Feb 21, 2006

Message from Michael Siggs
Saturday, February 18, 2006 1:08 PM
Subject: This week's topic

I write as Chair of the St Petersburg Healthcare Trust, a charity which has the object of developing palliative care in Hospices & Hospice Units across the Russian Federation and the Former Soviet Union. The provision of Hospices and palliative care for terminally ill patients has grown tremendously over the past 15 years of our activity at the grass roots of Russian Society. The growth has proved to be sustainable because of local governmental support. A major concern of these hospices is, however, the increased numbers of patients with HIV & full blown AIDs or TB that are coming forward for palliative care. These reports come from across the Russian Fed from the Russian Far East, Siberia, the Urals, Moscow, St Petersburg, the Volga valley, Ukraine, Belarus & Moldova.

The Global Fund has invested heavily in ROUND 3 & Round 4 in programmes for 2004, 2005 & 2006 in Russia; to what effect? How are "key partners" involving the doctors & nurses at the "coal face" of patient care? What teaching and training is being provided? We have a programme for teaching the whole spectrum of palliative care to Russian professionals, why can we not be involved in the battle against this scourge? We have plans for a major programme of elearning and website information. Which of your key partners provides this service?

Michael Siggs, Chair,
St Petersburg Healthcare Trust.

Sammi Fredenburg - Feb 17, 2006

Hello everyone:

There seems to me to be a reccurring theme of concerns for sustainability of programs, and assurance that the funds actually get to the ground where they are intended. Hopefully this will be a bridge that is gapped, as I believe it's the fund's best intention to do so.

Due to it's diversity and far-reaching scope, i'm hoping the fund can get the recipients networking with each other both in their regions and globally in their area of concentration. I hear of so many recipients feeling like they are alone and forgotten out there. . .. this may be an opportunity to bring people on the ground together. I perceive that it isn't always necessarily popular, as people love to hold their projects close to the chest (maintain a degree of secrecy) and rightfully protect and grasp onto their often minimum resources. Forgive me if I am wrong.

But even in the world of missions I experience people who live not too many kilometers from each other who don't get together for the good of the whole project, who feel their conferences or home offices and supporters will take care of them, and the other's resources are responsible for them. Sounds moreso in NGO's and NNGO's, and with so many out there in the field.

Can the Global Fund consider conferences and networking opportunties to bring the recipients of the funds together, to possibly combine and coordinate their work? maybe some who have gifts of sustaining can compliment those who have for implementation, or mechanisms that can cover a region, or. ..... Possibly a stipulation of receiving the funding could be for it to be for the good of the many, rather than the good of the one!

Thank you,
Sammi Fredenburg

rosejoshi - Feb 17, 2006

It is to be ensured that mechanisms contained in the national framework are functional. In my country's case, nepotism is practised. GF should provide training to all national level players.

We have discussed it at length in this forum ; it mirrors reality for example in Nepal within the UN system itself resources are granted without knowing where they are being sent...conflict of interest, nepotism....
Anyway we hope this forum may bring one common plate from which we learn what is constraining GF resources at the national level.

Rose Joshi, Nepal.
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With Love and Hug
Rose Joshi

Luc Comhaire - Feb 17, 2006

Coordination structures exist on paper (CCM) but their functioning and practical effectiveness can be improved. Subjects concerning real problems faced by the programme in the field are rarely or never discussed. The GFATM, through the CCM could stimulate the establishment of working groups with specific tasks oriented towards practical field-related problems and aiming at solving rapidly those practical problems. A reporting by those working groups to the CCM could be part of the normal routine agenda of the CCM and facilitate and speed up the decision-taking whenever needed. It may also strengthen the complementarity of the actions of the different partners.
_________________
Luc Comhaire
Project Manager
Damien Foundation (Belgium)
Boulevard Léopold II, 263
1081 Brussels
Belgium

Tshering - Feb 16, 2006

I agree with most of your contributions: partnership, collaboration and bottom up approach… however, we should be aware of the objectives of special interest to all the donor agencies, many of whom decide what the country needs rather than rely on local decisions especially by those at the grassroots level.

