2013-05-24T06:28:45-04:00 Natasha F. Bilimoria http://www.huffingtonpost.com/author/index.php?author=natasha-f-bilimoria Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Natasha F. Bilimoria Good old fashioned elbow grease. tag:www.huffingtonpost.com,2011:/theblog//3.1071485 2011-11-08T18:42:49-05:00 2012-01-08T05:12:01-05:00

Natasha F. Bilimoria http://www.huffingtonpost.com/natasha-f-bilimoria/
The report, aptly titled "Turning the Page from Emergency to Sustainability," focuses on the Global Fund's transition from a highly effective emergency response to the three pandemics, to a long-term sustainable mechanism for ensuring that its lifesaving work can continue in times of limited resources. As it heads toward its 10-year anniversary, the Global Fund is embracing the panel's recommendations, strengthening its commitment to best practices and "turning the page" in its fight against the three diseases.

An important part of this transition is the involvement of civil society. On this score, the Global Fund received high marks from the panel, which praised the Global Fund's "ability to 'galvanize everyone' and bring government, charitable groups, the private sector, donors, U.N. agencies and affected populations to the same table in the service of a common cause." This commitment to partnership, and the template for good governance set down by the Global Fund's grant management model, is crucial to ensuring countries can one day "graduate" from Global Fund support and create sustainable programs into the future.

The report continues: "The Global Fund has made ordinary and expected what was unthinkable in dozens of nations ten years ago, as in the following examples:

• HIV-positive people meet regularly and openly with ministers and presidents and appear in the media;


• Governments must account for spending that previously would have been off-the-books;


• Faith-based organizations coordinate the delivery of health care with State-operated institutions;


• [Nongovernmental organizations] bid for funds in transparent tenders;


• Donors engage recipients on their terms [with donor oversight]; and


• Ordinary citizens stand to represent their peers in competitive elections."

These are impressive strides but, as the report also points out, they don't come without serious challenges; among them, the occasional, unacceptable misuse of funds. At the time of its inception in 2002, the Global Fund and its creators were well aware of the risks inherent in its ambitious effort to finance lifesaving care in fragile states. That is exactly why it built its model on a foundation of transparency and accountability, in the knowledge that only by holding wrongdoers accountable, recovering any misused funds and constantly improving its oversight procedures can the mission of saving lives be sustained.

In this spirit, the Global Fund Inspector General (IG) released a number of reports this week that include information about the misuse and recovery of funds. The reports, part of an ongoing, cooperative effort of the Global Fund Secretariat and IG, demonstrate the Global Fund's continuing zero tolerance policy for fraud in action.

No one can guarantee that waste and misuse will never occur, but the Global Fund can guarantee that it will use the full force of the law to discover it, correct it and make the findings public. These latest reports are yet more evidence that the system of transparency and accountability is working. This should be embraced and expanded.

Shifting from an emergency response to long-term sustainability -- particularly in this tough economic environment -- will require an even stronger emphasis on oversight, ensuring that U.S. taxpayer dollars are used effectively and efficiently. The Global Fund continues to demonstrate that it's up to the challenge. In fact, two months after the release of the high-level panel's report, it will approve a detailed plan at its next board meeting to put the panel's recommendations into action quickly.

The Global Fund's embrace of these recommendations is yet another signal that the Global Fund is deeply committed to doing whatever it takes to safeguard donor resources and expand results. The Global Fund is working every day to ensure that resources are devoted to provide lifesaving health interventions to those most in need. These new IG reports are more evidence that it won't back down.
]]> tag:www.huffingtonpost.com,2011:/theblog//3.873943 2011-06-10T14:34:24-04:00 2011-08-10T05:12:01-04:00

Natasha F. Bilimoria http://www.huffingtonpost.com/natasha-f-bilimoria/
Through the help of Americans, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the U.S. president's Emergency Plan for AIDS Relief (PEPFAR) have provided the overwhelming majority of treatment and care for the millions of people living with HIV/AIDS in resource-limited settings around the world. The U.S. made the first contribution to the Global Fund at its start in 2002 and continues to be its largest donor and a strong champion. In 2003, under the leadership of former President George W. Bush, PEPFAR was launched and the program continues today under the support of the Obama Administration.

