Thanks to all people in the discussion on My GlobalFund. Happy to know the good news that global Fund welcomed Japan's announcement of donation of $560 million starting next year. GlobalFund have raise fund from fund partners, nation's contribution especially countries having good economic background. Budget to continue funding the existing health care, prevention centers, and open essential and specific projects for the NGOs worldwide, to initiate community leadership, especially from the youth generation to take action and leadership in creation of education, prevention, diagnosis, care and treatment programme. Encourage the new organizations [NGOs] to work forming small units for a large programme of action with a minimum expenditure to improve treatment access for more people having infected with HIV/AIDS, TB, and Malaria. GlobalFund is in a process of capacity building develop knowledge and relation with all global initiatives. The following subjects may be considered on the process: · To combat and challenges on prevention, treatment for the diseases and develop knowledge base tools of resources. The health practitioners, policymakers, lawyers, researchers, media and the community leaders to involve in good practices and continue process of training, membership, links, and involvement with GlobalFund. · There are incidences of violation of human rights and discrimination against women and marginalized groups. HIV/AIDS infections causing vulnerability and violation of human rights. The GlobalFund have to take initiative strengthening and reserve all human rights and promoting public health. · Specific Projects on HIV/AIDS: to reduce mother-to-child transmission, provide care, treatment, and support to the women living with HIV and their family. · Country wise assessment: Status of infections, economic-social-cultural background, institutional and governmental role on the programme, and determine the priority of programme and allotment of fund. · GlobalFund has been funding directly to the Governments, in such a way they can allot fund directly or by their own fund agents to the organizations [NGOs] engaged in works with HIV/AIDS, TB and Malaria. India has the great challenges with the virus transmitted from high-risk groups into the general population. It has a status among the highest number of persons living with HIV/AIDS, TB and Malaria. India has to strengthen capacity and decentralize the programme of action from states to the districts level. There are numerous NGOs working on HIV/AIDS, issues with the targeted intervention with high risk groups, treatment, education and awareness campaign with community development, children and orphans living with HIV/AIDS and other health care for vulnerable section of people. This is not enough and shall be continued on the issues. Thank you all. Asima Chakraborty General Secretary, The Organization for Peace Environment and Human Rights [TOPER],Kolkata, India

• The actors or sectors should not be conventional  it will be  good to collaborate with active  personalities or organizations, their qualities must be considerd improtant especially how bold and confident they are in their conventional societies.
  
• Focus must be the vulnerable population or traumtized people.
  
• GF must give priority to small and local NGOs which are specially working on mental health issues because this area is simply ignored.
  
• Funding should be for empowerment for capacity building so the beneficaries should become confident and independent.
  
• Donors have made the  process very complicated due to heavy documentation and complicated process, they must give the easy process of funding specially for the new NGOs.

The main stay of involvement is capacity building. integral to funding must be systems strengthening to ensure that the fund is sustainable. For CSO and PHA groups need to get training in leaderships and governance, advocacy for their rights and to update systems by employing people who are trained and professional by the requisite standards at the level of operation. The public actors also need to be trained on effective involvement of CSO for instance in Uganda One arm of the CCM the HPAC is only beginning to accept and engage the CSOs just as some CSO are beginning to accept the the involvement of government in their activities. partnerships must be strengthened to ensure joint ownership of planning, implementation and monitoring and evaluation. Trust and confidence between the public and civil society must be developed to ensure effective implementation of programmes and their sustainability. Public and Civil society depend on each other for service delivery there is no way out but to support and accept each other as equal partners and to complement each other and dill in the gaps of each others work

Effective involvement requires level ground. however the CSO are incapacitated and find it challenging to engage with government officers with the vast experience and sometimes the exposure they have. It must be noted that even on the CCMs, CSF committees and other HIV high level forums CSO continue to lag behind. due to in accessibility to information - in terms of cost involved in downloading printing and photocopying documents, that many are volunteers in addition to their routine employment they must spare time to do HIV and AIDS work that involves wide reading and consultations. limited funding to manage the activities that support the engagement - travel to different activities may not be facilitate d by their constituencies and they end up picking form their already deprived or strained pockets to attend the meetings. therefore there ought to be a deliberate affirmative action for GFATM to cater for strengthening the CSO and PHA organizations to manage effectively by providing additional support to transport, communication and secretarial requirements. These seem trivial but they are very very important for the CSO to get exposed. much of the already existing interventions do not ably address Sexual gender based violence. it should be noted that interventions that promote the rights of women and address specific vulnerabilities of women must be critical in reducing the HIV prevalence but unfortunately structures such as women and youth councils and their leadership often do not access funding. Programmes addressing the affirmative action for the marginalised must be given high priority to ensure ownership of the funds and effective implementation and M and E of local Projects. However the other deterrent is the bureaucratic nature of proposal development and competition. The most active and important community groups are unable to make proposals that meet the standard. However communities can vouch for the groups to be funded and this be a criteria for lower level governments to allow and give chance to small groups and associations to access funding and scale up their already nationally unrecognized but very strategic and crucial interventions.

