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Archive for "Partnership"



Funding &Partnership Bill Brieger | 12 Aug 2009

Global Fund – Donors Needed

Reuters reports that the Global Fund has been seeking a wider donor base. Looking toward the wider G20 membership, “Michel Kazatchkine, executive director of the Global Fund to fight HIV/AIDS, TB and Malaria (GFATM), said in an interview that nations such as China, Mexico, Brazil and South Africa may now be in a position to offer a hand to poorer countries that need help.”

gfatm-pledges.JPGThe search for more funding is spurred not only by the economic problems facing the core G8 donors, but by the fact that the other G20 members themselves have larger economies now and should share in supporting global efforts to curb these diseases. With the Global Fund facing a US$ 3-4 billion shortfall, involving more donor partners is essential.

The chart at the left shows country donors to the Global Fund and is derived from GFATM data available on their website.  One can see that the G8 makes up the bulk of pledges (77%) and payments (76%) at present.  The European Union itself, plus 15 other non-G8 members provide 20% of pledges and 21% of payments since inception.

Only seven of eleven G20 members who are neither G8 and EU were mentioned by name (Australia, Brazil, China, India, Republic of Korea, Mexico, Saudi Arabia), and that group pledged and contributed only about one percent of the total country donations to the GFATM since inception.  The remaining four G20 members may have contributed and their amounts were grouped under ‘other’.

Kazatchkine observed that G20 members are taking on a greater international political role, and believes they should also take on greater health and development roles.  He explained that, “I really think it is time for the G20, which is 85 percent of the world’s economy, to come into the circle of donors. The Global Fund has to expand. China is an obvious example, I know South Korea is quite prepared to come in as a donor.”

Kazatchkine reminds us that HIV, malaria and TB are not in recession, so the G20 countries, many of whom are endemic for the three diseases, should not let economics be an excuse for shirking their expected contributions toward controlling these diseases.

Community &Coordination &Partnership Bill Brieger | 07 Aug 2009

Getting ready for World Pneumonia Day

Pneumonia, diarrhoeal diseases and malaria are the biggest killers of children in the tropics. Malaria is the recipient of major funding efforts from the World Bank, the Global Fund, US President’s Malaria Initiative, DfID, Unicef plus many other bilateral, corporate and NGO donors.  Efforts to place a spotlight on diarrhoeal diseases and prevent mortality using oral rehydration in the 1980s and ’90s never really took off.  Pneumonia likewise has been a neglected disease.

wpnd.pngThe fate of pneumonia may change this year. One reports that during this year’s “World Health Day, a group of organizations and activists launched an effort to encourage the United Nations to declare November 2nd as World Pneumonia Day. Pneumonia which is the leading killer of children around the world taking upwards of 2 million lives of children under 5 every year is rarely discussed in the media as a childhood killer and is often thought of only as a disease of the elderly.”

GAVI observes that, “Pneumonia has been overshadowed as a priority on the global health agenda, and rarely receives coverage in news media. World Pneumonia Day will help bring this health crisis to the public’s attention and will encourage policy makers and grass roots organizers alike to combat the disease.”

Likewise Save the Children says, “We’re thrilled that so many people and organizations want to join forces for World Pneumonia Day to reduce the impact of the largest killer of children. Through our efforts, we expect to change the lives of millions of young children and parents by making childhood pneumonia deaths a part of history.”

Attention to Pneumonia does not detract from efforts to control malaria.  In fact the attached maps from the Malaria Atlas Project (MAP) and pneumoADIP show that the two diseases share common ground in the tropics. What is needed is an integrated at the community and household level that empowers local people to prevent and control childhood diseases through such actions as prompt and appropriate home management, hand washing, bednet use and vaccination.

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Coordination at the local level is the key to success. District health systems must be strengthened for us to realize the full potential that communities have to deliver the goods for child survival.

Funding &Partnership Bill Brieger | 18 May 2009

Flying against malaria – more partners in the fight (and flight)

When it comes to malaria, mosquitoes are not the only things flying.  British Airways announced recently in Lagos that some of the funds earned for UNICEF for the ‘Change for Good’ program will be used to provide ITNs in Nigeria.

Africa News reported that, “According to Andrew Crawley, the Airline’s Director of sales in Nigeria in a visit to health centers in Lagos during the World Malaria day says ‘We have made this commitment to support help reduce the suffering of people plagued by this ailment’ Speaking on BA’s collaboration with UNICEF, Crawley says ‘On behalf of everyone at the British Airways, I would like to thank all our customers who have donated their spare currency to the Change for Good program. Without them the funding of this program would not have been possible’ says BA sales director.”

