Open Letter to the Leaders Of the Health-8 (H-8) about the Scaling Up For Better Health Plan from the International Treatment Preparedness Coalition (ITPC)

[Guest guest]

Open Letter to the Leaders Of the Health-8 (H-8) about the Scaling Up For Better Health Plan from the International Treatment Preparedness Coalition (ITPC)

* * *

17 December 2007

The Gates Foundation

Ms. Patty Stonesifer

The GAVI Alliance

Dr. n Lob-Levyt

Global Fund to Fight AIDS, Tuberculosis and Malaria

Dr. Michel Kazatchkine

UNAIDS

Dr. Piot

UN Population Fund

Ms. Thoraya Ahmed Obaid

UNICEF

Ms. Ann Veneman

The World Health Organization

Dr. Margaret Chan

The World Bank

Mr. B. Zoellick

Dear Colleagues:

As civil society organisations fighting for improved health care in developing countries - including universal access to AIDS treatment, care and prevention services; the implementation of the Declaration of Commitment on AIDS; and the other health Millennium Development Goals - we welcome every new and bold attempt to realise the right to health.

At face value, the Scaling Up for Better Health plan, which is in fact a cluster of recent global health initiatives encompassing Germany’s Providing for Health, Canada’s Catalytic Initiative to Save a Million Lives, the United Kingdom’s International Health Partnership, and Norway’s Deliver Now for Women and Children; and which has recently been endorsed by all of you, could only make us happy.

However, when reading the final draft note of 1 November 2007, combined with our experience in developing countries, we fear that this new initiative might undermine some existing efforts to realise the right to health. In particular we fear that this new initiative might be inspired by recent public comments, according to which the world is spending too much on the fight against AIDS.

If this were the intention, we could certainly not support this initiative. The world is not spending enough on the fight against AIDS and the world is not spending enough fighting against other health crises and problems. Only if this is explicitly acknowledged as the foundation of the Scaling Up for Better Health plan, we would be willing to support this plan.

The following conditions would have to be met for us to support the Scaling Up for Better Health Initiative.

1. The Scaling Up for Better Health plan should explicitly aim for the realisation of the right to health, and adopt a foreign assistance for health target that matches this aim.

Health is a human right, and its realisation requires that all human beings have access to health care and the essential medicines they need, delivered professionally and to recognised effective standards. This includes, but is obviously not limited to, relatively expensive medicines to treat AIDS. Furthermore, the realisation of the right to health requires access to clean water and sufficient and appropriate nutrition.

We realise that this is not a modest claim. Estimates for foreign assistance needed to achieve the health-related Millennium Development Goals range from US$ 30 billion and US$ 60 billion per year. However, the combined Gross Domestic Product of the countries in Organisation for Economic Co-operation and Development in 2006 was US$ 36,316.6 billion. These countries promised to allocate 0.7% of their Gross Domestic Product to foreign assistance, which would be US$ 245.2 billion. If 15% of that would be allocated to health – which corresponds with the allocation promised by African leaders in the so-called Abuja Declaration – there would be US$ 38 billion available for foreign assistance for health, in an entirely predictable and sustained manner.

Any lesser target, or the absence of an explicit target, would mean that governments of developing countries would be left to make impossible choices. They would be forced to choose among tackling child mortality, maternal mortality, mortality due to AIDS, tuberculosis or malaria. In our understanding, this is exactly what the Scaling Up for Better Health plan seeks to avoid. If it does not want to force countries to make those choices – to reduce ambitions in one area for the sake of another – it should be explicit about it.

2. The Scaling Up for Better Health plan should explicitly adopt the novel approach to ‘sustainability’.

We worry when the Scaling Up for Better Health plan states it will be “Supporting countries in creating sustainable financing structures and systems so as to mobilize and sustain additional internal resources”.

Of course, we agree that states retain the primary responsibility to their citizens in realising the right to health. We agree that most governments of developing countries are not doing enough: they promised to allocate 15% of their budgets to health, and they are not doing it.

