Members of local community-based and non-governmental organisations and consultants took part in the two-month forum hosted by PortalSIDA, the Spanish-language knowledge management and networking website launched by the Alliance last August.
Discussion topics included the fact that Latin America receives fewer health and development resources from the international community than any other developing region. Contributors suggested that this is because international cooperation programmes focus on the poorest countries and those with the highest incidence of disease.
Shortly after the Global Fund was created in 2002, a debate developed concerning its country eligibility criteria. Particularly contentious was the rule concerning levels of income, which excluded countries with medium to high income levels during the Fund’s first years of operation.
This criterion was recently revised and the Fund has established a cost-share financing scheme for middle income countries with concentrated HIV epidemics, where prevalence is greater than 5% in at least one population.
The PortalSIDA debate examined four hypotheses:
The Global Fund prioritizes the poorest countries and those with the highest disease rates. There was consensus among participants that donating countries and agencies give priority to Africa, to the detriment of other regions with concentrated HIV epidemics. It was also recognised, however, that there are high levels of ignorance concerning the epidemic within Latin American countries themselves.
The Technical Revision Panel, responsible for evaluating proposals, follows a policy of not prioritizing the Global Fund or does not have an understanding of concentrated epidemics. There was little support for this hypothesis; most of the recommendations submitted focused on the Global Fund secretariat.
Proposals submitted by countries are of poor technical quality. There was clear consensus that there are serious problems with the quality of the proposals submitted, due to the lack of participation of civil society, a lack of transparency in procedures, and the fact that little time is invested in putting proposals together.
The region doesn’t need help from the Global Fund as most countries have sufficient domestic resources to cope with the epidemic. This hypothesis was not supported. It was felt that, given its global nature, all countries with generalised or concentrated epidemics should have equal access to the Fund.
The debate demonstrated that there are conflicting opinions regarding the Global Fund. There was consensus, however, concerning the serious lack of civil society and community participation.
Much of the frustration expressed centred on the Global Fund secretariat and the fact that existing channels of communication and feedback, such as the representatives of each sector on the governing body, are not used.
A briefing paper with detailed outcomes (in Spanish) is available on the website.
PortalSIDA plans to host further debates and consultations, including a forum on transgender people and HIV. Around 50,000 people have visited the site since its launch to download documents, look up personal and organisational contacts, find work opportunities and keep up to date with news.