26 March 2014
Shawn Clackett

What’s Behind this Photo?

Global Fund News Flash: Issue 40

Photographer John Rae
John Rae is a documentary and commercial photographer who has worked with the Global Fund since 2002 and delivered some of our most memorable images. Over the years, John has visited over 45 countries to document efforts to defeat AIDS, TB and malaria. This is the second in a series of memorable photos that John is telling us about:

In November 2007, I went to “the hills” of western Nepal – 4,500 meter rock walls that anywhere else in the world would be called mountains. A dangerous road got me to a small town called Silgadhi, where I saw a support group called People Living with AIDS. Its leader is Tara BK. She is my hero.

Tara is a short woman with bright eyes and a quick smile that belies the trials she has been through. She belongs to a low caste called the Bisokarma. That means if Tara goes to a restaurant she has to wash her own dishes when she has finished eating. It means she is not allowed to sell milk, and people in higher castes fear that buying milk from her will make the cow will climb up a tree. The caste system must still be going strong in rural Nepal. I have never seen any cows in trees.

Tara told me that she got married six years ago. Shortly afterward, her husband left in search of work in India and did not return for five years. She was tired of waiting and decided to join her husband in the southern Indian state of Andhra Pradesh. That was unusual for a woman in Nepal, but Tara was determined to be with her husband. Nine months later Tara gave birth to a healthy son. That same week, her husband began shivering and was running a high fever. He was diagnosed with AIDS. The local hospital was ill-equipped to treat him, and recommended he go to the “big hospital” in Hyderabad. But her husband’s health quickly deteriorated and he died just a week after the test.

Two days later, Tara began the long journey back to Silgadhi with her newborn son. Not long after her return, Tara began to feel weak. She was breathless and broke into a fever and began to shiver. Salibaan, a man from her village who worked at the local health clinic approached her and she confided in him that she feared she may have “desi rog.” Salibaan, who had received HIV/AIDS training told her that the clinic had a program for testing, counselling and medication.

Fearing for her baby, Tara took the test for HIV. It came back positive. She was devastated. She was warned not to breastfeed her baby. But without an income and unable to work, and with a hungry baby to feed, she saw no choice and reluctantly began to breastfeed her child. Within months her son died.

Soon after, Tara revisited the health clinic and received free antiretroviral medication and counselling. Staff asked if she would be willing to “come out” about the results. After losing her husband and her son to the disease, she did not care what others thought about her status. If “coming out” would help others, she thought, there was no reason to hesitate. She was the first in her area to acknowledge her status publically and realized she could use her sorrow and experience to help others. She joined the local People Living with HIV/AIDS support group and was elected president. She began receiving a monthly salary of 3,000 Rupees (about US$30.) It enabled her to slowly repay the loan for her marriage, and the medical and cremation expenses for her son. Her mission now is simple: to prevent new infections and support people suffering from HIV and AIDS.

Tara’s life is not easy. She lives with her mother-in-law in a small mud hut. She is HIV-positive. She faces discrimination, as a lower caste, and is also stigmatized for her HIV status. Despite it all, Tara still walks 15-25 kilometers a day through the “hills” to help patients living with HIV and AIDS. Tara is my hero.

26 March 2014
Shawn Clackett

Mozambique Aims to Reach Universal Malaria Protection in 2014

Global Fund News Release – 26 March 2014


MAPUTO, Mozambique – The Ministry of Health of Mozambique, together with the Global Fund to Fight AIDS, Tuberculosis and Malaria, World Vision and BHP Billiton Sustainable Communities today announced a partnership to ensure that every family in Mozambique will be protected from malaria by the end of this year’s campaign.

Working towards this goal, the Ministry of Health and World Vision-Mozambique , a Christian relief and development organization, have signed grants for US$85 million with the Global Fund to support malaria prevention, diagnosis and treatment for the next three years. BHP Billiton Sustainable Communities, a registered charity established by the company, has contributed US$10 million to the Global Fund to support these grants.

“Our country is committed to winning the fight against malaria,” said Francisco Mbofana  National Director Of Public Health of Mozambique. “We are looking forward to our net distribution campaign starting in July to reach universal coverage for malaria prevention,” he added.

The grants will fund distribution of long lasting insecticide-treated nets, indoor residual spraying (IRS) in areas not covered by these nets, training of health workers in the diagnosis and treatment of malaria, and community sensitization and mobilization. Partnership development within communities and with civil society will also be supported.

“The Global Fund is very pleased to continue to work in Mozambique to provide access to diagnosis and treatment through the national health system,” said Kirsi Viisainen, Senior Portfolio Manager for Mozambique at the Global Fund. “Mozambique is a good example of collaboration between government, civil society and the private sector in funding and implementing a national, concerted response against malaria, and we look forward to the continued strengthening of this partnership.”

