Your Voices, Your Views: Access, Accountability, Rights

Three Key Correspondents on-site at the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund)'s 2011 Partnership Forum in Sao Paulo have interviewed participants and produced the above video. Thanks to Vladimir, a Key Correspondent from Dominican Republic, for commendable video editing - CNS 


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Border Measures in Free Trade Agreements Will Impede Access to Affordable Generic Medicines

 The European Union (EU) is now pushing for stricter border measures for IPR enforcements in the EU-India Free Trade Agreement (FTA) negotiations, which will impact access to generic medicines.
Stringent EC Customs Regulations that allow European customs officials to detain generic medicines at transit points have been in place since 2003. This has resulted in detainment of many legitimate generic drug shipment of antibiotics and AIDS drugs, which were only in transit through the EU (going from one developing country to patients in other developing countries), on the grounds that they infringe European intellectual property law (patents and trademark). Later, it turned out that the medicines were not in violation of IP laws of the sending and recipient countries involved, but were legitimately produced by mainly Indian generic companies and were being imported by Brazil, Peru, Colombia, Mexico, Nigeria and other developing countries at affordable prices.

Shah Rukh Khan Blames The Fire Place For The Smoke In His Life

Shah Rukh Khan, the Bollywood super star, is once again in the news, albeit for wrong reasons. During the recent 12th International Indian Film Academy (IIFA) awards ceremony in Toronto, he reportedly blamed his initial days with theatre for his legendary smoking habit. Recalling his days as a theatre actor in Delhi, he said: "I remember when a fireplace was put up, the guys used to go behind the fireplace to smoke and put out the fire. That's how I also started smoking and it is not my fault. It has (this habit) got all to do with theatre.”

Gender Statistics paint a gloomy picture of Uttar Pradesh

The birth anniversary of late Prof P C Mahalanobis, (which falls on 29th June), the man who made invaluable contribution in the field of economic planning and statistical development has been designated as ‘National Statistics Day’. This year’s theme was ‘Gender statistics’. To celebrate this occasion, a day long programme was jointly organized by Economics and Statistics Division, State Planning Institute, Uttar Pradesh, NSSO (FOD) Lucknow and UNICEF Lucknow, at Yojna Bhawan on Wednesday.

Do Not Neglect Our Future: Include Children In All NCD Policies

The NCD Alliance has called for children and adolescents not to be overlooked in the final outcomes document and subsequent implementation and follow-up plan on non-communicable diseases (NCDs). “Children and adolescents are our future. They are a cornerstone in the prevention of NCDs. However, when it comes to addressing NCDs, children are too frequently left off the policy agenda,” said Dr. Kate Armstrong, Chair of the NCD Alliance Child-Focused Working Group and President of UNDPI/NGO associated non-profit CLAN (Caring and Living As Neighbours). “We therefore call on all stakeholders – including UN member states, UN-related agencies such as UNICEF, the private sector and civil society – to protect and promote the rights of children to the highest attainable standard of health.”

Countdown To The UN Summit On NCDs Begins: A Time To Start Raising Your Voices

With less than 100 days left for UN High-Level Summit on Non-Communicable Diseases (NCDs) to begin in New York, the NCD Alliance has called upon all those concerned, to make themselves heard by heads of state and health decision makers to make concerted efforts to control this menace. The leaders of the founding partners of the NCD Alliance (which include the International Diabetes Federation, the International Union Against Tuberculosis and Lung Disease, the Union for International Cancer Control and the World Heart Federation) recently launched together a ‘100 Days of Action’ campaign in preparation for the UN Summit on NCDs, to be held in New York on 19-20 September 2011.

It Is Necessary To Communicate about Non-Communicable Diseases

(Based on the speech of the UN Deputy Secretary-General, at the Media Forum on Non Communicable Diseases , in New York on 20.6.2011)
The UN Deputy Secretary-General, Asha-Rose Migiro, while speaking at a media forum on Non-Communicable Diseases (NCDs), in New York, reiterated the commitment of the United Nations to scale up efforts to fight the menace of NCDs, while being aware of the potential road blocks. She agreed that, unlike virus triggered diseases, non-communicable diseases were linked directly to individual habits like tobacco consumption, unhealthy eating and a sedentary life style. Hence there should be a concerted campaign to promote exercise, reduce excessive consumption of alcohol and cut the use of tobacco products.

Who is the champion of democracy?

