Author Archives: Jessica

Learn more about what happened at the London Family Planning Summit, hosted by DFID and Bill & Melinda Gates Foundation here.

As part of the Summit the UK Consortium on AIDS and Development and the UK Sexual Reproductive Health and Rights Network co-organised a side session on family planning and HIV integration. Download the RAISE the Bar Agenda.

In the build-up to the Summit, the Network and the Consortium, with other civil society networks/organisations have coordinated key messages around family planning and HIV integration. RAISE the Bar is the result. Do read and circulate please.

The RAISE the Bar Session Report August 2012 is now available.

For further information about this event or our messages, please contact Ben Simms (ben@aidsconsortium.org.uk); Luisa Orza (luisa.orza@gmail.com), Co-chair of the Gender Working Group, UK AIDS Consortium or Felicia Wong (fwong@aidsalliance.org), Co-chair of the Linkages Working Group, UK SRHR Network.

MPs urge acceleration of additional funding to Global Fund

A committee of MPs has voiced concerns that delays in a long promised increase in the UK contribution to the Global Fund to Fight AIDS, TB and Malaria could put lives at risk.

The International Development Select Committee’s comments came as they published their report of conclusions today following hearings they held on the funding crisis at the Global Fund. The funding crisis came to a head in November last year, when all scale up in programming across the three diseases was cancelled until 2014.

Diarmaid McDonald, Stop AIDS Campaign Coordinator said:

“This group of MPs have looked hard at the UK position and urged them to accelerate their increased contribution. We urge the government to heed their call, and move as quickly as possible to up the UK commitment and to bring other donors with them before lives are put at stake. The US is delivering on a 40% increased pledge made with the rest of the world in 2010. It’s high time for the UK to catch up.”

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This week is World Immunization Week. An opportunity for the World Health Organisation (WHO) and other stakeholders to promote the fact that immunization prevents debilitating illness and disability and saves lives.

The UK government shares this view, coming out strongly in favour of vaccinations and immunization in the June 2011 pledging conference for the Global Alliance on Vaccines and Immunization (GAVI). More than £814 Million between 2011-2015 has been earmarked. “Every day”, noted the UK Secretary of State for International Development, ”the lives of 7000 children are saved by vaccines. Vaccinations are proof positive that well spent aid saves lives. They are one of the best and most cost effective health interventions that money can buy.”

Globally more than 7.6 million children die annually from preventable diseases such as pneumonia and diarrhoea – a quarter of these deaths are of vaccine preventable diseases. Significant progress has been made since 1990 when child mortality exceeded 12 million yet significant challenges remain. In order to reach MDG Four on reducing child mortality by two thirds by 2015 progress must increase fourfold. Immunisation holds the key to accelerating progress and is one of the best methods we have to save children’s lives and to improve their health.

The WHO Expanded Programme on Immunization includes a broad spectrum of vaccines, including Rubella, Diphtheria, Tetanus and Polio but for some of the most neglected diseases of poverty immunizations are still sorely lacking. TB, Malaria and HIV/AIDS still want of an effective vaccine. Whilst developments have been made for all three diseases and major breakthroughs are possible and predicted, we need continued long-term political commitment and sustained funding to ensure that this momentum and optimism do not fade away.

For many advocates vaccines are the only cost effective, wholesale means of getting to zero deaths from some of the world’s biggest diseases. As we celebrate the developments made in the field of vaccines to date, we also reflect on the work still to be done. We absolutely need to make sure that all the vaccines we have reach the most vulnerable child, and we must continue to support the further development of new critical and life-saving vaccines against diseases of poverty such as HIV/AIDS, TB, and malaria. The poorest and most vulnerable children deserve nothing less.

Written by Caroline Hames, Global Health Advocacy Manager – RESULTS UK and co-chair of the TB/HIV WG of the UK Consortium

UK Consortium event on HIV and TB Vaccines
May 18th 10-1pm, Attlee Suite, Portcullis House, Westminster. RSVP to deborah@aidsconsortium.org.uk

The UK government has said that they intend to ‘up to double’ their contribution to the Global Fund to Fight AIDS, TB and Malaria, but will make the international health organisation wait for up to a year before confirming the increase. Speaking in front of a committee of MPs Secretary of State for International Development, Andrew Mitchell MP confirmed his support for the Fund but argued he needed more evidence that the institution was reforming before paying the increased amount activists said is needed to avert a funding crisis threatening millions of lives.

The Secretary of State was speaking as part of a hearing on the funding crisis at the Fund held by the International Development Select Committee on Tuesday 17th of April. Evidence was also given by Gabriel Jaramillo, the newly appointed General Manager of the Global Fund, Aaron Oxley of the UK Coalition to Stop TB and Mike Podmore, Chair of the UK AIDS Consortium. The committee heard evidence on the impact of the Fund, the on-going reform agenda and the consequences of a shortfall in donor funding for people living across the developing world.

