06-27-2008 3:07 PM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
Ashish,
Respectfullly, thank you for your well thought off contributions. You describe the ideal and make sound recommendations, but I feel no human finishing touch to it. I would like to add that when we write we must link to the worldview of the e-forum members and their educational levels. I know what I am talking about and can assess someone's understanding of me by the way they respond in subsequent correspondence.
By the way, as the global expert in my field and a visiting scholar I teach professors and anyone in that spectrum. On this forum I want to reach the members and encourage all of them to speak out. However, when I read your submissions truthfully, you don't fly over my head, but over the head of many others because it sounds so mechanical without a human face. Many public and personal letters come into my box because I address the e-forum not just according to my level of intellectuality/education, but I must put a human face to all I write and not use the policy/procedure face. If I use the later I will definately alienate the spectrum of e-forum members who may not be on my level resulting in me missing out on very interesting human responses of the picture on the ground. That is what we all are interested in to make the process work from the CCM to the endusers on the ground. My assessment based on observations on the ground in some countries is one of dismal failure.
Language barrier, being within the marginals of lack of functional literacy skills and competencies, computer illiteracy and lack of understanding of the entire GF process and not having access to complain, many not even having access to a cellphone to voice their their problems, has effectively marginalized them from the entire process. This is exactly what my disagreement is with the facilitators of this e-forum and I am not afraid to tell you that my assessment of the problem is not erroneous and not personally directed to you. I hope you understand that you are part of a body of people and are the one writing...but those you serve on all the other levels are no where represented on the e-forum.
Sofar, the picture you present versus the realities on the ground spanning from many African countries to India and Indoniesia is vastly incongruent. You are dealing with real people on this forum with real problems and you seem to be so separated from it all. I'm afraid I have read every members response and they are severe complaints against CCMs and others around the world. No one spoke in favor of CCM's performance and program relations and handling. Our perception of CCM's isn't encouraging at this point. They see things through the eyes of the CCM and not what happens from that point all the way to the end user. That is what this e-forum is genuineley interested in. If CCMs paint a rosy picture they fail to see that there is so much hell with the endusers that complain about being disenfranchized and marginalized in the entire process. How many CCM's are on the e-forum? And if there are a few, they attempt to converse on the level where all partipants feel comfortable relating. How many members of the India e-forum have been publicly conversing with you on this e-forum? Please see this as a constructive observation and not one to make you feel that you are not valued. I can see from your eyes as a CEO and President but on this forum I am just a person that works with those on the ground where you don't seem to operate. India hasn't spoken favorable on CCMs.
There is no way on earth with the current going's on in the GF structure that MDG# 6 will be achieved by 2015. They are so far and remote from the halfway mark. You are a CCM in leadership in India. Explain to this e-forum how have you linked your country priorities to MDG # 6's and how do you intend to achieve the half way mark of MDG # 6 this year 2008?
MDG # 6. combating HIV/AIDS, malaria and other diseases
• Halt and begin to reverse the incidence of malaria and other major diseases
• Halt and begin to reverse the spread of HIV/AIDS
• Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
The African worldview versus the Indian Worldview are vastly different. Doing business in Africa takes on a whole new dimension just ask Mr Dieter Mieppel who is a foreigner as myself that has worked in all of these jurisdictions...the differences are as much as night and day.
All your discussions submitted sound good in theory, but excuse my ignorance ....I have not seen anywhere that you have linked them to the realities on the ground. It appears that you are separated from those voices we need to hear on the e-forum. Why is India so under represented as a country? Where are all your grassroot CBOs/NGO's and why are all of them so silent?
FENNA E. BACCHUS
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06-27-2008 2:52 PM
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Alastair Green

