Holding Country Coordinating Mechanisms Accountable to PLWHA Sharonann Lynch, Health GAP

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Holding Country Coordinating Mechanisms
Accountable to PLWH/ASharonann Lynch, Health GAP
International Treatment Preparedness Summit Cape
Town, South Africa March 13-16, 2003
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Holding CCMs Accountable to PLWH/A

• Why should CCM accountability matter to AIDS
  treatment advocates?
• What benefits can come from CCM involvement?
• How can PLWH/A become members of their CCMs?
• What other ways can PLWH/A hold their CCMs
  accountable?

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Holding CCMs Accountable to PLWH/A

• By working from the inside
• As a part of a CCM
• By working from the outside
• Lobbying the CCM holding meetings with CCM
  leadership
• Supporting and collaborating with CCM members who
  are PLWH/As or other allies
• Building broad support for your demands of the
  CCM
• Both inside AND outside work are important and
  necessary for increasing treatment access

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The Past Country Coordinating Mechanisms

• The Fund will work with a country coordination
  and partnership mechanism that should include
  broad representation from governments, NGOs,
  civil society, multilateral and bilateral
  agencies and the private sector.
• (Fund Framework Document, VI.B.1)

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The Present Country Coordinating Mechanisms

• PLWH/As are underrepresented
• Average CCM 5 of members are PLW the diseases
  19 are NGOs 38 are from government 5 are
  from donor governments
• Simple representation of PLWH/A is not the same
  as full participation
• The GF Board must be pushed to accept the
  creation of minimum standards for CCMs

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The Future Country Coordinating
Mechanisms--what do we want?

• Minimum standards for CCMs
• Support for and expectation of REAL decision
  making power for PLWH/As
• Secretariat and Board pressure on CCMs to comply
  with minimum standards
• NGO, civil society, and PLWH/A representatives
  should not be chosen by government--they should
  be permitted to select themselves
• CCM deliberations should be transparent, with
  complete contact information and minutes posted
  publicly

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Why is PLWH/A involvement in CCMs important?

• CCMs have power
• National governments and donors currently
  dominate CCMs
• for example, US AID is a member of 26 of CCMs
• Prioritization of treatment access is more likely
  when treatment advocates are involved in writing
  CCM applications

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Weak CCMs lead to Global Fund problems

• Applications have been too shy in their
  requests for money for ARV treatment, and too
  modest in their projections for scaling up
  treatment access
• Governments and donors do not always behave
  independently
• CCMs usually dont have competent technical
  assistance in preparing applications with ARV
  treatment components

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What benefits could come with CCM involvement?

• CCM involvement benefits other treatment
  preparedness efforts
• Skills acquired in CCM participation are useful
  for other activities
• Full participation of PLWH/As in CCMs can play a
  role in fighting prejudice, indifference, and
  stigma

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How can PLWH/A get involved with their CCM?

• Request the CCM include PLWH/A who have the time,
  energy, and support to participate fully
• Request current information about complete
  membership and affiliation of CCM
• Build support for CCM membership request of
  qualified PLWH/A

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What if that doesnt work?

• CCMs may resist involvement of PLWH/A
• Build public and private support for PLWH/A
  involvement
• Identify potential allies within the CCM
• Communicate with the GF Secretariat about CCMs
  where PLWH/A are under-represented
• Consider non-CCM applications, if applicable
• non CCM applications are accepted by the GF,
  under any of three conditions (see GFs Third
  Call for Proposals)
• Countries without legitimate governments
• Countries in conflict or facing natural disasters
• Countries that suppress or have not established
  partnerships with civil society and NGOs

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How can PLWH/A pressure CCMs from the outside?

• Engage with CCM members
• Make public demands of the CCM
• Pressure the CCM to request adequate money for
  treatment access
• Pressure the CCM to be transparent in their
  deliberations
• Pressure the CCM to include minimum numbers of
  PLWH/A, NGOs, and civil society members
• Tactics can include
• Media work, building community support among
  decision makers for basic demands, public
  community meetings with CCM members where demands
  are presented, etc.

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Other resources

• Reports about CCM performance
• http//www.aidsalliance.org/_docs/languages/_eng/_
  content/_3_publications/download/Policy/NGO20Part
  icipation.pdf
• NGO Participation in the Global Fund October
  2002, The International HIV/AIDS Alliance
• List of current CCM contacts
• http//www.globalfundatm.org/files/CCMContacts_040
  203c.xls