Measures that could be taken to address some of these challenges include: - Provision of enabling environment that will allow program development to thrive in the country. -Availability of skilled Human resources:- capacity building- Training and retraining of manpower needed for program implementation. - Availability of material resources for program. - Adequate Funds. -Availability of information and communication to all stakeholders etc. - Repeated print and electronic media announcement on the proposed plan. - Organize one week National stakeholders workshop for sensitization and development of draft program (multisectoral). - Participants depart for consultations with the represented organizations and finetuning of the draft. - 2nd National meeting for final program development, review, publish and distribute the program which will include participation and access to funds for program.

It is my candit but humle oppinion that if recomendation given at the local and state government unit is being advanced to the National unit by getting the local fund agent to network. there will be impact on the whole sectment.

Firstly, relevant players/actors/sectors must be involved in any development of pragrammes that seek to introduce effective intervention strategies. The GF should be involved fully at country level so that the mechanistic controlling and dominating coordination at government level is greatly minimized. Government departments that are made key players especially the health wing, must be monitored and not given total power to run the show in the exclusion of other important segments within the country. The community, private sector and civil, must participate fully without reservations or fear of being bullied by the government wings at play. For meaningful and effectively developed proposals, a good representation of input is required to enable incorporation of burning issues from the front liners of all important angles within a country. The research and scientific fraternity, and the stakeholders, the community at large and professionals must form a basis of a well thought out developed programme that fits in all the necessary players. At government level, there must be steering committees conscientising all sectors to participate fully and transparently. Such a program would be razor sharp one, as it would become the best tool to operate on effectively during a good course of bringing down to a minimum the three important public health epidemics: HIV/AIDS, TB and Malaria in any country. I thank you all for participating in these very important topics that matter in many nations if not globally. f.s.todlana@rgu.ac.uk

There is need to address the challenges related to the effective involvement of all relevant actors/sectors in the development of programs at country level. The level of involvement of the global fund has been very limited especially at the country level. This is because the country coordinating mechanisms are always controlled by the country coordinating mechanisms which are dominated by the governments. The government especially the ministry of health should not left to control the exercise alone. Civil society and the private sector are not given the opportunity to give their input. In order to develop better proposals, they should have a proper representation on the CCM so that their issues are incorporated since they are mostly grass root oriented. The academic institutions should also be given the opportunity to do research on the current interventions so that they make recommendations. There is also need to build the capacities of the institutions involved so that they properly address the current problems using a holistic approach. These of discussions should be promoted at the country levels. The public should be given the opportunity to debate these kinds of issues so that the proposal makers get balanced views.

Measures to b taken for effective involvment of the relevant actors/sectors in development of a program is a vast topic but i will try to incite some pertinent ideas. Most projects/programs by pass the beneficiaries due to ill governance(governance driven by propoganda), ill awareness campaigns,will of the respective actors.Due to the above conditions we have to consider basic conditions in developing programs at a country level.The cornerstone has to be that there must be a democratically elected government which will represent the people unless and otherwise it is a futile excercise since it looses continuity and sustainabilty.Projects when designed need to asses the nedds of the people to serve but what always left behind is that the trust of the beneficiaries is crucial to put it together,so when the people live in fear of their admonistrators/governers one cannot expect a result even if the project is implemented to plan. Let i give some example from my experience,when i was working in Gambella regional state(Ethiopia) on the UNDP fifth country program focusing on Area based integrated program different projects were designed, out of them was a construction of toilets in Abobo area but after the contract was awrded and builtt a team were in the place to make other assesments with respect to health needs and during discussion an eldery asked the team "are you still to throw money while no one had used what you constructed ealier?". What one can see from the above is that since the people are not well consulted during the perliminary phase and also could not refute what their strong armed government brought to them,they see and produce not their voice to refute what is happening because if they do they know what will come i.e to fear imposed by their own governers. It is inevitable to study the nature of countries/policies of countries before commitment.