World Vision-Mozambique has hailed this “potentially life-saving development in a country where malaria is the leading cause of death of children in Mozambique.” Graham Strong, the child-focused organization’s National Director, added: “this effort is proof of the common resolve of civil society, government and the private sector to work alongside communities in stopping this on-going tragedy.”

Ian Wood, Chair, BHP Billiton Sustainable Communities, said: “BHP Billiton Sustainable Communities is delighted to have contributed US$10 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria.”

“This brings BHP Billiton’s commitment to Mozambique close to $30 million over five years.  In addition to the Global Fund contribution, we are supporting maternal and child health, improved access to clean water and sanitation, and sustainable livelihoods through the support of small scale farmers.”

BHP Billiton is a leading global resources company, and the major shareholder of Mozal Aluminium smelter in Boane, Mozambique.

Malaria is considered the most important public health challenge in Mozambique. Decreasing transmission of the mosquito-borne disease in Mozambique is an important goal for the country and its neighbors, as Mozambique is the only hyper endemic country in the region.

For more information please contact:

The Global Fund
Marcela Rojo

24 March 2014
Shawn Clackett

TB: Reach the 3 Million

Global Fund News Release: 24 March 2014

JOHANNESBURG, South Africa – The Global Fund is accelerating efforts to support countries implementing tuberculosis programs with the aim of reaching three million people that are not diagnosed, treated or documented in the fight against the disease every year.

Three million of the nine million people that get sick with TB do not get the care they need.

Many countries around the world are now strengthening their TB strategic plans and setting new targets to drive down the numbers of deaths and cases of TB, while identifying priorities, best use of domestic resources, and funding gaps for controlling TB.

The Global Fund has a new funding model that seeks to support countries in filling those gaps, by focusing on the needs of the most vulnerable people in settings with high rates of TB. Inclusive country dialogue and investing for impact are fundamental to the new funding model, and to finding the missed three million.

To mark World TB Day, Mark Dybul, Executive Director of the Global Fund, visited South Africa with Dr. Lucica Ditiu, Executive Secretary of the Stop TB Partnership, for a ministerial meeting of South African Development Community countries. The meeting – hosted by the South African deputy president and sponsored by the World Bank, Stop TB Partnership and The Global Fund – is working to harmonize the region’s response to tuberculosis infection amongst the mining community. This partnership has a focus on reducing the burden of TB amongst a population that accounts for about 30 percent of all infections in Southern Africa.

“Our partners are driving a more targeted approach, and we support efforts to accelerate in that direction,” said Dr. Dybul. “People in countries with these vulnerable populations who make up a big percentage of the missing cases can take advantage of the flexibility and agility of the new funding model to reach more people affected by TB.”

The World Health Organization and the Stop TB Partnership said that 75 percent of the three million cases are concentrated in 12 countries. The Global Fund is supporting projects in all 12 countries, but further work is needed within countries to target and speed up interventions to specific areas that account for gaps in diagnosis and treatment.

Countries implementing the new funding model can reprogram, prioritize and focus on this critical gap of the unreached to change the course of TB. The Global Fund has also set in place a regional initiatives mechanism to fight MDR-TB in the most efficient way. Dr. Ditiu said the new funding model will help countries to invest in interventions that will bear significant impact.

“With the new funding model, it is an opportune time for us – the TB community at large – to strategically invest funding on interventions that will have a significant impact, and make a difference to those suffering from TB and to ensure we reach people that are otherwise not reached,” said Dr. Ditiu.

“This is a significant partnership effort that requests that we really work together in a coordinated, transparent and supportive manner – country representatives, donors, communities, and people affected by TB, researchers, multilateral organizations,” she said.

23 March 2014
Shawn Clackett

Allocations Explained

Issue 40 – 20 March 2014 – Global Fund News Flash

The Global Fund launched full implementation of its new funding model this month, and at its core is a shift from a blanketing “one size fits all” approach to a more targeted approach, so that greater impact can be achieved globally and more people can actually be reached. Many countries that were informed on 12 March about their allocation amount for 2014-2016 are understandably now quite interested to know how those allocation amounts were determined. Many are asking: What was the allocation formula?

The Global Fund has prepared and published an explanation. It’s called “Overview of the Allocation Methodology” and it is pretty comprehensive and detailed. It can be found on the Global Fund website: http://www.theglobalfund.org/en/fundingmodel/allocationprocess/

The Global Fund’s overriding intent is to allocate funds to countries where the burden of HIV, TB and malaria is greatest, and where there is the least ability to pay. The two biggest factors in the allocation methodology, by far, are disease burden and national income level. After that, qualitative factors were taken into consideration, to account for special circumstances in each country due to past program performance, impact, increasing rates of infection, risk, absorptive capacity and other considerations.