Manish Tiwari, Congress spokesperson, has said democracy faces greatest peril from the tyranny of unelected and unelectable. He said that the Centre was running out of patience with 'irrational expectations and attitudes.' Earlier Pranab Mukherjee said that there is growing trend of undermining the democratic process and extra-constitutional authority might lead to complete collapse of democracy. Mani Shankar Aiyar said that he would have not paid any heed to the fasts undertaken as part of anti-corruption movements and dismissed them as circuses. Digvijaya Singh has been agressive all along and had demanded enquiry into the expenditure incurred during Anna Hazare's fast right in the beginning. Kapil Sibal had also ridiculed the process of drafting of Lokpal bill asking how it would help educate every child and provide drinking water to all.

Your Heart Is Worth Your Grain Of Salt

In India, salt (chemical name: sodium chloride, local name: 'नमक or namak') is not only an important ingredient on the kitchen shelf, it is also ingrained in our cultural psyche. There are many phrases in the vernacular Hindustani language which reflect its importance - जिसका नमक खाया है, उसके साथ  गद्दारी नहीं कर सकते  (you cannot be disloyal to someone whose salt you have eaten); if you are loyal to a person you are called namak halaal (loyal), else one is namak haraam (disloyal). Again, a sexually desirable person is often referred to as being नमकीन or salty.

Support the struggling people of the POSCO project area

Police in Orissa Shunting local Communities Out - that's POSCO!

In a live update around 3.10 pm IST aired on 11th June 2011 by NEWSX (an English news television channel in India) the local superintendent of police shamelessly termed the peaceful protests against POSCO by people in Dhinkia, "immoral". Importantly, women and children braved the scorching sun to save their land. It is obvious that the government and others favouring POSCO are greedy cowards who will resort to worse methods to try to achieve their ends. "It is crucial for us to remember that the residents of Dhinkia are fighting to protect the commons", remarked Leo Saldanha, the co-founder of Bangalore based Environment Support Group (ESG). After visits and investigations at the proposed site of the POSCO plant, Saldanha, PUCL activist and lawyer V. Suresh and noted film maker K P Sasi shared Tales of Betrayal, Treachery and Subversion at a discussion titled POSCO Fiasco. This was organized in Bangalore on 19th June 2011 by the People's Union for Civil Liberties (PUCL) and ESG.

2011 Global Fund Partnership Forum e-Consultations: Adding Your Voice to the Global Fund's 2012-2016 Strategy

The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) supported a consultative process through online thematic consultations, survey and in-country interviews among other mechanisms, in lead up to the Partnership Forum 2011. The analytical report of the online consultation and survey "2011 Global Fund Partnership Forum e-Consultations: Adding Your Voice to the Global Fund's 2012-2016 Strategy" summarizes what respondents to the eForum and the e-Survey said, in two parts: (1) Part I: Summaries from the three separate topics discussed over the multi-language e-Forum. The summaries capture contributions from e-Forum discussants, grouped by the three topics discussed; and (2) Part II: Analysis of the 2011 Partnership Forum e-Survey responses. Survey data is collated and presented under the five sub-themes of the 2011 Partnership Forum, highlighting broader feedback on measures for improved clarity and effectiveness in all that we do.

Coordination is the key: CCM partnerships in India

Bobby Ramakant - CNS
The Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) should strengthen national partnerships on specific issues and their coordination with Country Coordinating Mechanisms (CCMs). This is not only to optimise programme performance, but also ensure that community voices are central to health responses. India boasts of a CCM and also national partnerships on specific issues like HIV or TB. However a coordinated response between these national partnerships is lacking. According to Dr Nevin Wilson, Director of the International Union against Tuberculosis and Lung Disease (The Union) – South East Asia Office in New Delhi, "The level playing field is missing. We have the civil society and we have the government's national TB programme (formally called the Revised National TB Control Programme - RNTCP), [but] they cannot be equal partners. What stops the Global Fund from giving money directly to civil society?" Read more 


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Free Trade Agreements (FTAs) and health – more leverage required

Bobby Ramakant - CNS
Currently, a number of developing nations are negotiating many economic agreements with other countries or blocks of countries. Another alarming fact is that there is marked reluctance to divulge details about these negotiations, and harsh measures are taken against public health activists who demand their say.More than eighty per cent of antiretroviral (ARV) drugs purchased by the Global Fund are coming from such nations such as India where threat from such economic agreements looms large. According to Loon Gangte of the Delhi Network of People living with HIV (DNP+) and International Treatment Preparedness Coalition (ITPC – South Asia), "The Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) should look into it that more than 80% of antiretroviral (ARV) drugs purchased by it are coming from India and today we are at a very serious juncture with Free Trade Agreement (FTA) with the European Union. Although there are communities fighting against the FTAs from around the world but there is no serious position from the Global Fund against FTAs." Read more 