Play the leader's role among donors: I strongly favour the view that collaboration is the only way forward, but confusion remains as to who will play the leader’s role among donor agencies. I think here the Global Fund could play a major role of leadership. After discussion and consultations with the government of a country and existing NGOs, the GF should come up with plans to share responsibility by way distributing work : for example if an “A” group of NGOs is looking at one particular area with other existing grass-root organizations, then another group, “B” should focus on other areas. This avoids all NGOs focusing on unique target populations e.g. children, who may attract more empathy and donations.

Enhance collaboration on one national strategic framework: All NGOs should focus to tackle problems within the strategic framework (national targets of a country, rather than having their own targets), which leads to sustainability. Otherwise, disease prevalence might decrease while the NGOs exist in the country, but increase or remain the same once NGOs leave the country. Short term projects sometimes do more harm than good to the country.

Conclusion: To ensure sustainability (of programmes and results), there is great need for collaboration between NGOs and Governments. Finally, on health and political issues: ...“Good governance is good for the health of a nation”.
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Looking forward to participating in fruitful global discussions any health realted topics.

kokoi - Feb 15, 2006

There are three basic ideas that global fund should consider:
1. instituting/strengthening Monitoring Information System beginning from primary level.
2. Established collaboration with key partners in instituting M&E
3. Regular Program Implementation Review with key partners

Global fund should always think that they are a developmental agency not just a funding agency.

vmarencop - Feb 15, 2006

The Global Fund should have a more Hands On Approach, this means getting closer to the project implementation process on the ground. More intervention not for monitoring purposes but for capacity building and skill transmission. As a catalyst for change there should be more feedback and project discussion on the ground with all stakeholders.
_________________
Vanessa Marenco
International Programs Director
Institute for Behavioral Change and Research
Washington, DC
USA

steve knowles - Feb 15, 2006

Emphasis should be on the sustainability of the programme.Meetings with all parties should be facilitated by GFand run correctly with relevent agendas and focus on the pertinent issues. These should be on site and not only boardroom reviews. Results and outcomes should be monitored and be measurable. projects should be audited and have built in checks and balances. Bulk of the funding must be for service delivery and not consultants and other allowances. BF should not be short term, quick results orientated, but look to support long term, ongoing existing programmes which have a track record of being effective and effeciently run. Research and capacity building have their place but must be augmented with hands on tech support.
_________________
Steve Knowles
Manager: Malaria Programme
AngloGold Ashanti
Obuasi, Ghana
Tel: (0233) 582 40407 Ext 1745
Mobile: +233 (0)243710871
E-mail: sknowles@anglogoldashanti.com.gh

tarigwafa - Feb 15, 2006

Dear Moderator;
Top-down planning is one of the major problems in developing countries. Now GF is working in the same way in these countries ( at least one of them is SUDAN ) . It's better , and perfect enough to depend on bottom-up planning, in supporting implementation of the plans, not the reverse. In addition, partners working for GF should have integrated, not interdigitated implementation plans.

thanks,,
Dr.Tarig Dafallah ELHASSAN
HIV/AIDS State coordinator
SUDAN
_________________
Tarig Dafallah

Amadougalo - Feb 15, 2006

Dear members,

Many thanks for the e-mails and invaluable contributions. In my own opinion, I think that the only way forward for the fund and that its key partners to compliment each other, "partnership" in the implementation of projects and programmes most be strengthened and sustained at all levels. Stakeholders must come together and strategise their activities. This will help to prevent duplication of efforts and enhance the maximum use of resourses and accelerate progress. I am also of the view that the fund should be used to fund the activites of well established community Organisations in the programme areas its supporting. Also more funds should be devoted to service provision that to allowances and so called logistical arrangements. I wish you all a progressive year.

Amadou Bah
Assistant Producer
Gambia Radio & Television Services, Mile 7 studios.
( I am also the Secretary General of The Association of Health Journalists in The Gambia).

