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Here I Am: The Global Fund Is Vital for Communities

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This past week, the Global Fund to Fight AIDS, Tuberculosis and Malaria held an important regional meeting in Lusaka (Zambia) to speak with those most directly affected and infected by the 3 diseases about the roll-out of the New Funding Model in 2014.

We spent several days discussing the process of the New Funding Model; it's timelines and the tools and guidelines that will shape it. We talked about how to have a full and open national discussion to ensure that the country process is inclusive, that key and marginalized populations are included and what critical enablers like gender and human rights add to national strategies. We strategized about how to turn the country dialogue process into a Concept Note which starts the conversation between country and Global Fund and begins the funding application process under the new model.

GNP+, the Global Network of People Living with HIV, is a global network for and by people living with HIV who work to meet the needs of people living with HIV around the world. With the pledging conference for the Global Fund to Fight AIDS, Tuberculosis and Malaria only days away, I invited GNP+ to share some of their thoughts about the New Funding Model and the Global Funds role in the lives of people living with HIV.

Below, GNP+ Co-chair Anna Zacowicz shares some thoughts about the replenishment process and some of the key opportunities and challenges for the Global Fund as it moves into 2014 with the full implementation of the New Funding Model.

The Global Fund is Vital for Communities

By Anna Żakowicz, co-Chair of the Global Network of People Living with HIV (GNP+)

The Global Fund is vital for communities as it saves the lives of millions: those who receive prevention interventions (condoms, needles and syringes, opioid substitution therapy), those who can learn about their HIV status and those who are able to live healthy lives because of antiretroviral treatment (ART) and care received at health care services, both in medical and community-based settings.

The Global Fund is vital for communities in another way too, as from its conception, it has made room for representatives of the community affected by the three diseases to be a part of its governance, both through the communities delegation to the Board, in the development, monitoring and evaluation of effective programmes through our involvement in County Coordinating Mechanisms (CCMs) and implementation of the programmes at the community level.

In just over a decade the Global Fund has enabled over four million people living with HIV to access treatment. The CCM model has provided a blueprint for participation in national processes for people living with HIV. Through participation in the HIV response, we, as the community, have professionalized, and in many countries have been a driving force, for a positive change.

With the advent of the New Funding Model, there is an array of new opportunities for people living with HIV to participate in Global Fund processes. In the design of the New Funding Model, and in particular the country dialogue process, we are excited at the prospect of having meaningful participation of a broader range of stakeholders, in particular key populations, who have historically been excluded from Global Fund processes. A broad range of stakeholders and a strong gender component will ensure programmes that respond to the real needs of the communities.

Now is certainly the time for governments to be bold, continue their efforts and pledge to resource the Fund. The recent strong leadership shown by the French, US, UK and Nordic governments around replenishment has been promising. Their commitments indicate the need to invest in lives of millions through effective programming that answer the needs of communities affected by the three diseases. The pledges should encourage others to follow suit leading up to the replenishment meeting in Washington in December.

The Global Fund continues to be one of the soundest investments in the HIV, TB and malaria response, ensuring money is spent where it is most needed. The evidence is overwhelming that flat-lining investments in the Fund now will have far reaching and dire consequences for communities of people living with or affected by the three diseases. Scaling up our resourcing of the right interventions could finally mean having control over TB, malaria and HIV.

However, to be able to do it, communities of people living with and affected by the three diseases must be a vital part of the solution. We showed that we are effective in running programmes that are client-centred, cost-effective and targeting key affected populations. We have been tirelessly working on policy change and improving legal environments and we are central in ensuring that these policies are implemented effectively.

Our watchdog role both for the Fund Secretariat and CCMs cannot be understated. Using tools such as the PLHIV Stigma Index and the Positive Health, Dignity and Prevention Operational Research Tool, we held governments and CCMs accountable, and we ensured that the human rights of all those living with and affected by the three diseases are protected and promoted.

As with any other programming, community-based programmes need resources to continue the work and to ensure the capacity to effectively engage in Global Fund processes as technical partners and on equal terms with others. We are indeed technical partners - without our expertise and understanding of these epidemics, the effectiveness of Global Fund programming is severely compromised.

A new reality lies on the horizon for middle-income countries. As "ability to pay" and "willingness to pay" become critical factors in allocating resources, and countries move from being lower-income to middle-income, the Fund board and Secretariat need to ensure communities most affected by the three diseases are not further marginalised by greater access inequalities. It is essential that the Global Fund remains global.

The New Funding Model presents a host of opportunities to strengthen the HIV, TB and malaria response and for the community, to take a central role in bringing about an end to these three diseases. That is our role and we will continue to do it. Replenishing the Global Fund is the next step that needs to be taken in the response. Financing effective community-based initiatives through the Global Fund is an investment in strong structures that can be replicated; investment which needs to be sustained.

Feature video:

Shown at the recent Global Fund Board Meeting, this video is a compilation of some of the many voices in support of fully-funding the Global Fund we have heard in the "Here I Am campaign" over the last year.

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Lucy Chesire: TB-HIV advocate from Kenya and Board Member of the Global Fund Board Communities Delegation.

About the Here I Am campaign:The Here I Am campaign is a global call on world leaders to save millions of lives by supporting a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria. Here I Am brings the voices of people that are directly affected by AIDS, TB and malaria into dialogue about decisions that affect their lives and the lives of millions of others in their countries. Through video testimonies from all over the world, campaign ambassador advocacy, online actions and on-the-ground mobilizations, the Here I Am campaign is building collective power to end three of the world's most deadly diseases. www.hereiamcampaign.org