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Switzerland
Global Fund Secretariat
- Posts 108
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Re: Week 2: Program oversight and coordination
Fenna E. Bacchus:Mr. Clear Conscience, The handwriting was on the wall for weeks and weeks. For using the "C" word I received a severe reprimand that my free spirited writing may have offended the members and facilitators of the e-forum. I want to publicly apologize for this. I sounded alarm based on facts, but was told that I must follow the formal complaint processes. For the sake of yourself and others on this e-forum I don't want you to face the embarresments I faced. Please, I beg you to follow the rules even though your worldview dictates you to do different by expressing your anger publicly on this e-forum. Publicly expressing your pain with a system or process is not criminal, but its therapeutic. We all emphatize with you. I'm not the only one that supports your struggle for justice and you will see it by the responses. But I urge you to follow the rules. You need to channel your anger in the right direction and remain productive and move forward. The people we serve are most important and let us give them the dignity they deserve. "C" is rampant and rife in Africa and likely other places. Rest assured you and the disenfranchized marginalized people will see justice because we all read your submission and we want the findings to be made public on the e-forum. I know the GF is listening and let us not get e-facilitators upset. Fenna
Dear forum members,
The "C" word Fenna is referring to is "corruption". Whereas the word “corruption” per se can be mentioned, there can not be any specific allegations to persons or organizations.
When any member signs up to MyGlobalFund.org they agree to our Membership Agreement, which states that members are not permitted to “(…) make statements regarding corruption, mismanagement, malfeasance or any other activity that would fall within the scope of oversight of the Global Fund Inspector General.” This is so that members can feel that they can participate in a respectful environment, expressing themselves freely, as many have been doing. MyGlobalFund.org is a tool for exchange of experiences and best practices, and we encourage lively debate on the challenges you experience in your country and any proposed solutions you may have. If you have any questions regarding this, please contact us.
Discussions in the e-Forum 2008 are gaining momentum and this week’s question on coordination and oversight of programs have crossed the language barrier as you may have seen. We encourage you to continue providing your recommendations so that you can impact on the policies the Global Fund is developing.
Best regards,
Alastair
e-Forum Facilitator
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06-27-2008 9:28 AM
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ASHISH SRIVASTAVA

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India
Not currently affiliated with the Global Fund
- Posts 85
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Re: Week 2: Program oversight and coordination
To,
e-Forum 2008
Received your observation of GF supported program co-ordination &
oversight problems.
Regarding strategy,structure & performance
of GF supported program for achieving MDG goal.
GlobalFund should understand sociopolitical & economical environment
of African & Asian countries for longer term planning.
In GF supported program, consultancies, local fund agent, industrial
social audit, industrialsocial responsibility, governance, social
obligation could play an important role in mitigation of oversight
problems & identification of oversight improvement (process evaluation).
Validity of GF social audit should be based on procedure& factors.
- GF social audit should consist of countries social expectations
& GF supported program response by social,economical,political,
structure environment of countries.
- GF supported program should attach GF social objectives & associated
priorities.
- Description & details of GF objective in each program with
activity.
- Detailed information of available resources & capacity building
for achieving objectives.
I do hope above description will help in African countries for
promotion & awareness of GF supported programs.
Thank you,
ASHISH SRIVASTAVA
EX-International Marketing
CCM (SEAR-INDIA) 81237
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06-27-2008 9:19 AM
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obert.chinhamo

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Namibia
Not currently affiliated with the Global Fund
- Posts 3
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Re: Week 2: Program oversight and coordination
Clearconscience has precisely captured my point. All that glitters is not gold. Some institutions are good at project drafting and report formulation, which is the right thing to do, yet, there is no proper implementation on the ground. There is need to match excellence in project drafting and report formulation with project implementation. We are saying this so that the Global Fund can be on the look out. Monitoring should be done at all levels to deter would-be corrupt individuals and institutions. I still believe that the world today could have been much better and moving towards achieving MDGs, if we had removed corruption from our midst.
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06-27-2008 1:10 AM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
I wish my sister someone can interpret for us. We want to include you and hear what you are saying.
Fenna
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06-27-2008 1:09 AM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
Dieter,
Please accept my support for the situation you are in. This is so pathetic ...what else can I say. The way things are going...the handwriting is on the wall and the GF may not achieve MDG #6.
Are you a Pharmaceutical Entity?
Fenna
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06-27-2008 1:02 AM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
Mr. Clear Conscience,
The handwriting was on the wall for weeks and weeks. For using the "C" word I received a severe reprimand that my free spirited writing may have offended the members and facilitators of the e-forum. I want to publicly apologize for this.
I sounded alarm based on facts, but was told that I must follow the formal complaint processes. For the sake of yourself and others on this e-forum I don't want you to face the embarresments I faced. Please, I beg you to follow the rules even though your worldview dictates you to do different by expressing your anger publicly on this e-forum. Publicly expressing your pain with a system or process is not criminal, but its therapeutic.
We all emphatize with you. I'm not the only one that supports your struggle for justice and you will see it by the responses. But I urge you to follow the rules. You need to channel your anger in the right direction and remain productive and move forward. The people we serve are most important and let us give them the dignity they deserve.
"C" is rampant and rife in Africa and likely other places. Rest assured you and the disenfranchized marginalized people will see justice because we all read your submission and we want the findings to be made public on the e-forum.
I know the GF is listening and let us not get e-facilitators upset.
Fenna
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06-27-2008 12:18 AM
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clearconscience

