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Africa: Keeping Health Commitments
Apr 28, 2006 (060428)
(Reposted from sources cited below)
The Global Fund to Fight AIDS, Tuberculosis and Malaria has
announced a sixth round of grant proposals for this year, despite
fears that the global effort could falter for lack of sufficient
funds. But the momentum of global health efforts is still in doubt,
with crucial evaluation meetings coming up in Abuja, Nigeria and in
New York this month.
In late March the World Health Organization released its report on
its campaign to provide 3 million people with access to HIV/AIDS
treatment by the end of 2005, citing a total of 1.3 million (up
from 400,000 in December 2003).See
http://www.who.int/hiv/pub/progressreports/en. Health activists say
it is critical to set specific goals for the coming years and to
hold both the international community and African countries to
This AfricaFocus Bulletin includes today's press release from the
Global Fund to Fight AIDS, Tuberculosis and Malaria announcing
its sixth round for considering grant proposals, a background
note from the African Civil Society Coalition on HIV and AIDS on
the coming African and world summits to evaluate progress on their
commitments on HIV/AIDS made 5 years ago, and a report from the
UN's Integrated Regional Information Networks (IRIN) on the
forthcoming UN General Assembly Special Session on HIV/AIDS
For previous AfricaFocus Bulletins on health issues, visit
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Global Fund Board Launches Sixth Grant Round
28 April 2006
Global Fund to Fight AIDS, Tuberculosis and Malaria
Geneva, Switzerland - The Board of The Global Fund to Fight AIDS,
Tuberculosis and Malaria decided today to call for a new round of
grant proposals from countries striving to combat AIDS, TB and
Malaria. The call for a new round of proposals at this time - the
sixth in the history of the Global Fund - puts the Board on track
to approve a new round of Global Fund grants at its second
meeting in November 2006, following the period needed for the
submission and evaluation process.
Founded four years ago with the aim of drastically scaling up the
resources available to fight the three diseases, the Global Fund
currently mobilizes 20 percent of international financing to
combat HIV/ AIDS, and 65 percent of all international funds
invested in combating malaria and tuberculosis.
"Already, millions of people have benefited from the programs the
Global Fund is financing around the world and hundreds of
thousands of people are alive today who otherwise might not have
been," said Richard Feachem, the Executive Director of the Global
Fund. "The launch of Round Six today allows us to maintain this
vital momentum to win the battle against these three pandemics."
The launch of Round Six enables countries to seek funding for
achieving global targets such as universal access to AIDS
treatment and prevention by 2010, and to cut the number of deaths
from tuberculosis and malaria by half by 2015. In addition, the
launch of the sixth round is especially significant for a number
of countries whose current grants will reach the end of their
five-year lifespan over the coming years. Where countries have
shown effective use of donor resources, Round 6 presents the
opportunity to build on programs which are having an impact in
fighting and preventing the three diseases, and to ensure
continuity for those already on treatment.
"The progress made by programs supported by the Global Fund must
be rapidly accelerated," said Dr. Carol Jacobs, chair of the
Global Fund Board. "We know that countries and vulnerable
populations are depending on it and we must not fail them. With
the vote taken today to launch the Global Fund's sixth round, the
Board is proud to reinforce its commitment to this purpose."
Following the launch of a new round, grant proposals are
submitted by countries to the Global Fund, and evaluated by an
independent Technical Review Panel. Proposals of high quality are
recommended to the Board of the Global Fund for approval. The
Board approves programs for two years, with an option to renew
funding for a second three-year phase if the programs achieve
targeted results. Since it was created in January 2002, the
Global Fund has approved US$ 5.1 billion to 385 grants,
supporting programs implemented in 130 countries.
The deadline for submission of grant proposals will be August 3
and the grants recommended for approval will be presented to the
Board it its meeting, on 1-3 November 2006.
Simultaneous with the vote to launch the Global Fund's sixth
round of grants, the Board called for a concerted effort by
current and potential donors to pledge the additional resources
needed for full funding of Round 6 by the time the new grants are
ready for approval in November. Global Fund policy requires that
funds needed to finance the first phase of grants are deposited
with the Global Fund by the time of grant signing.