Jotham Mthembu - Feb 15, 2006

There should be a mechanism in place to motivate governments to commit funding with an aim to taking over the financial responsibiility rather than riding on the Global Fund. The danger in governments riding on the Global Fund is the fall of projects once funding dries up. We cannot expect a scenario where the Global Fund supports country projects permanently.

The funding should be phased out over time while governments funding kicks in slowly, presumably over 5 years. This calls for a Plan of action.

Jotham Mthembu
Malaria Control Programme
KwaZulu-Natal &
Lubombo Spatial Development Initiative

Luc Comhaire - Feb 14, 2006

Speaking about TB control.
The fund should be doing what it's good at and refrain from doing things where it's not good at. Objectives should not only be result-oriented but also process-oriented (e.g. is the programme able to manage ? If not, something needs to be foreseen to build the capacity of programme management within the GF).
Creating a sustainable TB control programme is more important than achieving short and medium term results at any cost (and under pressure of the millennium goals or other).
Proposals for support by GFATM should be looked at with "sustainability" in mind so that countries will be able to continue to achieve good programme results even after GFATM funding has stopped.

_________________
Luc Comhaire
Project Manager
Damien Foundation (Belgium)
Boulevard Léopold II, 263
1081 Brussels
Belgium

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Message from Sudhakar Malpe, India.

We are of the opinion that TGF must widen the scope of funding to the grassroots level NGOs, besides funds being given only through CCM. ...TGF must look at these aspect and facilitate to reach the NGO's like us who have wide experience of working on all that TGF has to offer to the community, in the years to come.

Sudhakar Malpe
Vice President (Projects)
GLOBAL CENTER FOR PREVENTION OF DISASES (GCPD),
53B, Mittal Court,
Nariman Point, Mumbai-400 021. INDIA.
Tele: 091-022-5625 75 76 \ 4002 55 76 E-mail: gcpd@vsnl.net

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Message from Tom Mboya Okeyo, Kenya

The Global Fund should continue to be a financing instrument but must review some of its procedures which are drilling a complex web of bureacratic steps making flow of funds through Government systems a major problem affecting program effectiveness and efficiency.

I would suggest that The Global Fund replace the LFA system with Regional or Country presence depending on the portfolio of Grants. The Fund Portfolio Manager for East Africa and the Indian Ocean for example should be based in Nairobi, Kenya.

The Global Fund must move first to be a Health Fund, which is what it was envisaged. It can retain its name but funding should be for priority health interventions with a significant proportion of the funds being earmarked for research and development activities for Vaccines and new drugs and innovative prevention tools.

As far as is possible, disbursement of funds should be through budget support earmarked for the health sector against agreed results. CCM reforms should aim to institutionalize CCM into the country's health sector coordination structures to avoid duplication.

Dr Tom Mboya Okeyo

Ministry of Health, Kenya

Timothy Mbugua - Feb 14, 2006

While the fund should continue to emphasize and concentrate on areas where it enjoys comparative advantage such as raising resources, it should not loose sight of the fact that efective and efficient implementation is equally crucial. Therefore, as GF continues to work on its core area, it will need to be more focused, specific and concentrate on funding particular aspects of the three diseases where it will create the biggest impact. For instance, it can choose to deal with prevention, treatment and care while leaving other partners to undertake other aspects of the diseases like policy debate and analysis and project planning and implementation at the country level.

Gerry - Feb 13, 2006

Regional and/ or program specific eforums or meetings to ensure that all the partners know each other and are forming collaborations whenever possible. Funding should be tied to positive collaboration.
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G Luongo, MSW

Feb 13, 2006

Given the discussions so far about the role of the Global Fund, what do you think it should it be doing to ensure that its work and that of its key partners complement each other in order to achieve better results ? For example what working arrangements should it seek to establish with its partners?

To read more about the Global Fund ATM partnership, please click on this link: http://www.theglobalfund.org/en/partners/partnership/

To view the last week’s discussions please click here: http://forum.theglobalfund.org/en/viewtopic.php?t=40