The Global Fund: A Successful Enterprise

The Global Fund is a unique, public-private partnership and international financing institution dedicated to attracting and disbursing additional resources to prevent and treat HIV and AIDS, TB and malaria. This partnership between governments, civil society, the private sector and affected communities represents an innovative approach to international health financing with the Global Fund’s model being based on country ownership and performance-based funding.

Since its creation in 2002, the Global Fund has become the main financier of programmes to fight AIDS, TB and malaria, providing AIDS treatment for 3.3 million people, anti-tuberculosis treatment for 8.6 million people and 230 million insecticide-treated nets for the prevention of malaria. Although the Global Fund financially relies on voluntary contributions from all sectors of society – governments, private sector, social enterprises, philanthropic foundations and individuals – donor governments continue to provide the largest source of financing. The UK is a major supporter of the fund contributing almost £1bn since the Global Fund’s inception in 2002 (8% of total contributions). In addition, the UK is the current Chair of the Global Fund with DFID civil servant Simon Bland leading the current reform process.

The Crisis of Confidence

Early in 2011, some media stories misrepresented allegations of misuse of funds discovered in grants financed by the Global Fund in a number of countries. These incidents were in fact uncovered by the Global Fund’s own Office of the Inspector General, which has been undertaking a thorough review of the Global Fund portfolio to identify areas of the Global Fund’s grant oversight and risk management that need strengthening. Less than 5% of the Global Fund’s grant portfolio was misused but at the time of the media reports the Global Fund was already experiencing funding problems and donors who were already going back on funding commitments now had an excuse to delay payments.

In response to these articles some donors, despite having previously been informed of the problems, delayed their contributions. This cash-flow issue compounded the poor Global Fund Replenishment effort for the period 2011–2013 (held in October 2010), which raised only $11.7 billion in pledges, well below the target of $20 billion and even below the low ‘maintenance’ level of $13 billion.

As a consequence the Global Fund board cancelled Round 11 of new funding thereby putting on hold live-saving programmes. This cancellation was a devastating blow to country ambitions to scale up HIV prevention, treatment, care and support services. It also brought into question how basic services for those people already on HIV medication would be continued. To try and ensure essential services were not affected, the Board agreed to put in place a Transitional Funding Mechanism (TFM) that would be accessible only to current grantees.

The Global Fund’s Transformation

The General Manager of the Global Fund, Gabriel Jaramillo, a former chairman and CEO of Sovereign Bank, started his one year contract in February 2012 with the aim of leading reforms. At the IDC hearing Jaramillo explained that the Fund was implementing the “Consolidated Transformation Plan” to ensure that efficiency, risk management, transparency and anti-corruption practices are improved. He quoted these transformations as ‘game changing’ in order to restore donors’ confidence as quickly as possible. He said, “some say the Fund is changing too quickly, I say not quickly enough”.

The reforms include staff reorganisation, simplification of processes and disease-specific monthly meetings organised with grant committees and Partners to ‘stop and reflect’ on the work conducted.

Jaramillo ended his evidence to the Committee on a positive note stating: “We are going to do better what we do best which is to save lives”.

The Impact of the Crisis on Efforts to Save Lives

The IDC heard from members of civil society and the UN – all of whom recognised that the Global Fund can continue to improve its work, but highlighted that it is one of the most transparent, effective and innovative funding mechanisms in existence. They reinforced that the fraud concerned was less than 5% of the Fund’s grant portfolio and that over the last 10 years the Global Fund has done incredible work to help save more than 7 million lives in more than 150 countries.

What is clear from evidence being collected by communities, NGOs and UN organisations is that cuts to the Global Fund is having an impact now and that delays in the funding of new grants will further affect communities around the world.

The next opportunity for countries to apply for new grants will be during the next replenishment period 2014-2016. NGOs at the IDC hearing pointed out that new services would be cut and that the TFM was a mechanism for the status quo that did not include crucial aspects such as social protection, prevention, care and support. The TFM allows for continuation of treatment, but not for new treatment places meaning that those individuals newly diagnosed with HIV will be denied access to life-saving treatment. The TFM is not a mechanism to scale up services to reach Millennium Development Goal 6 (MDG 6) by 2015. The country impact studies in the International AIDS Alliance’s ‘Don’t Stop Now’ report documents the many ways in which the HIV response is now endangered lives including in the new Republic of South Sudan whose government was counting on a round 11 application to cover the 80% of the national AIDS plan that is currently unfunded.