However, some countries are simply too poor; even if their governments would allocate 15% of their budgets to health, that would not be sufficient.

Too often, in our experience, ‘sustainable internal resources’ is simply translated as ‘payments from patients’. If that is what the Scaling Up for Better Health plan wants to promote, we disagree. User fees or health insurance schemes should be handled with care, and make little sense when the majority of the population will need an exemption or waiver anyhow, to realise universal access to essential health care. The fulfilment of the right to health and the achievement universal access, as we see it, are responsibilities of the State.

Sustainability concerns often act as an inhibiting factor for governments who want to reduce dependency on foreign assistance. They make estimations about their future capacity to finance health care without foreign assistance, and are reluctant to aim for an expenditure level that exceeds their own future capacity. As a result, some governments will not try to realise the right to health, as it seems too expensive.

There is a different way to approach sustainability concerns. “A sustainable health service must therefore be intended as an activity guaranteed on an uninterrupted basis, even if financed by external resources.” This quote comes from the website of the World Health Organization and we do agree with it.[1]

The Global Fund to fight AIDS, Tuberculosis and Malaria has already adopted this novel approach to sustainability, as it was essential to make AIDS treatment possible. As explained above, if the member states of the Organisation for Economic Co-operation and Development would allocate 0.7% of their Gross Domestic Product to foreign assistance, as they promised, and if 15% of that amount would be allocated to health, there would be US$ 38 billion available for foreign assistance for health, per year, in an entirely predictable and sustained manner. This should be included in the sustainability equation.

3. The Scaling Up for Better Health plan should confirm the primacy of the right to health, above macroeconomic concerns.

The International Monetary Fund imposes an extremely conservative policy on health and other social expenditures. The main reasons for this policy are:

· Fears about the macroeconomic impact of increased foreign assistance (the so-called ‘Dutch disease’);

· Fears about the volatility of foreign assistance.

To avoid these problems, the International Monetary Fund applies its ‘fiscal space’ concept: it defines maximum envelopes for health expenditure; it limits health expenditure to some level that will not cause any ‘macroeconomic disturbance’; it limits health expenditure to a level that can be sustained by domestic resources. If foreign assistance for the health sector exceeds ‘fiscal space’, the International Monetary Fund programmes foreign assistance to be used for increasing international reserves or for domestic debt reduction, rather than for an increase of expenditure. A recent report of the Independent Evaluation Office of the International Monetary Fund revealed that 70% to 80% of additional foreign assistance to Sub-Saharan countries since 1999 was diverted from expenditure to savings.

The Global Fund to fight AIDS, Tuberculosis and Malaria has developed an ability to avoid this ‘loss’ of 70% to 80% of foreign assistance. First of all, the Global Fund includes civil society in the participation of proposals. Civil society representatives do not worry about theoretical fiscal space constraints and false Dutch disease myths; civil society representatives worry about real needs and real financing gaps. Second, the Global Fund took a very strong stance on ‘additionality’: if a Global Fund grant displaces domestic or other foreign resources, it is refused. Global Fund grants cannot be used for increasing international reserves or for domestic debt reduction; they must be spent.

Did this cause any macroeconomic disturbance? If it has, the first report about it remains to be written. Furthermore, the International Monetary Fund itself admits that macroeconomic problems due to increased foreign assistance can be avoided, as long as additional foreign assistance is predictable and reliable in the long run. This should not be a problem if the Scaling Up for Better Health plan is based on an explicit ambition to mobilize US$ 38 billion – or 0.1% of the Gross Domestic Product of the members of the Organisation for Economic Co-operation and Development – in a sustained manner.

The Scaling Up for Better Health plan must be more explicit about supposed macroeconomic problems. “Identifying and addressing the fiscal and macroeconomic implications of the scaled-up health plan” sounds like a willingness to scale down health expenditure to fit within a questioned notion of “fiscal space”, while a Scaling Up for Better Health plan aiming for sufficient and sustained foreign assistance could simply overrule such imagined macroeconomic constraints.

