More Global Fund money to fight HIV/AIDS, STI in Pacific | Pacific Beat

More Global Fund money to fight HIV/AIDS, STI in Pacific

More Global Fund money to fight HIV/AIDS, STI in Pacific

Updated 13 June 2013, 11:14 AEST

More money is to be spent in Pacific nations to continue programs to tackle HIV/AIDS and sexually transmitted infections.

The Global Fund to Fight AIDS, Tuberculosis and Malaria is to provide $US5 Million to continue programs in eleven Pacific countries.

The Pacific has some of the highest prevalence rates for STIs in the world, and people who already have an STI are at greater risk of contracting HIV.

The funding was promised during a meeting in Geneva between Dr Jimmie Rodgers, the Director-General of the Secretariat of the Pacific Community and representatives of the Global Fund.

Presenter: Geraldine Coutts

Speaker: Dr. Jimmie Rodgers, Director-General, Secretariat of the Pacific Community

RODGERS: Well the Global Fund has committed to financing an interim arrangement to cover a two-year program on HIV AIDS amounting to five million US dollars. And I think the important thing with this is the SPC governing body two years ago has supported a proposal that the SPC would not re-engage with new rounds of Global Fund financing for the region. And I think the important thing now is that the countries have requested the SPC to continue to engage, and so we are working on an arrangement whereby that the five million US dollars coming into support HIV AIDS programs in the 11 countries where this program has been running but its funding was coming to end shortly. So SPC would be coordinating as the principle recipient re-contribution of that financing, continue to support HIV AIDS and STI programs in the 11 countries that the Global Fund has supported. So that is new because the current funding actually comes to an end at the end of this month.
COUTTS: And there'll be ongoing funding of course because it's curious that this funding is ending at a time that the Pacific in particular is peaking with its rates, but not peaking but it continues to rise the rates of STIs in the region?
RODGERS: That's correct, I mean I think there are a number of important things that the Global Fund is financing at this point. They have changed their modality in financing and previously in funding rounds the Pacific because it's not big enough has always submitted a joint proposal covering as many of the countries that are eligible as possible, except for Papua New Guinea that is eligible in its own right. But those proposals at the time when they go through assessment, if some of them weren't up to speed then of course it's very difficult for them to progress on to be awarded if you like grants. The change now has actually guaranteed that every single proposal will be able to get financing support regardless of the quality. Now of course that then means that for the Pacific if our proposal was submitted in say round 12 and it was not up to scratch, there would in fact be an allocation for the Pacific proposal, which means that we have a little bit more time to refine the proposal and we are guaranteed some funding at the end of that once we fix the proposal. So that's an important change. Now the other important change is the flexibility the Global Fund has in terms of recruitment of personnel that will implement the program. We have had a difficulty of recruiting long-term staff to manage Global Fund at once basically because we were given annual sunvention  The Global Fund is actually quite happy now to go on longer-term contracts on the basis of the length of period the grant is put for. So that opens up for me especially a much better if you like certainty that we can actually go out and get the appropriately qualified and experienced staff, which is very difficult to attract on 12 month contracts. So that change will actually also improve the management of Global Fund resources that are coming through the SPC. I think the third point which is very important is that the burden of diseases will still determine the magnitude of the resources that are going into the countries, and for the Pacific whllst STI is sort of high relative to HIV, in theory the overall burden of disease for Pacific Island countries and the territories, apart from Papua New Guinea, is fairly low compared to the Africas  and the other areas, and therefore we will continue to resist smaller proposals of Global Fund resources into the Pacific because of that, which raises the important thing that we cannot actually address the whole challenge the Pacific using Global Fund resourcing alone. And that we still need to raise resources to address STI, HIV AIDS concerns in the region through our normal funding arrangements with Australia, New Zealand, either bilaterally and supported by some regional finance support.
COUTTS: The reports that you were talking about that aren't up to scratch, is that by individual recipient nations and is it that old age question of them not understanding the bureaucracy required to get the ongoing funding?
RODGERS:  Yeah I think having agreement on Global Fund resources over the past nearly ten years we are reasonably aware of the complexity of pulling together global funding for us. So it's not the misunderstanding of the process, it is really down to the lack of capacity at the regional country level at the sub-recipient level.
COUTTS: But Dr Rodgers I have to say here this has always been the case, given the importance of STIs, HIV, tuberculosis and malaria that we're talking about, it's been ongoing for such a long time so why hasn't that been overcome?
RODGERS: Well simply many of the countries don't have the capacity and the resources. I mean if you really want to get down to details you'd have countries like Tuvalu that probably have two people managing the whole HIV AIDS program for government, for NGOs recording multiple funding coming through, and there's only a limited number of people and hours to do those reports. So I think the whole issue is to do with SPC working with countries to ensure they strengthen the capacity of the countries to not only implement the programs funded by Global Fund, but also to be able to report against their expenditures. And this is where the problem is because the Global Fund reporting is quite detailed in terms of outputs achieved and it takes a lot more time just to make sure that we are reporting against implementation. But importantly what they're after is reporting against outcomes and impacts, so it is sometimes more difficult to ascertain on shorter term reporting as opposed to long term programs. So a capacity issue is I think the critical one for the Pacific Island countries and territories, there's usually not enough capacity to report, and that's the thing that we've been struggling with. And at the regional level our role is to pull together all the reports we get from 11 different countries into one consolidated report to the region to the Global Fund. Now a key challenge for us if those reports don't come on time and or are incomplete it just takes longer to complete them and therefore the payment of Global Fund doesn't come on time. And it does create challenges at both the principle recipient level as well as the sub-recipient level in countries.
COUTTS: Are you confident that the treatment and the work being done to fight AIDS, tuberculosis and malaria won't be impeded because of this?
RODGERS: Yeah it's something that we are working with countries, and at the end of the day each country really has to establish its own national capacity. And TB is a critical one because in the Pacific we have the potential to eradicate TB. Global Fund is a major funder for TB, it's not very attractive for other donors but that's where I think our attention should be is to make sure that our work on TB gets it under control and then slowly towards eradication. Malaria is slightly easier because it's really only two countries; Solomon Islands and Vanuatu that comes under the regional program, Papua New Guinea has its own. And both these countries are working to establish their own capacities and over time to handover the total management of the grants of these two programs for these countries. STIs and HIV affects all the countries, and I think what we're trying to do is to ensure that we integrate the Global Fund finance activities into their national programs and focus more on building up capacity at national level. So in answer to your question we don't think it will be impeded, I think the processes that we're now trying to put in place to enhance country capacity and sustain it over the long term will actually in the end come up to be the key cornerstone of the fighting against these diseases in the other countries.

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