My view, that of a social purpose business comes from our private research in Ukraine. Not into HIV prevention specifically, but of an organisation setting out to tackle poverty and realising this as one of the consequences increasing in severity during our 4 year presence.

From the research paper, I draw one key paragraph:

"We see a staggering array of social problems arising directly from poverty, including but not limited to tens of thousands of children in orphanages or other state care; crime; disrespect for civil government because government cannot be felt or seen as civil for anyone left to suffer in poverty; young people prostituting themselves on the street; drug abuse to alleviate the aches and pains of the suffering that arises from poverty and misery; HIV/AIDS spreading like a plague amidst prostitution, unprotected sex, and drug abuse; more children being born into this mix and ending up in state care at further cost to the state; criminals coming from poverty backgrounds, ending up as bandits, returning to communities after prison, with few options except further criminal activity. These are all part and parcel of the vicious negative cycle of poverty, and this threatens to destroy Ukraine, if Ukraine is defined in terms of people rather than mere geographic boundaries. Overall, population is steadily declining; families have not sufficient confidence in tomorrow to reproduce more than 1.2 children on average per couple."

It was only last month, when the UN revealed that the draft national program was at risk, and the Kyiv Post acknowledged that the epidemic now threatened all Europe.

These figures, are of course low in comparison with African countries, but the rate of growth in a developed country is the most alarming and with great stigma existing in the treatment of HIV positive patients, it is very likely to be a conservative figure.

A search of Hansard, the record of parliament in the United Kingdom reveals that this matter has yet to register among political thinkers, neither has our European Parliament much to say. In these last 4 years, around $250 million has been allocated to tackle aids. World back funds have been allocated and then suspended due to lack of disbursement and the rate of infection still increases. Our research, as I say is about poverty and its consequences, particularly on children. not HIV per se. What we find are vast numbers economically orphaned and disposed of to an institutional system which is stripped of resources and exploited by predators. In the untouchable domain of Ukraine's Rada, a politician recently justified his criminal immunity by making the point that in investigating a local orphanage where young children were being prostituted, he needed this protection from the local law enforcement involved in the pimping.

ZIK news

We put forward a microeconomic strategy paper in October 2006, describing a national scale community investment program, developing business through microcredit, funding creation of group care homes and in-country adoption. In addition a request for urgent attention to the plight of disabled children in the provision of rehabilitation. The paper made a case for using profit from investment in technology to offset the cost and yeild a nil overall cost strategy.

So far in the intervening period, the US has responded in the creation of the East Europe Foundation at Davos this year. They are now dealing with a backlog of requests for sustainable community investment grants. The rehab centres were announced about a year ago, and about a month ago, came the announcement of the doubling of adoption allowances.

Clearly this does not address the need for urgent attention to dealing with those currently infected, for which I see there are calls for government intervention right now. Ukraine's Prime Minister has just announced that a plan will be ready in 3 weeks.

What we planned to achieved was to leverage action to tackle prevailing microeconomic conditions in Ukraine and to remove children in particular from sources of risk.HIV infection being just one of them. It will take time to observe the results.

 

Most mechanism developed by NGO's, government; public and private sector are innovative and relevant in the development of program at country level.

Many times funds disbursed are judiciously utilized. The basic lag and challenge lies in what sums up as “the burden”.

The absence of a burden for actors/sectors in the development of program at country level.

It is one part to innovatively design program for implementation within country, it is another to be, within heart, be passionately desirous to eliminate the diseases plaguing countries.

In Africa particularly, a vast number of actors in the health service, work for the remuneration and benefits attached than for the desire of eradicating or minimizing paramount health issues.  

In rare cases do we see health service providers who work because a burden is built in within to bring to a halt known health plague.

This absent inner drive has been substantially a major challenge for actors/sectors in the development of program at country level.

There is no much that can be said that does not take its root from failed burden within actors in the development of programs at country level.

Mismanagement of funds, sometimes poor initiatives, poor implementation strategy take roots from "the absent burden in actors/sectors.

Remedy may include, the development and culturing of the burden foremost within health service providers/actors and sectors through strategic capacity development that emphasizes burden.

Whenever we talk about demands, it indicates unmet needs of the particular society.