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Africa: Keeping Health Commitments

AfricaFocus Bulletin
Apr 28, 2006 (060428)
(Reposted from sources cited below)

Editor's Note

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 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 their commitments.

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 (UNGASS)..

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 Treatment).

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


Contact Information:

Sisonke Msimang - Programme Manager Open Society Initiative for Southern Africa (OSISA) Tel. +27-11-404-3414/ +27 83-450-7382 Email:

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:

  1. Include within the 15% health spending target, a specific set of separate targets for each of the three diseases: AIDS, Tuberculosis and Malaria;
  2. In partnership with civil society, establish national mechanisms to monitor the Abuja Declaration;
  3. Put in place clear targets for achieving universal access by 2010

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 transmission."

"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 Civil Society

The Abuja Summit is requested to adopt the following recommendation:

"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 Nations ]

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 participation.

"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 HIV/AIDS.

"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 Council.

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."

AfricaFocus Bulletin is an independent electronic publication providing reposted commentary and analysis on African issues, with a particular focus on U.S. and international policies. AfricaFocus Bulletin is edited by William Minter.

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