4. The Scaling Up for Better Health plan should allow appropriate responses to health crises.

One of the lessons learnt from the fight against AIDS is that fragile and poorly resourced health systems are unable to react swiftly to new challenges. Recent history shows that new health crises are looming on the horizon: Severe Acute Respiratory Syndrome (SARS), avian flu, extensively drug resistant tuberculosis (XDR-TB).

We fear that the stated objective of binding development partners “to implementing the national health plan and agreeing modifications through joint reviews” will turn fragile and poorly resourced health systems into even more static systems than they already are. We have not forgotten the lessons from recent history; we know that the introduction of AIDS treatment became a life-saving reality for hundreds of thousands of people because some non-governmental organisations, working closely with courageous health ministries, supported mainly by private donors, dared to challenge the international consensus. The Global Fund to fight AIDS, Tuberculosis and Malaria came as a deus ex machina and allowed the replication of pilot projects at a larger scale, because medical experts judged proposals on their technical merits, not by the prevailing health development consensus of the time. Once approved on their technical merits, development partners could not reject them.

We remember how major institutional donors, including the United Kingdom Department for International Development (DFID), tried to block this evolution and tried to stop the Global Fund from funding AIDS treatment. We can only try to imagine what would have happened if, at the turn of the millennia, the Scaling Up for Better Health plan and its compacts ‘binding all development partners’ would have existed. We are quite sure that the fight against AIDS would still be restricted to prevention campaigns.

For obvious reasons, we do not want that to happen for new health crises.

5. The Scaling Up for Better Health plan should take a nuanced, incremental and balanced approach to integration of vertical programming into health systems.

We are concerned that the Scaling up for Better Health plan renders a negative judgment on ‘vertical’ or disease-specific interventions.

We are aware of the fact that too much ‘verticalism’ can be harmful; however we reject the increasingly popular idea that AIDS, tuberculosis and malaria interventions are by definition disturbing health systems.

History and medical science show that disease-specific interventions can and have been effective in combating many diseases. There is no evidence-based reason to exclude them from future comprehensive health programmes.

It may not be the intention of the Scaling Up for Better Health plan to exclude vertical initiatives. If vertical initiatives can be viewed as part of a comprehensive health programme, it would be very helpful to mention explicitly that countries are encouraged to strive for the right balance between vertical and horizontal interventions.

Furthermore, recent history has shown that health sector reforms applied without regard to their effects on disease control initiatives can significantly disrupt these programmes. For instance, in the late 1990s, health sector reforms in Zambia caused the national tuberculosis programme to collapse. The Scaling Up for Better Health plan needs to take a nuanced, incremental and balanced approach to integration of vertical programming into health systems lest it hamper efforts already underway to control major public health threats.

6. The Scaling Up for Better Health plan should provide a transparent overview of contributions and grants.

From the start, the Global Fund to fight AIDS, Tuberculosis and Malaria provided information about received donations, in an unusually transparent manner. This allowed us to compare the efforts of different institutional donors, and to create peer pressure. It also allowed us to compare the ambitions of health ministries and to demand more efforts whenever and wherever appropriate.

As far as we can see, the Scaling Up for Better Health plan will not be able to provide this kind of information. The foreign assistance flows supporting health compacts will be a spider web of World Bank, Global Fund and bilateral grants; nobody will be able to tell which country is giving how much, and which country is trying how hard.

If you want us to do for the Scaling up for Better Health plan what we did for the Global Fund to fight AIDS, Tuberculosis and Malaria, we will need a transparent overview of contributions and grants.

7. The Scaling Up for Better Health plan should more fully integrate and ensure meaningful civil society participation.

Last but not least, the Scaling Up for Better Health plan should seriously work on its intentions to include civil society at all stages of the decision-making process.

As far as we understand, the elaboration of health compacts for the ‘first wave’ countries has already started, or will take place during the last months of 2007 and the first months of 2008. Until now, we have not been invited to participate.