Change for Good has been operating for around 15 years and has raised over 26million pounds for UNICEF projects in 60 countries.  “The Airline donated mosquito nets to remote villages in Lagos, where the breeding of mosquitoes is provoked by poor environment.”

Other airlines have been flying against malaria for several years to support UNITAID. The work of UNITAID has focused largely around affordable drugs for malaria.  Partner countries and airlines are many as seen below.

UNITAID receives its funds through airline ticket taxes or regular budget contributions. Countries implementing the airline tax as of the end of 2008 include Chile, Côte d’Ivoire, Democratic Republic of Congo, France, Madagascar, Mauritius, Niger and the Republic of Korea. Norway allocates part of its tax on carbon dioxide emissions from air travel to UNITAID. Jordan joined UNITAID in late 2008 and declared its intention of introducing the air tax. In addition, two African countries – Kenya and Burkina-Faso – pledged their intention of introducing the air tax in the near future to support UNITAID.

More innovative funding and awareness mechanisms are needed to reach our targets

ITNs &Partnership Bill Brieger | 15 May 2009

Marching toward 2010 Malaria Targets in Mali

Malaria-related headlines have focused on Rwanda, Ethiopia and Zanzibar where it has been possible to work in a relatively focused area to bring about large malaria program impacts.  Efforts in Mali have slipped under the radar according to Claudia Vondrasek, The VOICES field operations coordinator based in Bamako.  Claudia shares results from a Mali national survey conducted by HealthBridge Canada in Aug 2008 that have now become available.  Net progress is substantial.

  • 81.1% of households with at least 1 ITN
  • 78.5%  children under 5 years of age slept under a net the night before
  • 96.3% of children under 6 years of age slept under a net in households with at least 1 ITN
  • 73.9% of pregnant women slept under a net the night before

mali-nets-sm.jpgTwo important trends to mention – Not only are we closing the gap in Mali to achieve 2010 LLIN targets (80% use nationally) in Mali, it looks like many countries are making great strides on their way to reaching those targets in recent years. This is mainly due to a sustained commitment by the international partnership to support National Malaria Control Programs to achieve 2010 RBM targets of 80% coverage of key interventions.

The other less heartening trend is the lag time being recorded between grant approval, signature and Phase 1 disbursement.  Many suspect this is a function of evaporating resources available for GF grants.

Progress in Mali has been building for the past two years.  The US President’s Malaria Initiative has played a key role in “a unique public-private partnership with the American Red Cross, the International Federation of Red Cross and Red Crescent Societies, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and others, the President’s Malaria Initiative (PMI), through USAID, provided $1 million for the purchase of 169,800 long-lasting insecticide-treated mosquito nets (LLINs) as part of a national child survival campaign in Mali conducted in December 2007.”

There is even more to this partnership. Other key members “include ExxonMobil, the Measles Initiative (The United Nations Foundation, WHO, UNICEF, the U.S. Centers for Disease Control and Prevention, … the Canadian Red Cross/Red Crescent Societies, Malaria No More, Nothing But Nets, Major League Soccer (MLS), the Women’s National Basketball Association (WNBA), Malian government agencies, numerous local nongovernmental and faith-based organizations, … Assistance Technique Nationale Santé/USAID, the Mali Red Cross, … Helen Keller International, the Ministry of Social Development, Solidarity and the Elderly, the National Federation of Community Health Associations, Population Services International, the Network of Traditional Communicators, and journalists from local media.”

It is important to note that partner efforts went beyond the campaign in 2007, and continued to encourage people to USE the nets that they had received.  Partners must continue their efforts toward the universal coverage targets and the reduction of malaria morbidity and mortality envisioned in the Millennium Development Goals for 2015.

Funding &Partnership Bill Brieger | 04 Apr 2009

Who funds the Fund?

Qatar’s daily, The Peninsula, reports that, “The Minister of Public Health H E Dr Sheikha Ghalia bint Mohammed Al Thani yesterday received a delegation from the Global Fund for Fighting Malaria, chaired by Princess Astrid.” The Minister expressed appreciation of the efforts of the Global Fund in fighting malaria. The delegation in turn urged Qatar to become a contributor to the Global Fund.

