8 March, 2012
In this issue of the ICEM HIV/AIDS newsletter, we report on the ICEM HIV/AIDS regional workshop in Johannesburg, developments at the Global Fund to Fight AIDS, Tuberculosis and Malaria and on the severe consequences arising from the funding crisis.
Regional HIV and AIDS Workshop in Johannesburg
A very successful sub-Saharan Africa regional workshop was organised in Johannesburg from 14-16 February. With the active participation of national coordinators from ten countries, a review of activities in 2010 and 2011, the first two years of the present three-year project cycle, was conducted. Participants also presented country plans for 2012, the last year of the current project.
Key challenges and opportunities for the future and creative methods of addressing HIV and AIDS in the current social and economic environment were elaborated. In further group work, key elements for a possible new project cycle for 2013-2015 were developed. The outcome of this work were power point presentations from three groups which constitute valuable input for a possible new project.
Evelyn Serima, HIV/AIDS Technical Specialist in the Decent Work Team for East and Southern Africa at the ILO Pretoria office, gave a presentation on progress in the implementation of ILO Recommendation 200 concerning HIV and AIDS and the World of Work and on new targets for 2015, especially the UNAIDS triple zero initiative – zero new infections, zero death and zero discrimination. Her presentation was highly relevant for the work on a project beyond 2012.
The Global Fund at Ten Years – Not a Happy Anniversary
At the end of January, the Global Fund celebrated its tenth anniversary. These past 12 months, which ended with the Board persuading the Executive Director to resign, have been the Fund’s most difficult to date.
The stage was set for the Global Fund’s problem-filled 2011 when the Fund said in October 2010 that it needed well over US$13 billion to meet anticipated demand for 2011–2013 but donors pledged only US$11.7 billion.
Then on 23 January 2011, the Associated Press published an article entitled "Fraud Plagues Global Health Fund," based on public reports from the Office of the Inspector General (OIG). The story took off like wildfire. Alarmed, some of the Global Fund’s donors held back on delivering their promised contributions pending clear action by the Fund to deal with fraud.
The OIG’s findings on fraud were obviously important and required action. But the OIG made little distinction between outright fraud and multiple lesser crimes such as documenting expenditures using photocopies rather than originals.
The Fund set up a High Level Panel to review how the Fund identifies and manages risk in its grant-making. The panel issued a report in September that was daunting in terms of the number of things it said need fixing.
The downhill trajectory continued when the Global Fund, having launched Round 11 in August 2011, cancelled it three months later because of inadequate funding.
Then came a final nose-dive when the Global Fund Board, after reviewing the events of the past year and conducting an in-depth assessment of the managerial performance of Michel Kazatchkine, the Fund’s Executive Director (ED), concluded that Dr Kazatchkine had to go. He resigned on 24 January 2012 after the Board had appointed a General Manager to whom all top management would report.
The Global Fund performs vital work affecting millions of lives. The Fund cannot afford to have a second year like 2011, and might be permanently damaged if so.
(Source: Global Fund Observer, Issue 175 of 6 February. GFO is a free service of Aidspan www.aidspan.org; to receive GFO send an email to [email protected])
Delayed Disbursements of Grants Threatens South Africa’s TAC
The Treatment Action Campaign (TAC), a sub-recipient (SR) for a Round 6 HIV grant in South Africa, has experienced significant delays in receiving disbursements. TAC says that because of these delays, the organisation is perilously close to having to shut its doors. TAC is known world-wide for its pioneering advocacy work in South Africa on HIV treatment.
The South Africa National Department of Health (NDOH) is the principal recipient for the HIV grant. Under its contract with the NDOH, TAC was due to receive 6.5 million rand (US$833,000) by the start of July 2011 to cover expenses between then and the end of 2011.
TAC has still not received any of this funding. On 1 January 2012, TAC was due to receive a further disbursement of 2.7 million rand (US$346,000) to cover expenses for January to March 2012. That funding has also not yet been received, increasing the shortfall to 9.2 million rand (US$1.2 million).
On 23 November 2011, TAC issued a statement in which it said that the organisation faced possible closure because of the lack of funds. The statement said that TAC depended on the Global Fund grant for a large portion of its work. It added that the delays were primarily due to poor administration by the NDOH.
(Source: Global Fund Observer, Issue 176 of 20 February)
Zimbabwe: Improved AIDS Levy Collections
With global funding for HIV/AIDS on the decline, Zimbabwe's innovative AIDS levy – a three percent tax on income – has become a promising source of funding for the country, with a dramatic increase in revenue collected in the past two years.