The Global Fund is strongly encouraging every country to optimize the use of funding from all sources to see how they can best serve a country’s objectives. Country dialogue is the main vehicle to bring partners together to best decide how to maximize impact. In some countries, where allocation amounts are lower than was expected, there may be critical examination of existing grants, and discussion on how funds need to be shifted or grants reprogrammed. In some cases, there will be difficult choices. In some cases, reprogramming grants can improve support to work more effectively. Those who understand the situation on the ground in each country can decide best.

When the Board of the Global Fund made important decisions about the new funding model, Board members insisted that encouraging ambition be part of the picture, through incentive funding and other means. Some countries have asked how anyone can talk about ambition, when available funds are finite. Yet anyone who looks at HIV, TB and malaria on a global perspective can see that tremendous ambition and innovation and determination are needed to make the progress needed to defeat these diseases. Doing things the same way does not produce significant change. The response to these three diseases has to constantly evolve, to keep up with changes on the ground. To defeat these diseases, we all need to think creatively and aggressively. One tremendous lesson of the past decade is that, when working together, we may be able to achieve significantly more than seems possible today.

18 March 2014
Shawn Clackett

Gender Equality Central to Global Fund’s Next Steps

JAKARTA, Indonesia – The Global Fund is expanding action on gender equality and emphasising the importance of saving the lives of women and girls through increased high-impact, gender-responsive investments to tackle HIV, TB and malaria.

As it observes International Women’s Day, 8 March, the Global Fund cited the health needs of women and girls as a central part of gender equality work that is essential to have significant impact on responses to AIDS, tuberculosis and malaria.

Evidence clearly shows that gender inequalities make women and young girls more vulnerable to acquiring the diseases, and to access care and other services. The latter is particularly true for key affected women, including women living with the diseases and those who are sex workers, who use drugs and who are transgender.

Discussions on gender equality were highlighted at a Board Meeting of the Global Fund that concluded today. Board delegations were briefed on the new Action Plan of the Global Fund Gender Equality Strategy. Women and men from diverse communities in India, Indonesia, Malawi, Myanmar and Zimbabwe spoke of their experiences with the Global Fund and urged leaders to translate words into action.

Over 50 representatives from donor governments, technical agencies and affected women met to determine strategy on concrete steps toward gender equality and to target the world’s health investments towards the populations who need them most.

“We are making progress towards the defeat of these diseases, and greater involvement of women will be key,” said Dr. Nafsiah Mboi, Chair of the Board of the Global Fund and a long-standing gender advocate. “This is an important challenge for all of us. It will require a collective effort from all our partners.”

Women and girls are disproportionately affected by HIV. Gender inequalities increase vulnerability to HIV through violence, including rape. So do unequal power dynamics between women and men, and unequal access to education and economic opportunity. These factors make HIV rates especially high among girls and young women in many countries.

TB is a leading infectious cause of death among women in low and middle-income countries, and can impact fertility as well as create major care and treatment challenges for women and girls. Most malaria cases strike children under five and pregnant women are also particularly vulnerable, because their immunity to the disease is diminished by pregnancy.

In many societies, women do not enjoy the same rights, opportunities and access to services as men. The Global Fund is committed to ensuring its grants support equal and equitable access to prevention, treatment, care and support for all those who need it most, including women and girls in all their diversity. Women’s rights are human rights, making gender equality a cross-cutting concern for all of the Global Fund.

“We have to do more on gender equality,” said Mark Dybul, Executive Director of the Global Fund. “There are many aspects to this work, and one of them is putting women and girls at the center of our health interventions.”

The Global Fund encourages frank, open discussion about gender equality, gender-based violence and sexual and reproductive health rights wherever appropriate. Its new funding model opens a number of opportunities and entry points for strengthened gender equality and for engagement of women affected by the diseases to ensure they are fully involved in dialogues and delivering programs.

Ms Wendy McCarthy AO, Chair of Pacific Friends of the Global Fund

Ms Wendy McCarthy AO, Chair of the Pacific Friends of the Global Fund responds:

It was very pleasing to attend the recent Global Fund meeting and observe that the workshop on gender was oversubscribed. There is a sense that gender has to be center frame and it was wonderful to see the role modelling offered without comment when the Chair and Vice Chair of the Global Fund are female.

Women and girls are disproportionately affected by HIV and their world unravels very quickly. Gender inequalities increase vulnerability to HIV through violence, including rape. So do unequal power dynamics between women and men, and unequal access to education and economic opportunity. These factors make HIV rates especially high among girls and young women in many countries.

At this meeting there was a concerted effort to change these dynamics.

Pacific Friends operates under the auspices of the University of New South Wales Foundation.

Pacific Friends

Wendy McCarthy AO
Bill Bowtell AO
Executive Director

Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.



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