Social Movements

1
Social Movements the Fight for Resources for
HIV/AIDS Treatment

• Sharonann Lynch, Health GAP ACT UP
• International Treatment Preparedness Summit
• Cape Town, South Africa
• March 13, 2003

2
Purpose

• Identify sources of funding for
• Scaling up sustainable and affordable treatment
• Technical assistance
• Capacity-building
• Treatment education
• Other local needs

3
Potential Sources of Funding

• World Bank
• Global Fund to Fight AIDS, Tuberculosis and
  Malaria (GFATM)
• U.S. Agency for International Development (USAID)
• United Nations Development Program (UNDP)
• Catholic Medical Mission Board
• World Health Organization (WHO)
• Tides Foundation
• Irene Diamond Foundation (not attending)
• Levi-Strauss Foundation (not attending)

4
World BankMulti-country HIV/AIDS Program (MAP)

• Total worldwide commitments 2 billion (credits
  and grants)
• 612 million approved in support of national
  HIV/AIDS programs in 18 sub-Saharan African
  countries 70 million disbursed
• Additional programs under preparation in 11
  countries (Eastern Europe, Latin America, and the
  Caribbean)
• Policy on purchases of drugs lowest cost quality
  drugs, including generics
• Special Africa-wide Treatment Acceleration
  Program to link PLWHAs/NGOs with public and
  private sector programs to strengthen outreach,
  care, and treatment

5
Global Fund to Fight AIDS, TB, and Malaria

• New mechanism to attract, manage, and disburse
  additional resources through a public-private
  partnership
• Governed by a board composed of an equal number
  of donor and recipient countries.
• Includes affected communities in decision making
  processes.
• Bases disbursements on a demand-driven model
  where country-level grant applications are
  created submitted by Country Coordinating
  Mechanisms (CCMs)
• CCMs should include broad representation from
  governments, NGOs, people living with the
  diseases, civil society, multi-lateral, bilateral
  agencies and the private sector. (Source GFATM
  Framework document)

6
History of the Global FundThe 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

7
The Global AIDS Communitys Expectations of the
Global Fund

• Delivering a rapid scale-up of comprehensive
  prevention, care, and treatment programs
• Redressing the historic under-funding of AIDS
  treatment
• Producing meaningful and demonstrable results to
  overcome donors resistance to funding AIDS
  treatment
• 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

8
The Reality Where Are We Now?

• Approved grants to 164 programs (AIDS, TB, and
  malaria) in 85 countries, mostly in Africa
• Facing budget shortfall of 1.4 billion for 2003
  to meet anticipated needs of Round 3 proposals.
• Lack of credible large-scale treatment proposals
  including ARV therapy

9
ARV TherapyNEED versus COVERAGE

• NEED
  
• 6-9 million people in developing countries
  clinically require ARV therapy now (Source WHO)

• COVERAGE
• 230,000-300,000 have access
• 115,000 in Brazil
• By 2008 as a result of GFATM grants
• Projected number of people to receive ARV
  therapy 491,906

10
GFATM ARV Coverage by Region
11
Cycle of Mediocrity
12
Breaking the Cycle

• Ensure transparent participatory CCM operations
• Expand NGO membership on CCMs
• Institutionalize CCM as in-country experts
• Ensure technical assistance for CCMs
• Submit ambitious multi-year proposals including
  ARV therapy to GFATM
• Address costs of building up infrastructure in
  the first year of proposals (frontloading)
• Demand strong leadership from the GFATM
• Win massive, adequate, and sustained funding from
  donor countries

13
Building a Social Movement at the ITP Summit to
Fight for Treatment

• Exchange information
• Sources of technical assistance
• Needs for scale-up and treatment education
• Experiences interacting w/ GFATM CCMs
• Build strategies plans of action
• Inserting treatment access activists in CCMs
• Advocating designing substantial treatment
  proposals for this round and next
• Convincing advocates officials to AIM HIGH!!

14
Turning the Tide

• UNDER OUR CONTROLIts up to us
• Will we let the GFATM wither on the vine?
• Will we take back the GFATM and demand it not
  betray the hopes of PWAs?