This does not look like a serious endeavour to include civil society. Civil society was a critical force in the realisation of the Global Fund and is now integrated into the governance of the Fund at all levels, building an unprecedented resource for health in the developing world. Use us. We are not single-issue chauvinists. We are willing to fight for the right to health in general, as we did and continue to do fight for the rights of people with AIDS, tuberculosis and malaria.

If you are serious about the realisation of the right to health – if your intention is not to displace funds for the fight against AIDS to other specific health interventions, but to increase predictable and sustained foreign assistance for the fight against AIDS and for the realisation of the right to health in general – you should not fear us. You need us. A top-down approach relying solely on governments will fail. Civil society offers a vehicle to provide accountability, transparency and improved governance for health in our countries. We are the consumers (and often providers) of health care, we have a vested interest in seeing programmes succeed in reaching their goals. We are able to provide an independent voice from our countries’ villages to our nations’ capitals describing what we need in real terms and what is and isn’t working on the ground. We are willing to work together, but our conditions for collaboration are clear.

We would like to meet with all of you at your earliest convenience to discuss our concerns and how to move forward as partners in health. Please contact Greg Gray, the International Coordinator of the International Treatment Preparedness Coalition at itpc@... with your replies.

Yours truly,

A.K. Jamali

Mehran Reproductive Health Organization

India

Aleksandrs Molokovskis

Society Association HIV.LV

Latvia

Alessandra Nilo

Gestos

Brazil

Margery

Tanzania National Network of People with HIV/AIDS (TANEPHA)

Tanzania

ious Zindoga

National Council of Disabled Persons of Zimbabwe

Zimbabwe

Amira Herdoiza

Corporacion Kimirina

Ecuador

Anastasia Agafonova

Vergus

Vladimir Osin

International Treatment Preparedness Coalition, Eastern Europe and Central Asia

Russian Federation

Andriy Klepikov

International HIV/AIDS Alliance

Ukraine

Hunter

Khartini Slamah

Asia-Pacific Network of Sex Workers (APNSW)

Thailand

Anjan Amatya

Support Group & Alliance of ARV Users (SARV)

Nepal

Anselmo Fonseca

Pacientes de SIDA pro Política Sana

United States

A. Sankar

Empower

India

Asia

Health GAP (Global Access Project)

USA

Basil

Caribbean HIV/AIDS Alliance

Trinidad and Tobago

Brightson Kyapula

Twafwilishi Chambishi Community Centre

Zambia

Brook K. Baker

Northeastern University School of Law

Program on Human Rights and the Global Economy

USA

Bruno Spire

Floriane Cutler

AIDES

France

Caleb Orozco

United Belize Advocacy Movement

Belize

Fabian Betancourt

Equipo de Antropología Médica

Universidad Nacional de Colombia

Colombia

Carol Bunga Idembe

Uganda Women's Network (UWONET)

Uganda

Caroline Mubaira

Community Working Group on Health

Zimbabwe

Cesar Mufanequico

Mozambique AIDS Treatment Access Movement (MATRAM)

Mozambique

Bwembya

Valley Community Support Initiative (VACOSI)

Zambia

International Treatment Preparedness Coalition (ITPC)

USA

Stegling

Botswana Network on Ethics, Law and HIV/AIDS

Botswana

Kangale

Alliance Zambia

Zambia

Choo Phuah

International HIV/AIDS Alliance

Myanmar

Claude-Henri Ralijaona

Alliance International Contre le VIH/SIDA

Madagascar

Cyprien Ngouolele

Réseau Afrique 2000

Côte d’Ivoire

Dario Abarca

Fundacion Huellas

Ecuador

Stuckler

Faculty of Social & Political Sciences

Cambridge University, King's College

United Kingdom

Delme Cupido

Open Society Initiative for Southern Africa (OSISA)

South Africa

Desmond Kumakanga

Caring for People Living with HIV and AIDS (CAPLWHA)

