FIX THE FUND! TREAT THE PEOPLE! Transparency and Accountability of Global Fund Financing in Kenya Sharonann Lynch, Health GAP : FIX THE FUND! TREAT THE PEOPLE! Transparency and Accountability of Global Fund Financing in Kenya Sharonann Lynch, Health GAP June 12 2005
Kibera
About ACT UP and Health GAP : About ACT UP and Health GAP Activist organization founded in 1987, 1998. Mostly volunteer, no hierarchy. Everyone has a voice
We do:
protests and demonstrations, pickets
town meetings, forums
Outreach, education
lobbying politicians
media work
We see AIDS as a crisis that can end, but only if we pressure people who have power to put their power to good use
What do we do? : What do we do? Pictures from recent protests
1983 DENVER PRINCIPLES: : 1983 DENVER PRINCIPLES: We condemn attempts to label us as "victims," a term which implies defeat, and we are only occasionally "patients," a term which implies passivity, helplessness, and dependence upon the care of others. We are "People With AIDS."
1983 DENVER PRINCIPLES: RECOMMENDATIONS FOR PWAs : 1983 DENVER PRINCIPLES: RECOMMENDATIONS FOR PWAs Form caucuses to choose their own representatives, to deal with the media, to choose their own agenda and to plan their own strategies.
Be involved at every level of decision-making and specifically serve on the boards of directors of provider organizations.
Be included in all AIDS forums with equal credibility as other participants, to share their own experiences and knowledge.
Substitute low-risk sexual behaviors for those which could endanger themselves or their partners; we feel people with AIDS have an ethical responsibility to inform their potential sexual partners of their health status.
1983 DENVER PRINCIPLES: RIGHTS OF PWAs : 1983 DENVER PRINCIPLES: RIGHTS OF PWAs To as full and satisfying sexual and emotional lives as anyone else.
To quality medical treatment and quality social service provision without discrimination of any form including sexual orientation, gender, diagnosis, economic status or race.
To full explanations of all medical procedures and risks, to choose or refuse their treatment modalities, to refuse to participate in research without jeopardizing their treatment and to make informed decisions about their lives.
To privacy, to confidentiality of medical records, to human respect and to choose who their significant others are.
To die--and to LIVE--in dignity.
Donate the Dollars, Treat the People, Drop the Debt : Donate the Dollars, Treat the People, Drop the Debt
Treatment Access Movement : Treatment Access Movement “Treatment is a Right”
History of the Global Fund: The Call for a “War Chest” : History of the Global Fund: The Call for a “War Chest” “There has been a worldwide revolt of public opinion. People no longer accept that the sick and dying, simply because they are poor, should be denied drugs which have transformed the lives of others who are better off.”
- U.N. Secretary General, Kofi Annan
Abuja, Nigeria – April 26, 2001
Slide10 : GFATM STRUCTURE & PRINCIPLES Transparent
Representation of PWAs
Demand-driven (not supply)
Locally-driven (not donors)
Rapid
Meant to save lives!
The Global AIDS Community’s Expectations of the Global Fund : The Global AIDS Community’s Expectations of the Global Fund Closing the deadly gap in access to treatment
Improving the quality and length of lives of PLWHAs
Ensuring involvement of civil society/affected communities, particularly PLWHA, in defining programs and policies that affect their lives
Country Coordinating Mechanisms : Country Coordinating Mechanisms “The Fund will work with a country coordination and partnership mechanism that should include broad representation from governments, NGOs, civil society, multilateral and bilateral agencies and the private sector.”
(Fund Framework Document, VI.B.1)
Reality: Where are we now? : Reality: Where are we now? Approved Rounds facing “’renewal” after 2 years of funding
Funding not being disbursed quickly enough (Principal recipient)
Lack of information and power to CCMs to supervise and give input
Lack of information among communities affected
GFATM in KENYA: ROUND 2 : GFATM in KENYA: ROUND 2 Grant signed: August 27 2003
Weak CCMs lead to Global Fund problems : Applications have been “too shy” in their requests for money for ARV treatment, and too modest in their projections for scaling up treatment access
GOK is not transparent in its dealings with CCMs (Round 5, Round 2)
CCMs lack information and authority to supervise grants Weak CCMs lead to Global Fund problems
Holding CCMs Accountable to PLWH/A : Holding CCMs Accountable to PLWH/A By working from the “inside”
As a part of a CCM
By working from the “outside”
Lobbying the CCM; holding meetings with CCM leadership
Supporting and collaborating with CCM members who are PLWH/As or other allies
Building broad support for your demands of the CCM and GOK
Communicate with the GF Secretariat about CCM and GOK problems
Both inside AND outside work are important and necessary for increasing treatment access
How can PLWH/A pressure CCMs from the “outside?” : How can PLWH/A pressure CCMs from the “outside?” Engage with CCM members
Make public demands of the CCM
Pressure the CCM to request adequate money for treatment access
Pressure the government to be transparent in their communications with CCMs (and deliberations)
Pressure the CCM to include minimum numbers of PLWH/A, NGOs, and civil society members
Tactics can include
Media work, building community support among decision makers for basic demands, public community meetings with CCM members where demands are presented, etc.
Information resources : Information resources Reports about GRANT performance:
http://www.theglobalfundorg
List of current CCM contacts:
http://www.globalfundatm.org
GOK proposals to the GFATM:
http://www.theglobalfundorg