[procaare] Global Fund defends decision to deny funds to Zimbabwe

["Masimba Biriwasha" <procaare@healthnet.org>]

Spotlight: Global Fund defends decision to deny funds to Zimbabwe  
- Masimba Biriwasha, Zimbabwe  
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An article from the HDN Key Correspondent Team: 9 May 2008  

The Global Fund to fight AIDS, Malaria and Tuberculosis has defended its decision to deny donor finance to Zimbabwe and has encouraged the country to consider feedback provided by an independent panel of experts when applying for the next round of funding.

The Global Fund is a nongovernmental organization bankrolled by governments, international institutions and private donors. Its goal is to select the best programmes for delivering treatment in regions such as sub-Saharan Africa, Latin America and Asia and to finance those programmes under supervision.

According to the International Herald Tribune (IHT), the Global Fund has raised billions of dollars and has helped treat millions of people. But the rejection of the request from Zimbabwe for funds to fight tuberculosis (TB) in particular has been seen as a critical setback to efforts aimed at addressing the spread of the disease in the country.

In response to online questions submitted by people from around the world via the IHT, Michel Kazatchkine, executive director of the Global Fund defended its position and said the organization had a good record in Zimbabwe.

"The Global Fund feels a strong and heavy responsibility for the welfare of the many people in Zimbabwe affected and infected by the three diseases and continues to support the country's fight against them," Kazatchkine said.

"Paradoxically, given all the media criticism of us for not supporting Zimbabwe, the Global Fund is the largest - and almost only remaining - funder for health programmes," he said.

The Washington-based organization recently agreed to help pay the salaries of Zimbabwean doctors and medical staff in a bid to stem the massive brain-drain that has seen many qualified health professionals leave the country.

With hyperinflation out of control and the public health sector virtually crippled, there is little doubt that an injection of donor funds could bolster local efforts against the spread of HIV, malaria and TB in the country.

But the Global Fund has turned down five of Zimbabwe's seven funding proposals to date, each time citing the technical shortcomings of the proposals as the primary reason for the rejection.

The country's most recently rejected proposal sought funding to put in place programmes to respond to the rising problem of TB but according to Kazatchkine, it is the soundness of a country's approach and not the issues themselves that determine the success of a proposal.

"Zimbabwe's proposals to the Global Fund in the last two funding rounds have not been approved because the independent experts who review proposals were not satisfied with the technical and scientific merit of the country's proposals," said Kazatchkine.

He also denied allegations that the Global Fund was pursuing an agenda to stem the flow of funding to the country and said those responsible for drafting proposals at the country level should do more to make the proposals sound and concrete.

"The Global Fund is . . . in no way reducing its support to the country. The Global Fund strongly encourages Zimbabwe to use the feedback provided by the independent panel of experts from the previous two years and apply again for this year's financing round, which opened on 1 March," Kazatchkine said.

Zimbabwe has recorded some progress in the fight against the three diseases - a key development the Global Fund can build on. The country is the first in southern Africa to record a decline in HIV prevalence.

Zimbabwe has seen a steady decline in the number of HIV cases from more than 26% of the population in 2001 to about 15% in 2006, according to reports from the United Nations Joint Programme on HIV and AIDS (UNAIDS).

The limited funding that is finding its way into the country is mainly directed towards programmes tackling HIV. But as HIV and TB are linked, the absence of the funding, laboratory and diagnostic systems and technical support needed to fight TB means that the disease is threatening to unravel gains made against HIV.

The 2007 Global Tuberculosis Control Report by the World Health Organization (WHO) ranked Zimbabwe among 22 countries with the highest TB burden. TB has re-emerged as a leading killer in the country, especially among people living with HIV and an estimated two thirds of Zimbabweans with TB are also infected with HIV.

"Sources of support for civil society to undertake TB activities, particularly for community-based interventions, are non-existent," said Lindiwe Chaza-Jangira, executive director of the Zimbabwe AIDS Network (ZAN).

"The movement of people within the [South African Development Community] further threatens to increase [multi-drug resistant and extremely-drug resistant TB] in the region, and for Zimbabwe this is made worse by a weakened health system," Chaza-Jangira said.

According to Kazatchkine, the Global Fund's approach to health sector financing is unique as it is based on country ownership, recipient countries set their own priorities, design and implement their own programmes and are accountable for what is achieved.

"The Global Fund bases its financing solely on performance. All funds are released incrementally, based on demonstrated results against targets we have jointly agreed with the countries," Kazatchkine said.

"While judgment, of course, always has to play some role, the system is designed to prevent political or any other considerations from influencing decisions on funding . . . Donors and beneficiaries are equally represented on our board, contrasting with most financing institutions for development."

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The KC Team is coordinated by Health & Development Networks (HDN).  
Website: www.thecorrespondent.org   Email: info@thecorrespondent.org  
    


Cross-posted from AF-AIDS 
Tuesday, May 27, 2008 12:00 AM