The Global Fund is a unique global public-private partnership
dedicated to attracting and disbursing additional resources to
prevent and treat HIV/AIDS, tuberculosis and malaria. This
partnership between governments, civil society, the private
sector and affected communities represents a new approach to
international health financing. The Fund works in close
collaboration with other bilateral and multilateral organizations
to supplement existing efforts dealing with the three diseases.
Apart from a high standard of technical quality, the Global Fund
attaches no conditions to any of its grants. It is not an
implementing agency, instead relying on local ownership and
planning to ensure that new resources are directed to programs on
the frontline of this global effort to reach those most in need.
Its performance-based approach to grant-making is designed to
ensure that funds are used efficiently and create real change for
people and communities. All programs are monitored by independent
organizations contracted by the Global Fund to ensure that its
funding has an impact in the fight against these three pandemics.
Around half of the Global Fund's financing is being spent on
medicines, mosquito nets to prevent malaria and other products,
while the other half is for strengthening health services. As of
end December 2005, 384,000 people have begun Antiretroviral (ARV)
treatment through Global Fund supported programs, and nearly
triple the number of ARV recipients funded by Global Fund
resources by the end of 2004. Taken together, Global Fund
supported programs to combat malaria expanded distribution of
insecticide treated bed nets to 7.7 million. In addition,
tuberculosis programs have detected and treated more than one
million TB cases through DOTS (Directly Observed Short Course
For further information
Rosie Vanek The Global Fund (Geneva, Switzerland)
Phone: + 41 22 791 5951 Mobile: + 41 79 445 14 85
Jon Lidén The Global Fund (Geneva, Switzerland)
Phone: + 41 22 791 1723 Mobile: + 41 79 244 6006
Abuja+ 5, UNGASS +5 and Universal Access: What every African
AIDS activist should know
Prepared by the African Civil Society Coalition on HIV and AIDS
Sisonke Msimang - Programme Manager Open Society Initiative for
Southern Africa (OSISA) Tel. +27-11-404-3414/ +27 83-450-7382
Omololu Falobi Executive Director Journalists Against AIDS -
Nigeria (JAAIDS) Tel. +234-1-773-1457/ +234-9-672-1744 Email:
Question 1: What is 'Universal Access'?
Answer: Universal Access is the idea that everyone has a right to
the prevention, care, support and treatment related to HIV and
AIDS. The term was coined at the G8 Summit at Gleneagles in 2005
when the G8 leaders pledged $50 billion towards AIDS and agreed
that "[we will work to] significantly reduce HIV infections and,
working with WHO, UNAIDS and other international bodies to
develop and implement a package for HIV prevention, treatment and
care, with the aim of as close as possible to universal access
to treatment for all those who need it by 2010." $25 billion of
this money was pledged to Africa.
Since the G8 met, many people have been talking about the next
phase of AIDS activism. There is consensus that the world must
now focus on scaling up towards Universal Access. African civil
society organisations agree with the broad principle of
Universal Access - that all people in the world must have access
to health, education, clean water, shelter and a range of other
services. However, it is also clear that Universal Access will
only be achieved if leaders agree on specific targets to measure
progress towards universal access. It has been suggested that
targets should be developed at a national level. However, many
African civil society groups do not want governments to set
targets a) without their involvement and; b) without a broad
global goal to guide them. Therefore African civil society groups
want 7 million Africans to be on treatment by 2010. These groups
also want to ensure access to Prevention of Mother to Child
Transmission (PMTCT) programmes for all pregnant women living
with AIDS in Africa by 2010.
Question 2: What is the Abuja Heads of States Summit about?
Answer: On May 2-4, 2006 African leaders will meet in Abuja, at a
Heads of States Summit. The meeting will focus on whether leaders
have kept the promises they made on behalf of their governments
five years ago in the Abuja Declaration and Plan of Action on
HIV/AIDS, Tuberculosis and Other Related Infectious Diseases
(ORID). In the Declaration, African Heads of States made a number
of commitments including that they would spend at least 15% of
their national budgets on health by 2006.
Question 3: Why is the Abuja Declaration important?
Answer: The Declaration is very important because it is an
African document, which means that the African Union takes the
Declaration very seriously and has an obligation to report on
progress towards its implementation.