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HIV, sex-workers and injecting drug users: developing a rights-based approach in Central Asia and Eastern Europe

Evgenia Maron and Bobby Ramakant - CNS
According to the joint United Nations programme on HIV/AIDS (UNAIDS), Eastern Europe and Central Asia is the only region where HIV prevalence remains on the rise. The number of people living with HIV (PLHIV) has almost tripled since 2000, and reached an estimated total of 1.4 million in 2009. A rapid rise in HIV infections among injecting drug users (IDU) at the turn of the century caused the epidemic in this region to surge, and the epidemic is concentrated mainly among people who inject drugs, sex workers, their sexual partners and, to a lesser extent, men who have sex with men (MSM). About one quarter of the 3.7 million people who inject drugs in this region are living with HIV. Read more 


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Invest in the health of ALL populations at risk of HIV Infection in India

Shobha Shukla - CNS
According to a recent UNDP report India has 30.5 million men-who-sex-with-men (MSM), and over a million Hijras, or transgenders. The national HIV prevalence amongst MSM is estimated at 7.41%, with 24% MSM testing positive for HIV in the state of Goa, and 18.8% in Mumbai. While MSM are at a high risk of acquiring and transmitting HIV, only about 4% of those at risk are currently able to access appropriate HIV services in India. In this dismal scenario, the Global Fund For AIDS, Tuberculosis and Malaria (the Global Fund), Round 9 has done well to fund community-strengthening projects to reduce vulnerability and minimise risk of the further spread of HIV amongst MSM, and transgender populations in South Asia. Now it has to be ensured that through proper execution of these projects, more lives are saved and more infections are prevented in the members of this community. Read more

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Meeting the MDG targets for TB eradication in Zimbabwe: Global Fund money is vital

Ignatius Gutsa
Tuberculosis (TB) is a major public health problem in Zimbabwe. As of 2011, the country ranks 20th out of 22 on the list of high-burden TB countries. In 2008, Zimbabwe had an estimated 73,714 new TB cases, and an incidence of 557 per 100,000 people. To aid the national TB response in Zimbabwe, the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) supports a number of programmes. For example, funding received from Round 8 is used for strengthening and expanding the activities of the National Tuberculosis Program. This builds on activities funded under Round 5, to ensure gaps are weaknesses in TB programmes are addressed. The national TB response in Zimbabwe targets patients, and people living with HIV (PLHIV), the population at risk. Read more

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Mixed perceptions of the Global Fund in Kenya

Henry Neondo
Funding for health should begin targeting prevention programmes that address issues that affect women and children, and the Global Fund to fight HIV/AIDS, TB and Malaria (The Global Fund) has a key role to play. In the context of HIV, Professor Alloys Orago, Director of the National AIDS Control Council (NACC), says "for every one person put on treatment, two more get newly infected - women and the youth still bearing the brunt of the three most burdened some diseases: HIV, tuberculosis and malaria." Read more

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Between resentment and dependency: The Global Fund in Indonesia

Suksma Ratri
It is nine years since the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) was first established. Since its inception, the Global Fund has become the main financier of programs to fight these diseases, with a total approved funding of US$ 21.7 billion for more than 600 programs in 150 countries throughout the world. Though the mechanism may seem flawless and ideal, it is important not to rely just on national reports to assess the Fund’s effectiveness. We also need the views of stakeholder constituents – the direct beneficiaries of the funding. Anecdotally, we hear that experiences on the ground do not match the glowing reports released by governments. An example is Indonesia, a large country consisting of over 17 thousand islands. In October 2010, reported cases of AIDS were 24,131, with 4,158 cumulative deaths. With its complex geographical structure, does the Global Fund program run smoothly and ideally in all 33 provinces of Indonesia? Does the program have great impact to the Key Affected Populations, such as injecting drug users (IDU)? Read more 


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Public health and social justice: the time to stop criminalising Thai injecting drug users is now

Jittima Jantanamalaka - CNS
Thailand has been a leader in HIV prevention and treatment for 20 years. Success has come to Thailand in many HIV contexts, but not for HIV transmission driven by injecting drug use. The combination of the criminalisation of injection drug use and a lack of a coherent legal and policy framework on drugs, means that not only injecting drug users (IDUs) are at risk when they access services, but service providers are also at risk of being penalised for offering them. In Thailand, service providers have been arrested, jailed or blacklisted – confirming the gravity of the situation.Criminalisation of drugs can increase HIV infection rates, particularly among IDUs. The number of new hepatitis C virus (HCV) infections has also escalated since the 'war on drugs' was launched. On one hand, when in some countries rates of heterosexually transmitted HIV infections are falling, HIV transmission through the injecting drug route continues to rise. While harm reduction approaches have proven effective at reducing the spread and impact of the epidemic among IDUs, progress in addressing IDU's needs and priorities moves at a snail's pace. Read more