The levy was introduced in 1999 to compensate for declining donor support, but low salaries and the poor performance of industry meant not enough money had been collected until recently. In its 2010 report on Zimbabwe's progress in implementing the Declaration of Commitment on HIV/AIDS, adopted by the UN General Assembly in 2001, the government admitted the levy was "essentially non-existent in 2007-2008 due to economic challenges the country was facing."
According to the National AIDS Council Board, a total of US$20.5 million was collected in 2010 against US$5.7 million the previous year; non-audited figures for 2011 suggest a collection of US$25 million.
Although 347,000 people are on antiretroviral (ARV) treatment in the country, another 600,000 need the medication. The treatment gap widened after Zimbabwe adopted the new World Health Organization (WHO) guidelines that recommend starting treatment earlier.
The AIDS levy contributed almost a quarter of the money to purchase ARVs, while 76% of the treatment programme was financed by international donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the UK Department for International Development. But Zimbabwe – one of the hardest countries hit by HIV/AIDS – still needs a lot more funding to cover the worrying treatment gap.
(Source: IRIN, Harare, 3 February)
South Africa to Produce Active Ingredients for ARVs
South Africa is to build a ZAR 1.6 billion (US$ million) pharmaceutical plant to produce the ingredients for antiretroviral drugs. The plant is a joint venture between the government and Lonza, a Swiss chemicals and biotechnology company.
So far, most antiretroviral drugs used in South Africa are manufactured locally but all the active ingredients used in them are imported. South Africa is the world’s largest market for antiretroviral drugs. Pharmaceutical imports are one of the most important contributors to the country’s trade deficit.
(Source: Business Day, Johannesburg 10 February)
DR Congo: Alarm Bells over Poor Funding
The lives of thousands of HIV-positive people in the Democratic Republic of Congo (DRC) are at risk as the country faces declining donor funding and a severe shortage of treatment, according to Médecins sans Frontières (MSF).
More than one million people are living with HIV and of the 350,000 people who qualify for antiretroviral treatment, only 44,.000 – 13% – receive it. Seventy-five percent of funding in the DRC comes from the Global Fund, 25% from UNITAID and from PEPFAR, the US President’s Emergency Plan for AIDS Relief. Earlier World Bank funding ended in 2011.
As the DRC did not qualify for funding under the 9th and 10th round of Global Fund grants, it is using funds from previous rounds which will last at the most to 2014, not counting up-scaling. UNITAID funds through the Clinton Health Access Initiative are for paediatric and second-line ARVs and PEPFAR provides funds for the prevention of mother-to-child transmission.
(Source: IRIN, Nairobi/Kinshasa, 2 February)
News from Global Unions
The International Transport Workers’ Federation (ITF – www.itfglobal.org), in its latest HIV/AIDS update 119 of 1 and 15 February, reports on the signing of a policy on HIV and AIDS of the Confederation of Railway Workers of Bolivia with two railway companies. It also draws attention of affiliates to the process of reviewing ILO Recommendation 200 concerning HIV and AIDS and the World of Work, and the importance of trade unions getting involved in this process of monitoring the implementation of Recommendation 200.
Five Years Ago: From the March 2007 Issue (No. 18)
The first issue of the ICEM HIV/AIDS e-bulletin was published in October 2005. In current issues, we refer to an article from the same month five years ago and reflect on developments.
In the March 2007 issue, we reported on the signing of a Global Framework Agreement (GFA) with the Swedish paper multinational Svenska Cellulosa Aktiebolaget (SCA), which included an HIV/AIDS clause. The company agreed to comply with the ILO Code of Practice on HIV/AIDS and the world of work.
We pointed out the importance of such a clause for affiliates. If a company agrees to comply with the ILO Code of Practice on HIV/AIDS and the World of Work, this opens a whole range of possibilities for negotiations and activities for the unions organising inside a GFA company. The ten key principles of the Code of Practice include non-discrimination, gender equality, confidentiality, prevention, care and support. A GFA applies to all operations of a company worldwide. Often, local management is not familiar with a GFA signed by their head office. Insist on implementation and compliance!
Regrettably, only a minority of ICEM GFAs include an HIV/AIDS clause.
We also reported on the appointment of a new Executive Director at the Global Fund, Michel Kazatchkine. He resigned recently (see e-bulletin February 2012, No. 77).