Malawi

Dirk Van der Maelen

European Parliament

Belgium

Dominica Mudota

Lois Chingandu

Southern Africa HIV and AIDS Information Dissemination Service

Zimbabwe

Don Liriope

Maura Elaripe Mea

Igat Hope

Papua New Guinea

Dr. Altantsetseg Batsukh

National AIDS Foundation

Mongolia

Dr. Alvaro Bermejo

International HIV/AIDS Alliance

United Kingdom

Dr. Benu B Karki

Health and Development Association

Nepal

Dr. Cheick Tidiane Tall

African Council of AIDS Service Organization (AfriCASO)

Senegal

Dr. Maïkéré

Belgium

Dr. Jeanette Kennett

Governance Research Network

Australia

Dr. Khalida Bajwa

ASEER Foundation

Pakistan

Dr. Marleen Temmerman

International Centre for Reproductive Health and Senator of the Federal Parliament of Belgium

Belgium

Dr. Nazneen Akhter

HASAB (HIV/AIDS and STD Alliance Bangladesh)

Bangladesh

Dr. Réginald Moreels

Coordination Desk Environment and Health, Services of the President

Belgium

Dr. Sunil Mehra

Health Institute for Mother and Child (MAMTA)

India

Dr. Subhasree Sai Raghavan

Dr. L. Ramakrishnan

Mr. Pawan Dhall

Solidarity and Action Against the HIV Infection in India (SAATHII)

India

Duncan Maru

Nyaya Health

Nepal

Edgar Valdex

Instituto para el Desarrollo Humano (IDH)

Bolivia

Low

Positive Malaysian Treatment Access & Advocacy Group (MTAAG+)

Malaysia

Ekta Thapa Mahat

ABHIYAN

Nepal

Eleena Azaryan

NGO Real World, Real People

Armenia

Owiti

Healthpartners

Kenya

Emma Tuahepa

Lironga Eparu

Namibia

Enrique Chavez

AID FOR AIDS International

United States

a Kessie

AIDS Legal Network

South Africa

Evgeniya Maron

Charitable Female Foundation Astra

Russian Federation

Femi Soyinka

Network on Ethics, Law, HIV/AIDS, Prevention, Support and Care (NELA)

Nigeria

Fiona Barr

India HIV/AIDS Alliance

India

Francis G. Apina

The East African Treatment Access Movement (EATAM)

Kenya

Gorik Ooms

Médecins Sans Frontières-Belgium

Belgium

Grace Chidawarume

Positive Women and Child Care

Malawi

Gracia Violeta Ross

Latin American and Caribbean NGO Alternate Delegate to the UNAIDS Programme Coordinating Board

Latin American and Caribbean Delegate in the Developing Countries NGO delegation Global Fund Board

Bolivia

Graham

International HIV/AIDS Alliance

China

Igor Kilshevsky

Association CREDINTA (National League of PLWHA)

Moldova

Igor Sobolev

Estonian Network of PLWH

Estonia

Imran Nafees Siddiqui

STREET

Pakistan

Jaffer Inamdar

Positive Lives Foundation (PLF-GOA)

India

Clovis Kayo

I Change

Cameroon

Kamau

Kenya Treatment Access Movement-KETAM

Kenya

Janek Kuczkiewicz

International Trade Union Confederation (ITUC-CSI)

Belgium

Grossman

Centre for Applied Philosophy and Public Ethics

Australian National University

Australia

Leonardo Varón

RECOLVIH - Colombian Network of People Living with HIV/AIDS

Colombia

João Mayele

Missão Sem Fronteiras, ONG Angolana de Desenvolvimento Comunitária-MIFRO

Angola

Joe

AIDS INDIA & AIDS ASIA e FORUMs

Australia

Rock

International Treatment Preparedness Coalition (ITPC)

Australia

phine Matsanga

Support and Treatment to HIV Positives and AIDS Orphans

Congo-Brazzaville

T. Formetera

Positive Action Foundation Philippines

Philippines

o

Colectivo Sol

Mexico

Julius Amoako Bekoe

Young Activists against AIDS

Ghana

Jurgis Andriushka

Association Pozityvus Gyvenimas

Lithuania

Katharina Hermann

Institute of Tropical Medicine

Belgium

Kaumbu Mwondela

Zambia AIDS Law Research & Advocacy Network

Zambia

Kieran Daly

International Council of AIDS Service Organizations (ICASO)