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Simplify and build local competencies to manage Global Fund grants: a view from India

Bobby Ramakant - CNS
The Global Fund to fight AIDS, TB and Malaria (the Global Fund) has contributed significantly over the last decade in accelerating India‟s response to TB, HIV and malaria, saving lives and preventing infections. However a lot more needs to be done as it is clearly not enough. If the Global Fund and India do business as usual, currently unreached populations are unlikely to benefit."Over the last ten years the Global Fund has focussed on strengthening the national programmes in India", according to Dr Nevin Wilson, Director, International Union Against Tuberculosis and Lung Disease (The Union), South East Asia office, New Delhi. Read more

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The Global Fund: enhancing possibilities for people living with HIV in Zimbabwe

Ignatius Gutsa
Zimbabwe currently faces a huge HIV and AIDS crisis. Over the course of the past decade, the country has experienced a severe economic downturn, resulting in acute shortage of drugs and equipment to fight HIV. To aid Zimbabwe's response, the country received a major boost at the beginning of 2010, with a five-year US$84 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund). This grant has gone a long way towards increasing access to HIV services and treatment. Read more 


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The Global Fund in the Dominican Republic: accomplishments & challenges

Vladimir Encarnación Jáquez
In the Dominican Republic, initiatives financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) fall under the framework of the National Response to HIV, TB and malaria. After years of direct interventions focused on the prevention, control and treatment of these diseases, stakeholders consider the contribution of the Global Fund as a significant benefit to thousands of Dominicans. For Nicomedes Castro, Secretary of the Dominican Country Coordinating Mechanism (CCM): "The resources provided by the Global Fund have allowed for the acquisition and supply of medications, saving thousands of lives, and have also contributed with the implementation of successful practices regarding HIV, TB and malaria." In addition the "Support of the Global Fund contributed to the drafting of the National Strategic Plan and the strengthening of civil society," says Castro. Read more 


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The Global Fund needs a strategy to address HIV and Hepatitis C among IDUs

Evgenia Maron
Currently, the Global Fund to fight AIDS, Tuberculosis and Malaria (The Global Fund) has strategies for supporting people of different sexual orientations and gender identities, and promoting gender equality. However, there is no such strategy for improving HIV and hepatitis C responses among injecting drug users (IDUs). According to Ivan Varentsov, coordinator of Civil Society Action Team (CSAT), Eurasian Harm Reduction Network (EHRN), "We know that in many regions, not only gender inequality fuels the HIV epidemic, but also injection drug use. IDUs face no less stigma and discrimination, [and] suffer because of lack of access to prevention and treatment services." Read more 


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The Global Fund should support operational research to reach the unreached

Bobby Ramakant - CNS
Since its inception in 2001, the Global Fund to fight AIDS, TB and Malaria (The Global Fund) has saved approximately 5.7 million lives. Each day an additional 4000 deaths are averted, but in order to continue its existing programmes and rapidly scale up towards achieving the Millennium Development Goals (MDGs) in 2015, The Global Fund needs to invest resources in operational or applied research to confirm where it gets most value for its dollar, measured in terms of protecting human rights, saving lives and preventing infections. For Dr Nevin Wilson, Director of the International Union Against Tuberculosis and Lung Disease (The Union) - South East Asia office, "After the directly observed treatment shortcourse (DOTS) model was developed by The Union what new evidence has really been researched and put into practice. How is the Global Fund grant helping in implementing Principal Recipient (PR) to carry out the necessary operational research during the lifetime of their grant to provide the evidence that the intervention they have carried out works? This is especially true when we work with the community." Read more 


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What should the Global Fund be doing more of?

Bharathi Ghanashyam
As a part of the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) consultation project, the Biennial Partnership Forum 2011, an inclusive online debate was initiated to find answers to some key questions. The answers are expected to contribute towards constructing a more robust roadmap for the future of the Global Fund. The responses have been wide-ranging – in both suggestions and observations. They reflect the voices, expectations and hopes of affected communities, programme administrators and other stakeholders. They also indicate that the Global Fund has become a symbol of hope – stakeholders would like to see its scope go beyond just funding country programmes. Regardless of whether or not this is feasible, or fits with the Fund’s scope, the exercise has succeeded in revealing some very real gaps that need to be addressed. Read more

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Walk the path of human rights