These contributions have made a substantial difference in the fight against HIV/AIDS. The Global Fund has disbursed more than $13 billion to governments and local organizations to support disease educational programs, provide drugs and diagnostics, and strengthen health care systems. For every dollar it receives from the U.S., the Global Fund is able to leverage more than $2 from other donor countries. Together, the Global Fund and PEPFAR have provided nearly 5 million adults and children with lifesaving antiretroviral drugs for HIV/AIDS.

We have made great strides in the fight, but HIV/AIDS is still a pandemic affecting more than 33 million people worldwide. In 2009, 2.6 million people became newly infected with HIV, with more than two-thirds of these new cases occurring in sub-Saharan Africa. Every day, more than 1,000 children are born HIV-positive around the world.

But, HIV/AIDS is not solely a numbers game. Equally important, it is a narrative of stories and shared experiences in the prevention, care and treatment of those living with HIV/AIDS around the world. There was a bleak start after the initial discovery of HIV/AIDS in 1981, but the growing number of success stories during the nine-year history of the Global Fund has painted a picture of renewed health and hope for those affected by HIV/AIDS.

Mulikat Odutayo, a counselor at Lagos General Hospital in Nigeria, struggled upon learning of her HIV-positive diagnosis four years ago. Through the help of HIV and tuberculosis medications provided by the Global Fund, she was able to turn her attention to counseling other men and women taking their first steps toward HIV testing and treatment.

When she was desperate to start her own family, Mulikat turned to her doctors, who were able to provide her with a package of services, medicines and care supported by donor contributions to successfully prevent the transmission of HIV to her newborn baby. Her son, Mumbarak, is a now healthy, precocious child who does not have HIV and is part of a new chapter in the fight against AIDS. Such achievements can be shared today because of joint collaboration between public and private partners through organizations like the Global Fund.

Thankfully, Mulikat's story is not unique -- she is one of many women the Global Fund has helped. Between 2002 and the end of 2010, one million HIV-positive pregnant women received support from the Global Fund to prevent mother-to-child transmission of HIV, with more than 210,000 soon-to-be mothers treated in 2010 alone. In fact, with continued support, it is possible to eliminate transmission of HIV from mothers to their children by 2015.

I am serving as a member of the U.S. government delegation at the United Nations' General Assembly Special Session on HIV/AIDS this week, and I hope countries will use this meeting as an opportunity to redouble their commitment to battling these diseases. This session offers the perfect moment to reflect on the gains we've made as well as devise a solid plan of action for continuing to work together globally to save and improve lives.

Through this partnership, the support of the American people and continued funding, we can capitalize on the tremendous momentum we have in the fight against HIV/AIDS. Sustained U.S. leadership through contributions to the Global Fund will greatly expand access to treatment, as well as scaled up efforts to prevent HIV transmission through new and emerging interventions such as male circumcision, treatment of early HIV infection, microbicides and, I hope, someday, HIV vaccines. Let's build on the progress made in the past 30 years and achieve our shared end goal -- a world free of HIV/AIDS. ]]> tag:www.huffingtonpost.com,2009:/theblog//3.190460 2009-04-23T19:06:00-04:00 2011-05-25T13:15:26-04:00

Natasha F. Bilimoria http://www.huffingtonpost.com/natasha-f-bilimoria/
From my experience working in global health for almost a decade, numerous organizations -- some for-profit, some not-for-profit -- operate in low-income countries to improve health there. These organizations do different work in different ways, but three traits rise to the top among effective and cost-efficient organizations. These traits are: country-led, performance-driven, and multilateral.

Country-led: countries that have a strategy and an implementation plan for improving health are the ones best equipped to use funding assistance. For example, governments across Africa have created individual national malaria control plans, and then organizations like PMI and the Global Fund to Fight AIDS, Tuberculosis and Malaria work with each country to help it achieve its goals according to its national plan. With the national government coordinating all partners, money does not get used at cross-purposes, and everyone is accountable to each other to reach the common goals. In other words, the sum is more than the parts alone.