To date just over $13 billion has actually been contributed to the Global Fund, although over $19 billion has been pledged. 95% of this comes from countries, while the remaining comes from private or other sources (most notably the Gates Foundation at $450 million).  Among country donors, few of those sometimes termed middle income countries like Qatar have contributed.  For example, Saudi Arabia has actually given $19 million so far, South Africa has contributed $8 million, China has provided $12 million and India has given $3 million.

gfatm.bmpDelegates representing 28 donor countries and foundations just concluded a meeting in Spain to assess the Global Fund’s resource needs. The discussed “The question of how to fill an estimated funding gap of at least US$ 4 billion urgently needs to be addressed as the Global Fund’s Board will be approving a ninth round of proposals from recipient countries in November this year.”

The Global Fund’s Executive Director called on the G20 countries to step up efforts to support the Fund. Delegates “also called on the Global Fund to step up efforts to seek new government donors and attract more private sector contributions. Delegates from South Korea attended for the first time.” The visit to Qatar is in line with this stepped-up approach.

The G20 Summit did offer some hope along these lines toward the end of their lengthy statement:

We reaffirm our historic commitment to meeting the Millennium Development Goals and to achieving our respective ODA [Overseas Development Agencies] pledges, including commitments on Aid for Trade, debt relief, and the Gleneagles commitments, especially to sub-Saharan Africa.

We fully expect that the global economy will benefit when large portions of the world’s population no longer suffer loss of life and productivity from diseases like malaria.  It is in everyone’s interest to contribute.

Leadership &Partnership Bill Brieger | 12 Dec 2008

A job with a difference

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WHO is recruiting for the position of Director Global Malaria Programme (GMP). The Director is expected 1) to provide strategic and technical direction, 2) to undertake resource mobilization and management and 3) to facilitate Partnerships and Coordination.

Overall the GMP “is responsible for malaria surveillance, monitoring and evaluation, policy and strategy formulation, technical assistance, and coordination of WHO’s global efforts to fight malaria.” While WHO and its GMP are among the partners in the Roll Back Malaria partnership, some partners might be perceived as more equal than others – in part because WHO sees itself as “the foremost global authority on health.”

The GMP is a major source of the latest technical knowledge on all aspects of malaria ranging from case management to insecticides.  The position of Director is such a group certainly demands wide ranging technical expertise, but even more, it requires skills in leadership.  Since malaria control, elimination and eventual eradication requires the broad ranging collaboration among donors, technical agencies and civil society organizations as embodied in RBM, the Director of the GMP needs to exercise his/her leadership role in a special way.

A spirit of collegiality and inclusion is essential for the new Director, since no one agency or person has all the answers to the problem of malaria. Not surprisingly the job posting stresses a “Commitment to collaborate effectively with other key partners.”  We encourage all those with such a commitment to apply.

Funding &Partnership Bill Brieger | 23 Nov 2008

Clinton’s possible post as Secretary of State – implications for malaria

The William J Clinton Foundation is among the constituency members of the Roll Back Malaria Partnership. As such, the Clinton HIV/AIDS Initiative (CHAI), is not aimed at only one disease.  According to the website …

  • CHAI’s first malaria price negotiations reduced the price of one ACT, an effective malaria drug, by 30% and reduced price volatility of artmesinin, the plant extract in ACTs, by 70%.
  • CHAI initiated a pilot subsidy on ACTs in Tanzania which reduced the price in targeted areas by 95% and increased uptake by approximately 45% for people of all ages – 62% for children under 5.

In a conversation between Bill Gates and Bill Clinton on malaria at the Clinton Global Initiative meeting this year, the former President showed his clear interest in the disease by saying that, “Malaria is a good example of the sort of thing that we just celebrated on the stage here. This is something that you can break down into discrete units so no matter how much or little money you have, you can give it to an NGO that will buy a high-quality bed net, put it up, do it in the right way. And so, if you had $5 a year to give, you could still make a big difference in a family’s life.”

CBS News confirmed that, “Former President Clinton’s foundation has signed pricing agreements with several suppliers involved in making a malaria-fighting drug in an effort to stabilize the medication’s fluctuating costs and ensure more dependable availability.” Another side of the story, is that, “Besides benefiting from a more stable market, the suppliers that join the Clinton effort also get business and marketing assistance from the foundation.” Issues like the latter mean that questions are being raised as to how these accomplishments and those for HIV and other global health causes would be affected if Senator Hillary Rodham Clinton becomes Secretary of State in the upcoming Obama administration.

The Washington Post considers the possibility that major donations to the Foundation from international business tycoons, among others, “could present ethical concerns for Sen. Clinton if foreign governments believe they can curry favor with her by helping (such donors), or if they fear that restricting (such donors’) activities would damage their relations with her.” Suggestions range from revealing all donors, to reduced or no involvement by the former President in the Foundation and its fundraising and even to voiding existing standing donations.