Canada

Kim Nichols

African Services Committee

USA

Lawrence King

University of Cambridge, Faculty of Social and Political Sciences

United Kingdom

Lillian Adhiambo

Women's Health in Women's Hands

Canada

Lillian Mworeko

International Community of Women Living with HIV/AIDS (East African Region)

Kenya

Schechtman

Zeitz

Global AIDS Alliance

USA

Loon Gangte

Pradeep Dutta

Delhi Network of People Living with HIV/AIDS (DNP+)

India

Di Giano

Argentinean Network of Women Living with HIV/AIDS

Argentina

Losuba Wongo

International HIV/AIDS Alliance

Sudan

Lucia Stirbu

UNOPA

Romania

Luyanda Ngonyama

a Clayton

Gregg Gonsalves

The AIDS and Rights Alliance for Southern Africa (ARASA)

Namibia

Lydia Mungherera

Uganda Treatment Access Movement

Uganda

Lydia Saloucou

Initiative Privee et Communautaire Contre le VIH/SIDA au Burkina Faso (IPC)

Burkina Faso

Magatte Mbodj

Alliance Nationale Contre le Sida (ANCS)

Senegal

Marcel van Soest

World AIDS Campaign

Netherlands

Marco Gomes

Global Youth Coalition on HIV/AIDS (GYCA)

Canada

Mark Harrington

Treatment Action Group (TAG)

USA

Mark Platt

UK Ukrainian AIDS Response

United Kingdom

Martha Tholanah

Network of Zimbabwean Positive Women (NZPW+)

Zimbabwe

Matilda Moyo

Pan African Treatment Access Movement (PATAM)

Zimbabwe

Meena Saraswathi Seshu

Sampada Grameen Mahila Sanstha (SANGRAM)

India

G. Nielsen

Médecins Sans Frontières-Denmark

Denmark

Michel Vasic

Médecins Sans Frontières - Artsen Zonder Grenzen

Belgium

Milly Katana

International HIV/AIDS Alliance

Uganda

M. Ismail

Pakistan National AIDS Consortium

Pakistan

Nadia Rozendaal

International AIDS Vaccine Initiative

Netherlands

Najat Sarhani

Association Marocaine de Solidarité et Développement (AMSED)

Morocco

Naoko Kawana

Japanese Network of PLHIV (JaNP+)

Japan

Natasha Leonchuk

East European & Central Asian UNION PLWH

Ukraine

Nazir Masih

New Light AIDS Control Society

Pakistan

Nenet L. Ortega

Robin CarbonelInternational Treatment Preparedness CoalitionPhilippines

Nicolas Ritter

Hardy Beeharry

Prevention, Intervention et Lutte contre le SIDA

Mauritius

Nicoli Nattrass

AIDS and Society Research Unit, University of Cape Town

South Africa

Noel Pascual

Eddy Razon

Pinoy Plus Association

Philippines

Nofal Sharifov

Public Organization on AIDS Fight

Azerbaijan

Noreen M Huni

REPSSI Secretariat

South Africa

Nurali Amanzholov

Kazakhstan’s Union of PLWH Kazakhstan

Kazakhstan

Oswaldo Rada

Latin American Network of PLWHA - Redla+

Colombia

Oum Sopheap

Khmer HIV/AIDS NGO Alliance (KHANA)

Cambodia

Figueroa

PRCoNCRA - Puerto Rico Community Network for Clinical Research on AIDS

USA

Kasonkomona

Treatment Advocacy & Literacy Campaign (TALC)

Zambia

Thorn

TB Survival Project

United Kingdom

van Rooijen

International Civil Society Support

Netherlands

Pervjav Tsevendendev

Positive Life

Mongolia

Prabhakar Varma

Alliance for AIDS Action, Andrah Pradesh

India

Qaisar Ismail

CRY- Coalition on Rights and Responsibilities of Youth

Pakistan

Ranganadha Rao

LEPRA Society

India

Rashmi Samaram

Vasavya Mahila Mandali (VMM)