Performance-driven: programs that are funded based on proven results. It's a straightforward concept, but it's surprising how many programs don't set goals and measure their progress toward those goals.

Multilateral: multilateral programs, loosely defined as a partnership working together on a given issue, have also proven to be extremely cost-efficient because a multilateral pools the money of all partners, often sharing resources and responsibility both at an organizational level and on the ground. Multilateral approaches to disease control, for example, typically work to build health systems in-country, creating infrastructure -- distribution systems, health care providers, clinics -- not just to combat a particular disease but also to combat other health problems.

Are all of these characteristics necessary for an effective and cost-efficient program? No, but it's a powerful combination.

The Global Fund, for example, mandates all three of these approaches, and while its had its challenges, its success has been tremendous. Today, just seven years after it was created, the Global Fund is the world's largest financier of malaria programs. It's already provided $1.8 billion in financing to country-led, performance-driven malaria programs in low- and middle-income countries, and it's promised another $5 billion more in 83 countries. The impact on the ground is astounding. Families, communities and even entire countries are healthier and more productive because of the Global Fund's work.

This Saturday, April 25, is World Malaria Day. It's a day to note the accomplishments the world has made in fighting malaria and the distance we still must travel to eliminate this disease. The U.S. government has been a leader in this fight, recognizing the value of investing in cost-effective programs like the Global Fund.

Malaria might not be something that most of us in the U.S. think about every day, but people in places like Nigeria and India -- two countries that bear the weight of most of the malaria cases in their respective areas of the world -- think about it daily. Each day, they face the reality of malaria, from sleeping under mosquito nets to searching for effective medicines to watching people needlessly suffer and die from this disease. Thanks to the U.S. government's continued investment, the momentum to eliminate malaria is reaching a critical mass. And thanks to effective and important organizations like the Global Fund, the U.S. government can rest assured that its dollars are being used well, saving lives around the world.]]> tag:www.huffingtonpost.com,2008:/theblog//3.130292 2008-10-13T13:44:46-04:00 2011-05-25T12:45:25-04:00

Natasha F. Bilimoria http://www.huffingtonpost.com/natasha-f-bilimoria/
The 2008 Millennium Development Goals Malaria Summit was the venue where more than $3 billion was committed for malaria programs worldwide. The largest announcement came from the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has submitted to its Board of Directors for approval $1.62 billion for malaria-specific funding. If approved, this will represent (by far) the biggest request for malaria financing to date. This much-needed financing would purchase 100 million bed nets -- in addition to effective malaria medicines -- over the next two years, significantly advancing the goal of universal bed net coverage by 2010.

The event, which was hosted by the Secretary General's Special Envoy on Malaria, the Bill and Melinda Gates Foundation, Malaria No More and the UK Department for International Development, also announced the release of a Global Malaria Action Plan by Roll Back Malaria with the broad support of the malaria community. This plan represents a comprehensive outline for global malaria control and demonstrates that, if we are able to provide for full bed net coverage by 2010, it will be possible to save millions of lives. The plan also lays the foundation for a long-term effort to eliminate malaria.

Between the Global Fund's proposed financing and the Action Plan laid out last week, malaria elimination has now in fact become possible in our lifetimes. Malaria, when left untreated, is life-threatening. Transmitted by the bite of an infected mosquito, it causes fever, headache and vomiting. It can rapidly lead to death because it disrupts the blood supply to vital organs. Nearly one million people die of malaria each year, the vast majority of them children under the age of five in Africa. This means one African child dies every 30 seconds from a preventable and curable disease. The disease also costs African countries an estimated $12 billion in lost economic productivity each year.

Since 2002, the Global Fund has been committed to helping countries fight this deadly disease, and currently funds two-thirds of all malaria programs internationally. Already the Global Fund has committed $3.7 billion to malaria through 146 grants in 78 countries around the world, financing 60 million malaria treatments and 59 million insecticide-treated nets to protect families from malaria. As Rwandan President Paul Kagame pointed out at the Summit last week, success is visible on the ground; there has been a 66% decline in child deaths from malaria in Rwanda, a decline due in part to Global Fund financed programs that distributed more than 2.4 million insecticide-treated nets and rolled out ACTs nationally.