DFIDs response to the Global Fund Crisis: Their Delay will Cost Lives

In 2011 DFID released a Multilateral Aid Review (MAR) within which the UK publicly acknowledged how critical the Global Fund is to the delivery of MDG 6. The MAR rated the Global Fund highly in terms of good value for money and delivering results but that it wanted to see reforms made to further strengthen its work.

The Fund has been shown to be an effective funding channel, the Fund is implementing the reforms that the UK wants to see, and there is a dire urgency to get the Fund fully funded and back to normal.

So why is the UK Government dragging its heels and not showing public confidence in the Global Fund by committing to fund its fair share? Why wait when lives are being lost?

Civil Society and UN partners at the IDC hearing called on DFID to support the call for a replenishment opportunity at the G20 Summit in Mexico in June- the perfect opportunity for the UK to play a central role in leveraging support from other donors.

The UK government’s Position

Andrew Mitchell told the IDC enquiry that DFID will continue its funding of the fund and in fact will commit to a £128 million in 2013, 2014 and 2015, working towards the previous Labour Government’s commitment of £1 billion to 2015. Beyond this he held out the possibility of a doubling in contribution from 2013 onwards. Great news. But the extra funding will be led by evidence that the Global Fund has made the necessary reforms. The Secretary of State was not opposed to a re-launch of pledges at the G20, but was concerned about the short amount of time between now and then.

The UK has traditionally demonstrated historic leadership on HIV. The UK should use its position to leverage others. Instead, it seems that the US and other non-European governments are taking the lead. On World AIDS Day, Barack Obama stated, “To the global community — we ask you to join us. Countries that have committed to the Global Fund need to give the money that they promised. Countries that haven’t made a pledge, they need to do so.” Germany, Japan ($340 million), Saudi Arabia ($25 million) and the Gates Foundation ($750 million) have all already pledged their support.

Like Walter Savage Landor famously stated: “Delay in justice is injustice”. What are we waiting for? Why wait? Delay is simply not acceptable because lives are at stake. Waiting will undermine the gains made so far in the HIV response and will lead to unnecessary illness and death.

It is time for the UK government to not delay and instead lead the way in the global rush to save lives.

Written by Marie-Ophelie Sarrade, Communications Volunteer, UK Consortium on AIDs and International Development

If you want to watch the video of the committee meeting go to: http://www.parliamentlive.tv/Main/Player.aspx?meetingId=10623  

If you want to see more on what the Global Fund has achieved in 10 years, have a look at this video: http://www.youtube.com/watch?v=OA-31xD0log  or go to http://www.theglobalfund.org/en/

Evidence of the impact of the Global Fund crisis can be found in their “Dont Stop Now” report: http://www.aidsalliance.org/publicationsdetails.aspx?id=90566

TB is the leading killer of people living with HIV.

TB and HIV are dual epidemics – inextricably linked. Approximately 13% of all TB cases occur among people living with HIV, and in 2010, TB caused an estimated 350,000 deaths among people living with HIV.

Since 2004 WHO has recommended increased collaboration between HIV and TB care and support services. There are now many examples of where HIV and TB service integration has been a success and benefited the lives of those individuals co-infected with the two infections. However, even though the benefits of integration are clear, integration is not universal.

To coincide with World TB Day the UK Consortium on AIDS and International Development has today released a policy briefing “Fighting TB/HIV Co-Infection: Realising Commitments Through Integrated Programming”. The briefing seeks to highlight the rationale for integration, and also explore the opportunities and challenges to promoting greater integration.

Download “Fighting TB/HIV Co-Infection: Realising Commitments Through Integrated Programming”

In sub-Saharan Africa, an estimated 90% of care for people living with HIV and AIDS is done in the home by family or community-based caregivers.

Community caregivers are essential – which begs the question – where would the AIDS response be if we had not had the input of unpaid caregivers?  Would we still be looking positively towards a World Without AIDS?

Caregivers are a vital workforce in the response to AIDS – but they are an unpaid one. Most primary and secondary caregivers are not remunerated for the work that they do – even when it leads to the loss of other income sources and missed opportunities. Is this right? Or should we now be looking at remunerating caregivers to ensure a future sustainable workforce that does not leave carers worse off?

To explore this argument, the UK Consortium has produced a policy briefing “Past Due: Remuneration and Social protection for Caregivers in the Context of HIV and AIDS” to encourage the development community, including our Consortium membership, to join the debate and take action towards ensuring a better deal for caregivers.

The policy paper considers who caregivers are and the impact that their work has – at a personal, community and global level. Most importantly, the briefing suggests models of remuneration that donors, national governments and programmatic NGOs can use to compensate caregivers for the work that they provide.

Download “Past Due: Remuneration and Social protection for Caregivers in the Context of HIV and AIDS”