Question 4: Has there been any progress on the progress made in
the Abuja Declaration?
Answer: According to the African Union only two African countries
- Botswana and the Gambia - reached the target of 15% of health
spending within their national budgets by 2004. However, a Shadow
Report produced by ActionAid demonstrates that when debt
repayments are factored in, not a single African country would
have reached the target set in 2001.
Question 5: What is the link between Universal Access, the Abuja
Summit and the UNGASS Review meeting?
Answer: The Abuja Summit will be an important space for deciding
on Africa's position on Universal Access. The discussions at the
Summit will be critical in shaping the positions of African
countries as they prepare to go to New York to participate in the
review of the Declaration of Commitment. This is why the language
suggested in the answer to Question 6 below is very important.
The Abuja Summit and the UNGASS Review will not come up with any
new Declarations. Government and civil society leaders agree on
this. However, both meetings will come up with short Outcome
Documents that will make important statements about how the fight
against AIDS will be conducted over the next five years. These
documents are likely to mention Universal Access. Civil society
groups want to make sure that Universal Access discussions do
not remain vague and devoid of targets. Without global and
national targets there will be no progress towards reaching all
those who need prevention, care and support and treatment.
Question 6: What do African Civil Society Organisations want from
Heads of State at Abuja and UNGASS?
Answer: There is a concrete list of civil society demands
contained in the African Civil Society Statement issued on April
14, 2006. The key demands for those seeking to influence their
countries or talking to the media about these issues are:
- Include within the 15% health spending target, a specific set
of separate targets for each of the three diseases: AIDS,
Tuberculosis and Malaria;
- In partnership with civil society, establish national
mechanisms to monitor the Abuja Declaration;
- Put in place clear targets for achieving universal access by
Outcome statements from the Abuja Summit and the UNGASS Review
are requested to adopt the following recommendation:
"By 2010, ensure that at least 10 million people have access to
HIV treatment - including 7 million Africans - through an
acceleration of HIV treatment scale-up efforts by all
stakeholders, including civil society, people living with HIV,
member-states, donor countries and multilateral institutions. In
order to ensure that this target is reached equitably, Member
States should develop, in an inclusive manner, specific targets
for the inclusion of vulnerable populations in national
treatment plans, including, for example, children, women, people
displaced by conflict, migrant populations, men who have sex
with men and injecting drug users."
"By 2010, ensure that all pregnant women living with HIV have
access to information and ARV therapy to prevent mother to child
"By 2010, ensure that the information and means to avoid HIV
infection is available to all citizens through an accelerated
effort by civil society, people living with HIV/AIDS, member
states, donor countries and multilateral institutions."
4. Track progress towards Universal Access in partnership with
The Abuja Summit is requested to adopt the following
"By June 2008, ensure that the African Union Commission, in close
collaboration with civil society organisations and other key
stakeholders, produces a High-level Review of Progress towards
the goals of ensuring that a minimum of 7 million Africans have
access to treatment services related to HIV and AIDS; ensuring
that all pregnant women living with HIV have access to
information and ARV therapy; and ensuring that all Africans have
access to the information and means to avoid HIV infection."
Question 7: What can I do to make a difference?
By April 27, write to your Health Minister and Head of State requesting
that he or she insist that at Abuja and UNGASS, the key
issues outlined above are addressed in the outcome documents. A
sample letter is available to help you to do this.
Fudging the UNGASS Report Card
April 20, 2006
UN Integrated Regional Information Networks
[This report does not necessarily reflect the views of the United
As high-level negotiations get underway in preparation for the
UN General Assembly's Special Session on HIV/AIDS (UNGASS), civil
society organisations in Southern Africa are struggling to make
their voices heard.
The goal of the meeting in New York from 31 May to 2 June is to
review progress in implementing the Declaration of Commitment on
HIV/AIDS, adopted by the General Assembly in 2001.
Part of that commitment included working towards greater
collaboration between the public and private sectors, yet civil
society organisations in the region complain that in the runup to
the meeting there has been little consultation with national
governments or internationally.
According to Sisonke Msimang of the Open Society Initiative for
Southern Africa (OSISA), which is involved in an international
effort to enable delegates to go to New York, about 300 African
civil society organisations have successfully applied to attend
the UNGASS meeting, but lack of funding will likely mean that
fewer than 100 will actually go.