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Cameroon
Not currently affiliated with the Global Fund
- Posts 23
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Re: Week 2: Program oversight and coordination
Dear mma Fenna,t
he problem is not only in cameroon but in all African countries.The CCM and the principal recipients of the global fund grants are not working according to the terms of contract with the global fund.That is all the more reasons the rural communities in Africa could not benefit from the global funds grants for TB, MALARIA TB,HIV/AIDS; whereas in their paper works the two co- workers: CCM and the principal receipients puts well in papers reports that they have served the minority groups. The funds disboursed by the global fund is enough to creat impact in the rural communities.The rural communities has no access to medications-because of their long distances to clinics, hospitals and health facilities.Childrens and adults are dying daily because of malaria TB and hiv/aids.
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06-26-2008 11:39 PM
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clearconscience

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Cameroon
Not currently affiliated with the Global Fund
- Posts 23
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Re: Week 2: Program oversight and coordination
I have read your posting and got interested.Mr Chinhamo. These group so called principal receipient of the global funds grants are expert in project drafting and report formulation. When they present their projects it looks 100% very nice and attractive. On the other hand, when it comes to the implementation of the projects they CARRY OUT A DIFFERENT ACTION.
If the global fund does not put a STOP to the principal fund receipient scenario any effort they shall put in place to redress the present situation will RELAPSE. These so called principal receipient of the global funds grants are organisations who spent more than 50% of the grants on luxirous administrative expenditures. In fact, I am not afraid to say there is a lot of fraud in the country level. CCM and the principal receipients are in the best position to tell us the truth.
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06-26-2008 4:23 PM
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d.meppiel

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Switzerland
Not currently affiliated with the Global Fund
- Posts 4
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Re: Week 2: Program oversight and coordination
Dear Fenna,
thanks for your valuable comments. As you can imagine, it's quite difficult to openly talk about "C" and who is involved. Generally, as you correctly stated, this can be seen more or less everywhere. With redtapism it is the same: Starting from local authorities with regard to registration of a product up to important institutions like e.g. WHO, where redtapism is slowing down pre-qualification process of new products and make a successful application nearly impossible for smaller pharmaceutical companies.
Just to give you one example: We were asked to provide a bioequivalence study for our new ACT for small children. But as this is not a generic product, we don't have this. Further, the special galenical formulation (pellets to be applied directly into the mouth of a small child) can't be compared to any other antimalarial because such a form with the same composition doesn't exist. So, it's a back and forth with no result. Clinical studies and practical experience in several African countries have shown a very good efficacy and safety, but still, there is resistance (because another very important Swiss company so far has more or less a monopoly situation ?). Profit is surely not a big issue, at least with malaria drugs for treatment. And even more important is the support on all levels for those who are still willing (and able) to invest into R&D for drugs for neglegted diseases.
With the Millenium Goals in mind, only an active cooperation with all parties involved can make a difference! And the role of the Global Fund and other institutions: Why not implementing the principle of subsidizing ACT's in general ? This would make it more possible to also reach the private market players (drug shops etc.) where most people in rural areas get their drugs.
Best regards,
Dieter
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06-26-2008 3:54 PM
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Mirta Villanueva Dominguez

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Cuba
Country Coordinating Mechanism (CCM)
- Posts 14
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Re: Week 2: Program oversight and coordination
Dr Mohammad Fareed:
I second the idea of Mr. clearconscience. It is a proven fact that the quality is guarantteed only in case of perfect market and fair competition. Suppose this or that country failed to receive fund for a program in the last round. The reason could be incompetency of the Applicant or PR. Then nobody knows how many of competent organizations are there in that country who are able to have great achievements, how many of competent enough organization were selected as SR and impatiently waited to receive the fund and serve the communities.
I recommend:
1. As Mr. Cleaconscience recommended, a wide range of organizations should have access to the fund on individual basis.
2. Global Fund should budget enough time and professional staff to monitor the CCMs and the projects in the field. Although the number of recipients and project are too much, but considering the importance of the health problem and huge amounts of donations pledged, it will be wise if significant resources (money and experts) be in disposal of monitoring and supportive supervision. Stop in-hurry visits!
3. As the aim is fighting against the disease; strong technical support system should be established to help the countries/organization that do not have satisfactory achievements. If we just withdraw the funding form the failed ones, then the disease and suffering of the people will be still there and deteriorate the health situation further. The technical support must identiry the challenges in time and recommend proper solutions based on experience in the successfull contexts.
4. Develop a mechanism of Responsibility/Accountability between CCM and Global Fund!
Discupen el comentario en español, pero mi inglés no es bueno y tengo poco tiempo para revisarlos, incluso pido disculpas por los errores de escritura en mis mensajes anteriories, pero tengo el tiempo es oro y estamos en ciere de trimestre, he sido poco cuidadosa en esto pero espero haya llegado a uds. mis consideraciones en forma clara.
Tengo un punto de vista diferente al colega. Aprecio que más organizaciones o personas sigue aportando más de lo mismo. Los análsis donde las cosas no funcionan o andan mal son de la responsabilidad del MCP y del RP, las intervenciones deben ser para conocer las causas tanto por el ALF como del gerente de carpeta.
Ratifico mi moción de dar tiempo y espacio al gerente de Carpeta no solo para situaciones de crisis, sino para las corrientes.
Solo para algún caso complicado y para llevar a cabo una investigación seria y no opinática estaría de acuerdo con lo propuesto. También no debe desconocerse que ONUSIDA y otras agencias de cooperación están involucradas en este sentido de la supervisión.
Saludos,
Mirta.
Translation from the Facilitation team:
I apologize from the comment in Spanish, but my English is not very good and I have little time to proofread it. I apologize for the mistakes in my previous messages, but time is an asset and we have quarterly deadlines at the moment. I haven't been very careful with this and I hope that my comments have reached you in a clear manner.
I have a different point of view from our colleague (quote above*). I appreciate that more and more organizations or people are saying more of the same. The analysis of the things that do not work well or that do not work at all are the responsibility of the CCM and the PR. The interventions should be done to know the causes by the LFA and the Fund Portfolio Manager.
I confirm my motion of giving time and space to the Fund Portfolio Manager not only in critical situations, but in their daily work.
Only for a more complicated case, or in order to run an investigation I would agree with what was suggested.
It should also be recognized that UNAIDS and other cooperation agencies are involved in the oversight.
Regards,
Mirta.
*clarifications added by facilitation team.
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06-26-2008 3:45 PM
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konjit

