  101. Priya Talwar27 May, 2011

    PANCHAYAT MODEL

    Why cannot health partnerships build upon the panchayat model at local level?

    Priya Talwar, India

    ReplyDelete
  102. Isaac Kireti27 May, 2011

    I have been reading the comments and feel that many contributors are observing that CCM's role should be reassessed in order to increase transparency, accountability and improve implementation, and I agree.

    Isaac Kireti, Tanzania
    CSO Director
    Moshi - Kilimanjaro
    Email: kili-heritage@email.com

    ReplyDelete
  103. Pastor Phainos Muhindi27 May, 2011

    Partners are encouraged to consider the long term's programmatic sustainability of existing efforts to respond to three diseases. This can be undertaken in four steps:
    -Situational analysis:
    * Strong points of the partnerships.
    * Difficulties/Gaps/opportunities the partnerships needs to work on.- Identify focus areas;
    * Focus areas within the partnership.
    * Focus areas within the community.- Make strategic decisions:
    * Priority choice for the development of objects and activities. -Developing objectives and activities:
    * Goal:(Where do want to get to in a number of years)
    * Objectives:(what we want to achieve)

    Pastor Phainos Muhindi, Kenya
    Email: phinosmuhidi@yahoo.com

    ReplyDelete
  104. David Mukwege27 May, 2011

    ENGAGE PATIENTS

    Engaging patients will strengthen country-level partnerships.

    David Mukwege, DRC

    ReplyDelete
  105. Eric Joshua Oluwakayode27 May, 2011

    IMPROVING COUNTRY LEVEL PARTNERSHIPS AND ALIGNMENT

    Below are my suggestions on how The Global fund can improve on country strengthen level:

    1. Review both MOU and Budget submitted by each partners from each country,

    2. Remind each partners about their MOU and budget and let each of them compile and do accordingly,

    3. Let OIG team review, investigate and ensure compliance of each partners so that there will be VALVE FOR MONEY(VFM)

    4. Let this be a quarterly review so that no partners will do otherwise.

    5. Let each partners embark on more awareness in their country

    6. The Global Fund should welcome more partners from any country so that the work can spread to the nooks and craning of countries

    Eric Joshua Oluwakayode, Nigeria
    Email: ericjossy2003@yahoo.com

    ReplyDelete