The Clinton Global Initiative has posted on its own website a 2006 article from the New Yorker that describes Clinton’s continued international connections on a trip to Berlin. Attending one of the World Cup matches, “The Clintons took their seats in the ‘statesman’s section,’ at midfield. While Clinton’s statesmanship has been strictly freelance for the past six years, he was not far from the German Chancellor, Angela Merkel, and he spent time during the game, and during the breaks, chatting with old friends-the schmoozer in excelsis.”

The Washington Post talked with Bill Clinton’s associates and concluded that, “those close to the former president said they would be reluctant to see him back away from charitable work that has provided a source of AIDS treatment for 1.4 million people, a major engine in the effort to reduce greenhouse gases and sponsorship of anti-obesity programs in American schools.”

Bill Clinton has been quoted as saying that he will do and disclose whatever is needed to enable Senator Clinton to become Secretary of State. Will this also be good for malaria?

Partnership Bill Brieger | 26 Sep 2008

Global Malaria Action Plan – launched with billions

rbm-sm.gifThe Roll Back Malaria Partnership has launched the Global Malaria Action Plan around the world with the “collective input of 30 endemic countries and regions, 65 international institutions and 250 experts from a wide range of fields.” The goals of the plan follow:

  • Achieve universal coverage, as recently called for by the UN Secretary-General, for all populations at risk with locally appropriate interventions for prevention and case management by 2010 and sustain universal coverage until local field research suggests that coverage can gradually be targeted to high risk areas and seasons only, without risk of a generalized resurgence;
  • Reduce global malaria cases from 2000 levels by 50% in 2010 and by 75% in 2015;
  • Reduce global malaria deaths from 2000 levels by 50% in 2010 and to near zero preventable deaths in 2015;
  • Eliminate malaria in 8-10 countries by 2015 and afterwards in all countries in the pre-elimination phase today; and
  • In the long term, eradicate malaria world-wide by reducing the global incidence to zero through progressive elimination in countries.

At the same time the international community gathered at the United Nations Headquarters in the context of meeting the Millennium Development Goals to pledge support that would make this plan a reality.  According to the BBC, “World leaders and philanthropists have pledged nearly $3bn (£1.6bn) to fight malaria at a summit in New York. The meeting, at the UN, is looking at ways of meeting the Millennium Development Goals – targets on reducing global poverty by the year 2015. Donors hope the money will be enough to eradicate malaria by that time.”

Eradication by 2015 may be a bit of a stretch because according to the Guardian, “A key part of the strategy is the introduction of a vaccine against the deadly disease, which is now just entering the final stage of trials. Although the vaccine is expected to be only partially effective, it will still save thousands of lives.” Working out the logistics of delivering the new vaccine will take time, but that is not reason to dispair.

The launching and fundraising was noted in Uganda, one of the countries that could benefit. Uganda’s New Vision reported that, “Health state minister Dr. Emmanuel Otaala yesterday said the malaria toll in Uganda stands at 320 people a day translating into 115,840 victims a year. He said the Global Malaria Action Plan involved a combination of prevention measures which include use of insecticide-treated mosquito nets, indoor residual spraying, use of anti-malarial treatments and killing of mosquito larvae.” The New Vision accounted that the nearly $3 billion of pledges came from a wide variety of sources ranging from the Gates Foundation and the World Bank to DfID, the Global Business Coalition on HIV/AIDS, TB, and Malaria, the United Nations Foundation, Malaria No More and even the Sesame Workshop.

AFP quoted Bill Gates: “”We need innovation, new drugs, and the most dramatic thing we need is vaccine.” Gates noted that malaria control programs “are achieving impressive new gains,” and that scientific innovation “could soon give us powerful new vaccines and drugs. “If we build on this momentum, we can save million of lives and chart a long-term course for eradication of this disease.”  In The Gates Foundation’s home town, the Seattle Times called the event at the United Nations, “a malaria Woodstock.”

Afrol News reported that these “Funding commitments will support rapid implementation of Global Malaria Action Plan.” This will only be possible if there is a strong health systems strengthing component, since as we have noted before, existing achievements are in many places still below the Abuja targets set for 2005. Rapid movement without attention to the systems that can sustain elimination interventions will never lead to eradication.