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Ethiopia
Not currently affiliated with the Global Fund
- Posts 12
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Re: Week 2: Program oversight and coordination
Dear Forum members,
I read and followed the interesting discussion and although I am late to join this inspiring discussion here are my thoughts on the issue from what i have observed.
Regarding oversight, yes this is important at the level of the GF and at the country levle, in order to meet the objective set out. I see the need for an oversight office (or an advisory board) particularly at the country level or at par (or component) with LFA is important, with main responsibility of the oversight on identification of gaps in implementation , accountability and also on civil society participation.
At the GF level, the oversight should be focused on explaing the procedures and regulaton.
I do agree that the GF should be more active in particularly developing procedures and guidelines on the particpation of Civil socieyty as a PR or SR, as well as the CCM should be more gender sensitive, and there should be an affirmative policy at the GF for gender sensitivity proposals as well as acceptances.
The GF should be more gender sensitive and more advancing the participation of civil society through development of guidance and criteria in the GF policies of funding, this should be strongly reflected as well as evidence informed through active monitoring of the programs and the funds that are approved.
Regarding evaluation and monitoring, the GF should be able to gather data and information at the community level and strenghten the capacity of the national actors including CCM on monitoring and evaluation of the programs funded by the GF.
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06-26-2008 3:35 PM
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Robson Olwe

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Uganda
Not currently affiliated with the Global Fund
- Posts 22
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Re: Week 2: Program oversight and coordination
The following project processes are critical to the seccessful implementation of the GF project:
Advocacy and mobilisation form the core initial Gf activities at all levels. The primary target audience is the political and community leaders who play an important role in encuring long term committment to GR services and in the planning, implementation and monitoring of the project activities.
The expected outcomes are increased awareness, stronger political will and committment and increased demand for GF services.
Sensitisation and orientation should also be conducted at national, district, sub-county and community levels. This should involve government counterparts especially line departments to help to define functional linkages at field levels more clearly to avoid duplication of activities and maximise resources.
At the community level the aim should be to develop shared perceptions on the importance of GF projects and brief participants on procedures to be followed, agree on terms of reference and develop an action plan. This will enable them to participate in project implementation.
The capacity of the implementer should also be built at all levels through training activities and support for institutional building and material and logistic support. The NGOs selected should work in collaboration with the districts technical personnels to train the communities. There should also be community involvement and participation in the project in consequential to its success and one of the guiding principles for the project is ownership by the beneficiaries and sustainability of project achievements. This should be done in aparticipatory planning process to develop plans for GF project including training of the communities.
Also linkages should be established with other relevant services to improve the efficiency and cost effectiviness of project inputs.
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06-26-2008 3:04 PM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
Br. Saka from Nigeria,
Welcome again and I applaud your submission and support it 100%...There are three of you from Namibia, one of you from the Southern Asian region that have brought more colour, fragrance and zest to this discussion, putting the endusers of services in the drivers seat to give us their opinions how well they are served.
Thanks you are the greatest
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06-26-2008 2:53 PM
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Fenna E. Bacchus

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Kenya
Not currently affiliated with the Global Fund
- Posts 147
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Re: Week 2: Program oversight and coordination
BEST ANSWER OBERT ...Namibia is making an excellent case of the beneficiaries not being respresented on the forum and ofcourse I hope the GF is listening
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