Shobha Shukla - CNS
A report from the UN Special Rapporteur calls upon nation states to decriminalise consensual same-sex conduct, repeal discriminatory laws relating to sexual orientation and gender identity, repeal laws criminalising sex work, and provide human rights education for health professionals. Criminalisation is not only a breach of a State's duty to prevent discrimination, it also creates an atmosphere where affected people are disempowered, unable to achieve full realisation of their human rights. According to a recent UNDP report, India has 30.5 million men who have sex with men (MSM), and over a million Hijra and transgender people. The national HIV prevalence in MSM is estimated at 7.41%, with 24% testing positive in the state of Goa and 18.8% in Mumbai. While MSM in India are at high risk of acquiring and transmitting HIV, only about 4% are able to access appropriate services. The situation is more serious for transgender populations. Here, HIV prevalence can be as high as 42% in Mumbai, and 49% in Delhi. This has been attributed to low levels of awareness, unsafe sexual practices, inadequate services and social marginalisation. Read more

Women and children: scaling up services for HIV, TB and malaria in India

Bharathi Ghanashyam
The theme of this article is based on the question, "Is the Global Fund adequately supporting services for women and children in your country?" Perhaps a more apposite query would be this: "Is your country doing enough to convince the Global Fund to adequately support services for women and children in your country?" Read more

Why is Government exasperated with campaign against corruption?

Manish Tiwari, Congress spokesperson, has said that democracy faces the greatest peril from the tyranny of unelected and unelectable. He said that the Centre was running out of patience with 'irrational expectations and attitudes.' Earlier Pranab Mukherjee had said that there is growing trend of undermining the democratic process and extra-constitutional authority might lead to complete collapse of democracy. Even though the government is jointly drafting the Lokpal bill with members of civil society yet it is clear that it is not very serious about it. Senior members of the ruling Congress Party are very bitter about the participation of the civil society in drafting the bill. What is the reason of their exasperation?

Human Rights: A La The European Union Style

In a significant development, the European Parliament (EP) has linked the Kashmir dispute with the signing of Free Trade Agreement (FTA) with India. According to a news (Source: The Nation, 14 June 2011), the para-33 of the resolution passed by the European Parliament on May 11, 2011, over the FTA between India and European Union, states that "Human rights, democracy and security are essential elements of the relationship between EU and India. Therefore we call on both the sides to ensure that dialogue on open issues is stepped up with particular reference to Kashmir".

Inflation, poverty and food security

[हिंदी] [Photo] The shock, condemnation and rejection of the Planning Commission's deeply flawed arguments and insistence on keeping a low poverty line, thereby excluding large sections of society, from even the present day minimalistic food entitlements provided by the Government, leave alone ensuring full food security to the people of the country, was evident at the day-long meeting organized by the Asha Parivar and National Alliance of People's Movements (NAPM) in Gandhi Bhawan, Lucknow. "We are deeply concerned at the recent recommendations of the Planning Commission which has decided to keep a very low poverty line (Fixing it at Rs. 20 per day expenditure for urban areas and Rs. 15 per day expenditure for rural areas for year 2005) which will exclude large populations from the getting the benefits of subsidized food. Can Montek Singh Ahluwalia, Vice Chairman of the Planning Commission, live on Rs 20 a day?" asked Dr Sandeep Pandey, Magsaysay Awardee (2002) and a noted social activist.

Impact of Free Trade Agreements on People Living With HIV

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the UN organized a High level Meeting on AIDS from 8–10 June 2011 in New York to review progress and set targets and commitments for the coming years on HIV prevention, treatment care and support. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response to “Zero New Infections – Zero Discrimination – Zero AIDS Related Deaths”.

Beware The Might Of The Tobacco Industry

As civil society, governments, and other stakeholders, all over the world, struggle to enact lifesaving measures of the World Health Organization’s Framework Convention on Tobacco Control (FCTC), tobacco companies aggressively fight its implementation, using a range of tactics to undermine advances being made by the aforesaid global tobacco treaty. Threats to health policy include aggressive lobbying, political intimidation and strategic charitable donations. The  recent report of Corporate Accountability International, ‘Philip Morris International Exposed, An Alternative Annual Report’, outlines many of the tactics from litigation to bullying that the industry uses to undermine public health.

Local realities in tuberculosis (TB) care and control

The Global Fund's 4th Partnership Forum will soon open in Sao Paolo, Brazil (28-30 June 2011). In the lead up to the Partnership Forum, the CNS Stop-TB Initiative is opening a time-limited online discussion (9-23 June 2011) to document voices from the frontlines on issues around TB care and control in local contexts. The guiding question is: what are the challenges and successes in TB care and control in your local setting? Please have your say.