11 February 2014
Shawn Clackett

Rwanda Pilots Innovative Financing Mechanism

Global Fund News Release

Dr. Agnes Binagwaho, Minister of Health of Rwanda

Dr. Agnes Binagwaho, Minister of Health of Rwanda

KIGALI, Rwanda – The Government of Rwanda and the Global Fund are taking the lead on an innovative approach to health financing that is expected to significantly contribute to improving the efficiency of the fight against HIV in Rwanda and achieve greater impact.

A new grant agreement signed today will be used to implement Rwanda’s national strategic plan for HIV (2013-2018) with sharply reduced oversight. Rwanda and the Global Fund designed this new approach that is aligned with existing national systems and strategy, ties future disbursements directly to outcome and impact indicators, and lessens administrative burden and cost, in a framework of harmonization and mutual accountability.

It is the first time that the Global Fund is using this approach, and Rwanda has been chosen to pioneer this innovative model, because of its track record of success in health program and financial management.

Rwanda has emerged as a special success story for global health, having built a health care system, by coordinating development partners around one national plan, to give all citizens access to quality care. It has made tremendous gains against HIV and AIDS, and has already achieved a more than 50 percent reduction in HIV incidence rate among the adult population since 2000. If the current trends continue, Rwanda will go beyond the Millennium Development Goal target. As His Excellency President Paul Kagame said “MDGs are a ceiling not an end.”

Under the terms of the agreement signed here today, Rwanda and the Global Fund agreed that future disbursements will be directly tied to achievement of key outcome and impact indicators. This new flexible, Performance Based system emphasizes mutual accountability and greater country ownership of the national response.

“This is a great approach,” said Dr. Agnes Binagwaho, Minister of Health of Rwanda, adding that it is testimony to the achievements Rwanda has made in managing grant funding, and the partnership we enjoy with the Global Fund. We are confident that we will sustain the universal access to treatment and care, reduce new infections by two-thirds, and halve the number of AIDS deaths in the next five years.

The agreement, which includes funding of US$204 million, gives more flexibility on how funds are spent, and allows for savings to be re-invested in the national response. Grant funds will be part of a joint investment framework with financial assistance from the Government of Rwanda and other development partners.

Under the agreement, Rwanda will continue to monitor the achievement of universal access to HIV treatment and care for people living with HIV, and the reduction of new infections for key affected populations. The Global Fund will jointly verify the results with Rwanda.

 “The main idea of this approach is to empower high-performing countries like Rwanda to further invest for higher impact,” said Dr. Nafsiah Mboi, Chair of the Board of the Global Fund. “They have proved this is possible, building on an outstanding HIV program, a robust HIV and AIDS national strategic plan, and strong financial and monitoring systems. We are proud to be their partners, and admire their accomplishments.”

The Global Fund will be looking into extending the approach to other countries, and also consider it for tuberculosis and malaria grants.

5 February 2014
Shawn Clackett

Susan Desmond-Hellmann Named Chief Executive Officer of the Bill & Melinda Gates Foundation

susan desmond-hellmann

SEATTLE — The Bill & Melinda Gates Foundation has selected Susan Desmond-Hellmann, M.D., M.P.H., as its next chief executive officer. Currently the chancellor of the University of California, San Francisco (UCSF), Desmond-Hellmann will assume her role on May 1, 2014.

“We chose Sue because of her scientific knowledge and deep technical expertise on the foundation’s issues, as well as the organizational and leadership skills required to lead a large, growing and dynamic global organization. Sue shares our commitment and passion to create a more equitable world,” said Melinda Gates, co-chair of the foundation.

“I am honored by the opportunity that Bill and Melinda have extended to me. I’m excited to join such a dynamic and ambitious organization, with such a clear and focused mission—improving the lives of the world’s most vulnerable,” said Desmond-Hellmann.

“Sue’s background in public health policy, research and development, and higher education, make her an exceptional fit for this role. She impressed us as an innovator and an outstanding leader and manager,” said Bill Gates, co-chair of the foundation.

An oncologist by training, Desmond-Hellmann is a recognized leader on issues of higher education, public health, drug development, regulatory innovation and health policy. She has led UCSF since August 2009, when she became the first woman to serve as the university’s chancellor, overseeing all aspects of the university and medical center’s strategy, academic programs and operations. She has extensive experience in product development, and a deep understanding of how to bridge applied research to delivery of product. Prior to her tenure at UCSF, she was President of Product Development at Genentech, where she led the development and introduction of two of the first gene-targeted therapies for cancer, Avastin and Herceptin.