India

Regis Mtutu

Treatment Action Campaign (TAC)

South Africa

Reji Chandra

Palmyrah Workers Development Society (PWDS)

India

Shilamaba

SAHRINGON

Tanzania

Stern

Agua Buena Human Rights Association

Costa Rica

Rico Gustav

Indonesian Civil Society Coalition for UNGASS Watch

Indonesia

o A.O. Nebrida

Asia Pacific Health and Development Center

Philippines

Cabello

Via Libre

Peru

Rodrigo Pascal

Fundación Ciudadana para las Américas

Chile

Ron Nsaliwa

Helping Hand Foundation

Malawi

Ruslan Bidayshiev

PCF Positive Initiative

Kyrgyzstan

Sam Anyimadu-Amaning

Ghana HIV/AIDS Network,

Ghana

Sanjay Basu

Yale University Prison Health Program

USA

Sergey Uchaev

Public union of PLWH Ishonch va Hayot

Uzbekistan

Sevara Kamilova

NGO GULI SURKH

Tajikistan

Shabana Kazi

Veshya Anyay Mukti parishad (VAMP)

India

Shaun Mellors

Communities Living with HIV, TB and affected by Malaria Delegation

Global Fund to Fight AIDS, Tuberculosis and Malaria

United Kingdom

Shiba Phurailatpam

Asia Pacific Network of People Living with HIV/AIDS (APN+)

Thailand

Sibonelo Mdluli

Women and Law

Swaziland

Simão Cacumba Morais Faria

SCARJOV - Associação de Rintegração dos Jovens/Crianças na Vida Social

Angola

Shefali Oza

Sanfe Bagar Achham

United Trauma Relief

USA

Snehansu Bhaduri

Madhya Pradesh Network of People living with HIV/AIDS (MPNP+)

India

Sosthene Dougrou

Alliance Nationale contre le SIDA en Cote d’Ivoire (ANS-CI)

Cote d’Ivoire

McGill

Stop AIDS in Liberia

Liberia

Sudin Serchan

National Association of People Living with HIV and AIDS, Nepal (NAP+N)

Nepal

Sunil Pant

Blue Diamond Society

Nepal

Suren Lama

Prayas ( NGO of Drug Users and PLWHA)

Nepal

Amoaten

International HIV/AIDS Alliance

Mozambique

Tapiwanashe Kujinga

Southern African Treatment Access Movement (SATAMO)

Zimbabwe

Ted Gaudet

Global Network of People living with HIV/AIDS North America

Canada

Tendayi Westerhof

Public Personalities against AIDS Trust

Zimbabwe

Terry White

Vladimir Zhovtyak

All-Ukrainian Network PLWHA

East European & Central Asian Union of PLWHA Organisations

Ukraine

Valeriy Epov

Positive Wave Foundation

Russian Federation

Vijay Nair

Nipasha+

India

Vitaly Djuma

Russian Harm Reduction Network (RHRN)

Russian Federation

Wendi Losha Bernadette

Actwid Kongadzem

Cameroon

Wim Vandevelde

European AIDS Treatment Group (EATG)

Belgium

Yeugeniy Spevak

Byelorussian public union Positive Movement

Byelorussia

Sandris Klavins

AGIHAS (PLWHA Support group)

Latvia

Anandi Yuvraj

India

Gennady Roshchupkin

Russian Federation

Ovchinnikova

Russian Federation

Ted Schrecker

Canada

Wojciech Tomczynski

Poland

Chikosa Banda

United Kingdom

Rochelle D’Souza Yepthomi

India

Jabin Sharma

India

Suresh

India

Sethulakshmi Chandra

India

Dr Tokugha Yepthomi

India

Jugnoo Trust

India

Love Life Society

India

Rakshak

India

Spandhana+

India

Udaan Trust

India

[1] http://www.who.int/hac/techguidance/tools/disrupted_sectors/module_06/en/index6.html