März 2016 - Thema des Monats: MMS/aidsfocus.ch in the Swiss Delegation to the Global Fond Board
MMS/aidsfocus.ch - Since last year MMS/aidsfocus.ch is part of the Swiss Delegation to the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) Board. The Swiss are part of the Canadian and Australian Constituency. The three countries together have one voting seat and aim to contribute and influence the Global Fund policies and practices. MMS/aidsfocus.ch’s role is to represent the civil society perspective related to the work of the Global Fund within the Swiss Delegation.
The Global Fund to fight AIDS, Tuberculosis and Malaria founded in 2002 is perhaps the most important and innovative health initiative developed in the 21st century. The Global Fund was created to radically increase resources to fight these three diseases. As a partnership between governments, civil society, the private sector and affected communities, the Global Fund represents an innovative approach to international health financing. The Global Fund raises and invests nearly US$4 billion a year to support programs where the disease burdens are high.
The Board is the supreme governing body of The Global Fund. The Global Fund Board includes 20 voting members, with equal representation by implementers and donors. The developed country NGO Delegation and the developing country NGO Delegation are counted as the representatives of the non-governmental organisations. Communities Delegation comprises of delegation members who live with HIV and/or have or had TB and/or living in or working with communities affected by Malaria. Their ultimate goal is to influence the board decision towards increased access to quality prevention, treatment, care and support for communities living with and affected by the three diseases based on the principles of equity and human rights.
Being part of the delegation MMS/aidsfocus.ch has insights into the following thematic themes of the Global Fund:
- Strategy Development
- Governance Oversight
- Commitment of Financial Resources
- Assessment of Organizational Performance
- Risk Management
- Partnership Engagement, Resource Mobilization and Advocacy
The following chapters highlight the development of the new Global Fund strategy 2017 to 2022, the consultative processes which led to the framework and the preoccupation of the NGO Delegations.
Partnership Forums as an innovative approach to consultation
One of the overarching theme at the Global Fund in 2015 was the development of the new strategy 2017 to 2022. Many consultations, meetings and debates took place around the world to capture the different regional differences (s. graphic below). A highlight for us was the Buenos Aires Partnership Forum in September 2015. This partnership forum was the last of the three regional consultations organized by the Global Fund on the new strategy 2017-2020 and the main issues related to it. It was meant for Central & Southern America as well as Eastern Europe & Central Asia. Some one hundred participants took part, mainly from NGOs and Civil Society Organisations, with three Donors Representatives (USA, CH and Private Foundations), and a few Parliamentarians (EU, Canada, Barbados).
During this 3rd Partnership forum, as most countries in this region are transitioning out of Global Fund investments because of moving towards Middle Income Country (MIC) status based on the World Bank classification, the issue of sustainability of Global Fund supported activities was on top of the preoccupation. Most people living with HIV live in middle-income countries. The CSOs state that the Global Funds abrupt and unpredictable exit as an investor in those countries will only put at risk the achievements made in terms of better health systems, community systems, and progresses on epidemiological and health results. A consequence, which has already been observed in those countries, which have experienced a sudden stop of investments of Global fund due to the changes of their income status.
The Communities Representatives advocated for continuous engagement in Human Rights and a stronger consideration for the needs of “key populations” and the credo “leaving no one behind” ran through all of the discussions. There was also consensus that the strengthening of health systems and community systems play a key role in the fight against the three diseases.
The new Global Fund Strategy 2017 to 2022
This new Strategy is expected to be adopted by the Board of the Global Fund in spring 2016 in Abidjan, Ivory Coast. The consultative processes with various multilateral consultations, meetings, and dialogues and partnership forums have significantly contributed at the regional and national levels to the outcome of the strategic framework 2017 to 2022. It evolved greatly from the current framework and it is based on the challenges of a changing landscape. First and foremost the focus of the strategy is to align with the Sustainable Development Goals in order to end the three diseases by 2030 and the strategic objectives originate from this primary goal.
The strategic framework 2017 to 2022 was adopted at the last Board meeting in November 2015 in Geneva. Its aims are to “investing to end the three epidemics In we decided on the new” with four core areas: 1) to maximise impact against HIV, TB and malaria, 2) to build resilient and sustainable systems for health, 3) to promote and protect human rights and gender equality, and 4) to increase resource mobilization. (s. Figure xy)
Civil Society engagement during the development of the strategy
The Civil Society Organisations (CSO) strongly advocated for greater support for programmes that promote and advance human rights and gender equality in the new strategy. Gender-based discrimination and violence, punitive laws, and discriminatory practices against people living with and affected by the three diseases pose significant barriers to the availability, accessibility, acceptability and quality of medicines and services. At the national level as well as within the Global Fund Gender inequality (as a driver of the three diseases, and cause and consequence of violence) has not been consistently addressed which can be observed in weak national policy and programmes. Achieving gender equality requires political will and financial resources.
CSOs urge the Global Fund and partners on the Board, including donors and technical partners, to better support and engage in dialogues with governments to improve the legal and policy environments for key affected communities. They would like to see stronger commitments to encourage community-based responses, to build capacity and stronger support for the role of civil societies in advocacy, accountability and implementation.
Transitioning and Sustainability
One of the main issues which have been highlighted not only during the Partnership Forum in Buenos Aires is transitioning and sustainability of programs in countries which are no longer eligible for Global Fund investments due to their World Bank classification. In the next 15 years at least 24 countries will phase out of Global fund investments in at least one disease area (e.g. Thailand, Ethiopia, Kenya) and 15 countries have transitioned in the last 4 years (e.g. Argentina, Brazil, Croatia). .
The Civil Societies raise concerns again and again about those countries where the government will not continue to support HIV programs. The Civil Societies in particular criticise the Global Fund for not planning adequately and supporting those countries by giving clear guidance and technical support for the transition phase. The NGO Delegations have urged the Global Fund to develop an overarching sustainability and transitioning policy. They ask the Global Fund to assess a country’s readiness, willingness and ability to transition to lower levels of funding and to stay engaged with those programs until they can be sustained without Global Fund support. Planning how these programs can be sustained once the Global Fund withdraw from a country or is anticipated to withdraw must start early enough and is not a matter of money alone. Political will is needed to increase domestic resources.
Outlook
For MMS/aisfocus.ch it is a privilege to be part of the Swiss Delegation and to be close to the strong advocacy movement to the Global Fund. It opens eyes and doors to the civil society movements around the world.
There are many challenges ahead once the new strategy 2017 to 2022 is adopted. The Civil Societies and the communities affected by the three diseases will monitor closely the implementation of the new strategy and will raise their concerns if vulnerable groups and key populations are left behind. (Photo: Lilian Buser / AIDS2010)
References
Board Overview:
http://www.theglobalfund.org/en/board/
Board Decisions:
http://www.theglobalfund.org/en/board/decisions/
Constituencies:
http://www.theglobalfund.org/en/board/constituencies/
Partnership Forum 2015:
http://www.theglobalfund.org/en/partnershipforum/
The Global Fund. Key themes and positions on the Global Fund Strategy 2017–2021 as stated by civil society representatives from Eastern Europe and Central Asia. (2015):
Transition preparedness assessment framework tool developed:
http://www.aidspan.org/gfo_article/transition-preparedness-assessment-framework-tool-developed