Desmond-Hellmann also served as a member of Genentech’s executive committee, beginning in 1996. She sits on the boards of directors of Procter and Gamble and Facebook, and was previously a member of the Federal Reserve Bank of San Francisco’s Economic Advisory Council.

Desmond-Hellmann will take over from Jeff Raikes, who announced his retirement from the foundation in September 2013 after five years at the helm. He was the foundation’s second CEO, and served after a long and successful career as a senior executive at Microsoft.

4 February 2014
Shawn Clackett

Global Fund Sees End to Paternalism

Global Fund News Release

ICASA Conference

CAPE TOWN, South Africa –Mark Dybul, Executive Director of the Global Fund, said the paternalism overshadowing relations between rich countries and poor in global health is giving way to an era of partnership that owes much to the vision of Nelson Mandela.

In a closing speech at the 17th International Conference on AIDS and sexually transmitted diseases in Africa (ICASA), Dr. Dybul paid a rousing tribute to the late South African leader, saying Mandela “broke the silence on HIV in Africa and he broke the silence on HIV in the world.”

“This week, let us finally end the paternalism in the world,” said Dr. Dybul.

Instead, he urged everyone to embrace Mandela’s vision for a world where every human being was a master of his or her destiny. A meeting of the International AIDS Society in Durban in 2000, which Mandela addressed, was widely seen as a turning point in the fight for wide access to treatment for HIV and opened the way to the creation of the Global Fund two years later.

The theme of the ICASA conference in Cape Town was entitled “Now More Than Ever: Targeting Zero,” underscoring a mood of growing optimism that the HIV pandemic can be turned into a low-level endemic that no longer poses a public health risk.

Dr. Dybul also called for the next ICASA meeting to add tuberculosis — the leading cause of death among those with HIV — to its name so that the disease “receives the emphasis it deserves.”

“HIV and TB are like two evil twins and we have the power and the responsibility to release them and we have the power and the responsibility to defeat them,” he said.

The time was long gone for “people from somewhere else” to tell countries in Africa how to tackle the AIDS, tuberculosis and malaria. “Your results have shattered the paternalistic myths of what should and can be done,” Dr. Dybul said.

Earlier in the day, Edwin Cameron, who serves as a justice on South Africa’s constitutional court, said stigma was one of the biggest obstacles to defeating the HIV pandemic.

“Stigma remains the most intractably resistant force in the epidemic,” Justice Cameron said. “It spreads blame, fear, inhibition, inaction and silence.”

Justice Cameron, who became the first senior official in South Africa to state in public that he was living with HIV,  said men who have sex with men were shamefully treated in Africa: “Thirty-eight countries in Africa still persecute those who, like me, are oriented towards our same sex.”

The chair of the ICASA conference, Robert Soudré, said African countries could not continue to rely indefinitely on external support for HIV treatment.

“More than 80 percent of medicines are financed from external sources and that cannot continue,” said Soudré. “Our countries will have to make available their own resources and governments will have to rely above all on themselves.”

He added: “Zero stigma is what we should aim to achieve everywhere in the world, but also on our African continent.”

Dr. Dybul said although there was no single “silver bullet” that could end the HIV pandemic it was essential to deal with strongholds of infection among young women and girls; men who have sex with men; sex workers; people who inject drugs and prisoners.

“If we are going to address this epidemic we must deal with the strongholds. We must have our tools available for the most vulnerable and that means creating an inclusive human family,” he said.

“Let’s end silver bullet approaches to this epidemic and let’s just end the epidemic.”

3 February 2014
Shawn Clackett

IFRC and Global Fund Target Tuberculosis Treatment for All in Niger

Global Fund News Release

IFRC and Global Fund Target Tuberculosis Treatment for All in Niger

31 January 2014

Geneva – The International Federation of Red Cross and Red Crescent Societies (IFRC) and the Global Fund to Fight AIDS, Tuberculosis and Malaria have signed a grant agreement to fund universal treatment for tuberculosis (TB) in Niger, a country with one of the worst rates of TB in West Africa.