In South Africa, media coverage has been dominated by whether the
government would retreat from blocking UNGASS accreditation for
the Treatment Action Campaign (TAC) and its affiliate, the AIDS
Law Project (ALP), over concerns that they would use UNGASS as a
platform to criticise the allegedly tardy official response to
the HIV/AIDS epidemic.
The government of Namibia has blocked accreditation of two local
NGOs: the AIDS and Rights Alliance for Southern Africa and the
AIDS Law Unit of the Legal Assistance Centre.
But beyond the issue of which civil society organisations would
go to New York, the bigger question of what they would do there
has received little attention.
Paul Roux of the Kidzpositive Family Fund, a Cape Town-based NGO,
expressed doubts about the value of attending when the agenda
appeared to offer few opportunities for civil society
"I think they're inviting us to pay lip service to the idea that
they're consulting with civil society," he said. "But it sounds
like the vast majority of us will be sitting up in a gallery
somewhere, watching other people talk."
Mary Ann Torres of the International Council of AIDS Service
Organisations (ICASO), part of an international civil society
coalition aimed at influencing the UNGASS proceedings, noted that
civil society involvement in preparations for the summit was
often more important than being present at the meeting.
Msimang agreed: "Essentially, the negotiations about what's going
to happen at UNGASS are happening now and African organisations
are not in a position to fly to New York now, so by the time they
arrive, other than the importance of being on the scene to garner
media attention, they're not going to make a difference, other
than on a symbolic level."
Only a handful of the South African organisations invited to
attend have been involved in pre-meeting preparations. Dawn
Cavanagh of the Gender AIDS Forum observed that campaigns run by
her organisation have focused on sections of the UNGASS
declaration concerning the vulnerability of women and girls to
"We've done quite a bit of work on UNGASS because we recognised
it as a key political space for us to advance our agenda,"
Cavanagh noted. "We have managed to inform a core group of
organisations about the UNGASS process, but the truth is that
most organisations have not really engaged with the process."
According to the UNGASS guidelines, one of the key opportunities
for civil society engagement is in compiling the report on each
country's progress. But several prominent South African NGOs have
complained that they did not have the opportunity to comment on
their government's progress report before it was submitted, and
the TAC has described it as "an inaccurate, rosy view of South
Africa's response to the HIV epidemic."
A civil society forum monitoring South Africa's official response
to HIV/AIDS wrote to UN Secretary-General Kofi Annan last week
rejecting the progress report on the grounds that it excluded
important data on HIV mortality rates, prevalence and incidence;
that budget figures were inaccurate; and alleged that "it does
not truthfully reflect the current views of all major
stakeholders in South Africa".
Local NGOs in several countries, including South Africa, have
submitted 'shadow' country reports, sponsored by ICASO, aimed at
giving what they regard as a more balanced view of national
progress on the UNGASS commitments. The South African report
identifies a number of limitations only mentioned in passing or
not at all in the official one, such as the lack of a plan to
address the shortage of healthcare workers; weak prevention
programmes; an inadequate nutritional assistance programme; and
an unrepresentative and allegedly ineffective National AIDS
As part of a regional effort by African NGOs to pressure
governments to scale up implementation of the UNGASS Declaration,
as well as the Abuja Declaration on HIV/AIDS adopted by African
leaders in 2001, over 80 representatives from African civil
society met last week in Abuja, the Nigerian capital.
In a statement issued at the end of the meeting, participants
noted their disappointment at the lack of a sustained effort to
meaningfully involve civil society, and drew attention to a
number of key targets in the two declarations that African
governments have failed to meet.
The biggest failings have been in the area of prevention: no
African country has met the UNGASS goals of reducing HIV
prevalence among young people by 25 percent; ensured 90 percent
access to HIV/AIDS information and education; or reduced
mother-to-child HIV transmission by 20 percent.
"Our targets were very low for UNGASS," said Msimang. "For
example, we know how to reduce mother-to-child transmission but
we're not even committing to that. I wish civil society had been
allowed into the space to say that treatment, care and support,
and prevention are equally important."
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