The same day these malaria announcements took place, Democratic Presidential nominee Senator Barack Obama said that as President he would echo the call made by those at the MDG Summit. Republican nominee Senator John McCain has supported the cause as well. Their support underscores the fact that malaria is not just an issue for the developing world, but an issue that the U.S. government sees as an important part of its overall foreign aid agenda.

While there are still challenges ahead, last week's commitments prove that with leadership and commitment, a disease that has been cutting lives short for centuries can finally be put to an end. The U.S. plays a critical role in this fight, especially through its support of the Global Fund. We must continue to put significant resources behind these successful and indispensable programs. Together, we can make the goal of elimination a reality -- and that truly will be historic.]]> tag:www.huffingtonpost.com,2008:/theblog//3.106273 2008-06-10T12:10:57-04:00 2011-05-25T12:35:19-04:00

Natasha F. Bilimoria http://www.huffingtonpost.com/natasha-f-bilimoria/
These numbers are proof that the U.S.'s investment in the Global Fund, a public-private partnership funding programs to eliminate the world's most deadly yet preventable diseases, is working. Through the President's Emergency Plan for AIDS Relief (PEPFAR), the U.S. contribution to the Global Fund has significantly helped provide infrastructure, prevention and treatment services, food and free ARV treatment to those infected and affected by AIDS around the world. More than ever before, more people are receiving the treatment they need and thankfully, are living longer, healthier lives. This is a life-long commitment, so it is critical for the U.S. to maintain its strong support.

The AIDS pandemic is the greatest public health challenge the world has ever faced. It has ravaged populations across countries and socio-economic status, hitting the parts of the world hardest where access to even basic health care and infrastructure are at best, limited.
Yet as evidenced by the numbers just released the Global Fund's long-term strategy has had significant impact in some of the hardest to reach places. For example, in Swaziland, one of the 136 countries the Global Fund works in, almost one third of the adult population is HIV positive. Before 2002, only 900 people were receiving AIDS treatment in the country. With Global Fund support, the government of Swaziland is aggressively establishing treatment centers, providing food support, and enrolling orphans and vulnerable children in schools though community-based programs. As a result, nearly 25,000 people are now receiving ARV treatment through 7 newly established treatment centers. Global Fund grants are also providing nearly 35,000 people with food support and enrolling more than 21,000 orphans and vulnerable children in formal schools.

Investment in the fight against HIV/AIDS is about more than just statistics, it's about saving lives, families and entire communities. This is a compelling story that is being told in an exciting new exhibition called Access to Life that opens at the Corcoran Gallery of Art in Washington, DC on June 14 and runs through July 20.

Through a partnership between the Global Fund and Magnum Photos, Access to Life chronicles the lives of AIDS patients as they begin ARV treatment in nine different countries -- bringing to life the difference that the Global Fund is making. The people in these photo studies have made remarkable improvements in their health and well-being as a result of their treatment. Without the Global Fund, these individuals would have a very different and tragic story to tell.

We should celebrate today's treatment announcement and the stories told through Access to Life, but it is also a moment to recommit ourselves to do even more in the fight against AIDS, TB and malaria. This summer Congress will work to renew the PEPFAR program, which includes continued support of the Global Fund over the next five years. PEPFAR has been a powerful demonstration of U.S. leadership and compassion around the world and its investments are paying major dividends. The bill, which overwhelming passed with bipartisan support in the House, must do the same in the Senate -- not only to ensure that this lifesaving work continues into future - but also to send a clear message to countries around the world that the U.S. is fully committed to continuing these programs around the world.

The Global Fund's vision is to invest the world's money to save the lives of those affected by AIDS, TB and malaria. This is making a real and dramatic difference. While the U.S. provides nearly one-third of all Global Fund financing, we in the U.S (almost more importantly) take a vital, leadership role with this commitment. We need to remember that now, more than ever, is a critical time in this fight against some of the greatest global health challenges of our time.]]>