A new two-year Global Fund grant of 10 million euros will allow the population of Niger, estimated at around 17 million, to access quality TB diagnosis and treatment services. The grant will expand and enhance TB services for more than 26,000 people in 200 treatment centres by 2015, targeting vulnerable populations, including those in nomadic communities, migrant groups and prisons.

TB is a major global health concern, killing 1.3 million people every year and infecting a further 8.6 million, despite being an entirely preventable and curable disease. In Niger, while overall numbers of people with TB have fallen in recent years, incidence of the disease is still high. The vast majority of TB cases can be easily cured when medicines are provided and taken as prescribed.

 “Access to sustainable diagnosis and treatment services is a burning priority in a country like Niger, where a lack of predictable funding, sustained technical support and health care workers have seriously undermined the government’s capacity to regularly provide quality TB services and distribute drugs” says Bekele Geleta, Secretary General, IFRC. “With support from the Global Fund, we will be able to ensure access to treatment for people living in the most underprivileged areas, especially those facing discrimination and living on the margins of society.”

In Niger, despite a high degree of political commitment and local ownership of the TB response, the disease is putting a heavy strain on an already overburdened health system. Treatment can take up to six months and requires extensive supervision and patient support by a health worker or trained volunteer. Without this, treatment adherence can be difficult and the disease can spread further.

“This grant will support and strengthen existing in-country capacities, working closely with the National Tuberculosis Program of the Ministry of Health” said Mark Dybul, Executive Director of the Global Fund. “The IFRC is an excellent partner combining a unique community perspective and experience that will accelerate scale-up of TB interventions and provide faster screening of at-risk populations.”

In Niger, only 46 per cent of people with TB are ever tested for HIV. HIV and TB form a lethal combination, each speeding the other’s progress. Someone who is infected with HIV and TB is much more likely to become sick with active TB. The grant will ensure that all TB patients will access HIV testing and early treatment services.

“We believe that no one should be left behind in the fight against TB” said Geleta. “Equitable access to quality diagnosis and treatment services, combined with skilled community volunteers – is the winning formula to accelerate progress towards zero TB deaths, infections and suffering.”

31 January 2014
Shawn Clackett

Persevering in Central African Republic

Global Fund News Flash: Issue 36

One morning this week, an aid worker saw scores of Muslim refugees climb into 30 trucks in a town in the southwestern corner of the Central African Republic. Fleeing violence, they were headed to the border with Cameroon. Many ultimately want to get to ancestral homes in neighboring Chad, even though their families have lived in the Central African Republic for generations. This evacuation was just one episode in an unfolding humanitarian crisis characterized by fighting between Muslims and Christians in recent months. Nearly one million people, roughly one-fifth of the population, have left their homes. Refugees now huddle in sprawling settlement camps in the capital, Bangui. One camp, by the airport, already has more than 100,000 people. Interim President Michel Djotodia left the country, and this week lawmakers chose Catherine Samba-Panza, the Mayor of Bangui, as the next interim President, the first woman to serve in this role.

Social and political upheaval always poses an extra challenge for health programs. But the diseases do not follow political developments. A relatively weak health system in Central African Republic has been further strained by the humanitarian crisis, with the mass dislocation and with the ransacking of health facilities in some areas. Yet the Global Fund is continuing to work hard with partners to fight a serious malaria epidemic, and continuing efforts on HIV and tuberculosis. “We are determined to keep fully engaged in the Central African Republic with our partners at a time when violent upheaval is putting many vulnerable people at increased risk,” said Lelio Marmora, Head of the Africa and the Middle East Department at the Global Fund. The Central African Republic faces many health challenges, with estimates that 16 percent of children die before the age of five. Malaria is a big killer. The Global Fund is currently working on a project with the International Federation of Red Cross and Red Crescent Societies (IFRC) to enable distribution of more than 2.3 million mosquito nets. The Global Fund is also part of efforts to keep testing and antiretroviral therapy for HIV on track, and keep supplies of anti-TB drugs coming. Before the country’s descent into chaos, more than 16,000 people were receiving antiretroviral treatment with the support of the Global Fund. “We are able to deliver drugs to the central warehouse at Bangui airport, but we are struggling to get HIV and TB treatment to the health facilities,” said Corina Maxim, a Program Officer at the Global Fund. “We don’t know what is getting through because of the disruption and all the people who have hidden in the bush.” The efforts will continue.

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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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