Advocacy &Partnership Bill Brieger | 04 Aug 2008

Zambezi Expedition – the journey is not over

In March of this year the Zambezi Expedition set out on a three-month quest to rally political support for the fight against malaria and demonstrate the need for coordinated cross-border action by navigating three thousand kilometers through Angola, Namibia, Botswana, Zambia, Zimbabwe and Mozambique. The Roll Back Malaria-sponsored Expedition spread awareness of malaria with the help of NGOs like Nets For Life and corporations like ExxonMobil. In fact the ExxonMobil press release observed that exactly 150 years after the Scottish missionary David Livingstone embarked on a historic journey along the Zambezi River, malaria remains a problem for the people along its shores.

The Mail and Guardian reported that, “Expedition members said many villagers along the river must travel long distances to the nearest medical post. Limited access to medical care and a lack of regional cooperation are hindering malaria prevention, group members said. ‘There are no borders for malaria,’ expedition manager Herve Verhoosel said. ‘Mosquitoes don’t get their passports stamped at the other side of the border.'”  A Reuters television news clip available on the Expedition’s website quotes one of the travelers talking about the challenge of community members trekking 70 kilometeres to a health facility to get malaria treatment in Angola.

In June as a follow-up the Zambezi Expedition was featured during a panel at the World Economic Forum. The Expedition website noted that, “Panelists Prof. Awa Coll-Seck, Executive Director of the Roll Back Malaria Partnership (RBM) and Sipho Mseleku, CEO of the Association of SADC Chambers of Commerce and Industry (ASCCI) underlined the critical importance of political commitment in fighting diseases of poverty such as malaria. They called for increased multi-country collaboration with specific attention to strengthening community engagement against poverty and disease. ‘Malaria knows no borders and the Roll Back Malaria Zambezi Expedition is a model for multi-country cooperation,’ said Prof Coll-Seck, ‘We hope that countries in other sub-regions will collaborate in this way because they have similar problems.'”

end-of-zambezi-expedition-in-mozambique_.jpgNow more than two months after the Expedition reached its end at the Indian Ocean [see photo by Marcus Bleasdale], malaria and mosquitoes still cross the Zambezi and the borders of countries along its shores.  As stated in the theme of the expedition and the first World Malaria Day, which was celebrated along the journey, malaria is a disease without borders – the journey of collaboration among countries and partners in the region should not stop just because the boats have reached their destination.

Funding &Partnership Bill Brieger | 06 Jul 2008

Will the G8 keep promises?

g8-hokkaido-half.jpgNic Dawes of the Mail and Guardian Online wants G8 leaders at their upcoming summit in Japan to make good on past promises.  He reports that, “A draft text of the G8 communiqué, leaked to the Financial Times, commits the group in broad terms to pledges on aid that were made at the 2005 summit in Gleneagles. But it makes no mention of the previously agreed 2010 deadline to increase aid to Africa by $25-billion annually. Also unmentioned is a target date for spending $60-billion to strengthen healthcare systems in the developing world which was agreed to at last year’s Heiligendamm summit in Germany.

Although Dawes reported that, “Britain was more or less alone in wanting to stick to a firm time-frame on aid, UN officials, poverty relief activists and diplomats”  He did mention iIn addition that, “Germany, for one, is pressing for the Heiligendamm promise on health to be maintained.”

One particular G8 members has received criticism recently for promising more but ‘not enough’. AfricaFocus provided details: “At the end of May, Japan hosted the Fourth Tokyo International Conference on African Development (TICAD IV), receiving representatives from 52 African countries, including 40 heads of state or government. Government officials were consistently upbeat on the prospects both for African growth and for increased Japanese aid and investment. Civil society networks from Japan and Africa also welcomed increased Japanese involvement, but expressed disappointment at the level of commitment on AIDS funding and the dominant emphasis on private investment over direct support for development goals.”

The Associated Press notes that at least one other the G8 leader may also be aware of these discrepancies.  While there will be much on the Summit agenda about issues like global warming, “Bush himself says a priority of this year’s summit is not advancing new initiatives but making good on ones from previous summits, especially promises for health aid for countries in Africa and other underdeveloped nations. ‘We need to show the world that the G-8 can be accountable for its promises and deliver results,’ Bush said ahead of the summit. ‘America is on track to meet our commitments. And in Japan, I’ll urge other leaders to fulfill their commitments, as well.'”

Unfortunately a few US Senators have been holding US disease control aid hostage, making it difficult for the United States to speak with a united voice at the summit in Toyako, on the northern Japanese island of Hokkaido.

Summit organizers have released discussion points for ‘Development and Africa‘, which recognizes that this is the midpoint toward achieving the Millennium Development Goals. It also reviews three past Summits where these issues were discussed and proposes increases in Japanese aid.  We hope that these 8 leaders, with the support from all components of their governments back home, will make good on and even increase their commitments to health and development in Africa.

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