Re: India CCM Website and Call for proposals for round 6

[Guest guest]

Dear Dr. Bobby ,

Is the CCM also prioritizing proposals that would emphasize funding for ARV

access for both children and adults?.

I think this should be a priority. These might not be NGO proposals, but

proposals through NACO or other large scale service providers. If India has

500,000 people who need treatment access now, saving their lives should be a

major priority of proposals, in my opinion. Even though we know that by the

time the proposal is approved, and the funds are disbursed that many of these

people will have died. But there will be many more who continue to need

treatment.

I also wonder if the (apparently) slow implementation of projects approved in

previous rounds will affect the probability of new proposals being accepted. I

am not fully aware of how well implementation of the varioius Indian projects is

going, but when I visited last year it seemed to be going quite slowly.

I have written some articles focusing on ARV access in India after visiting

Mumbai twice in the past two years.

Sincerely,

Stern

San , Costa Rica

e-mail: <rastern@...

[Guest guest]

Dear FORUM,

Ref: Stern's posting on India CCM Website and Call for proposals for

round 6

It is gratifying to know that Mr. Stern travelled across the globe to

Mumbai twice. His concern for the Indian needing ART is well taken too.

However, despite what Mr. stern, or I may want a country to do or not do, there

are in country processes that take precedence over our individual preferences

and prescriptions.

The India CCM process is one such, and till such time that all parties that form

the India CCM do not arrive at a commonly held position, we can only work with

our respective constituencies that represent us there to influence the final

outcome, which in your mind, very legitimately ought to be ARV provision to

adults and children.

As and when the CCM does finish formulating the country coordinated proposal, it

should reflect the aspirations and concerns of each of the constituencies, and

indeed those of the people that live with the 3 diseases, as also the concerns

of the agencies that will seek to deliver the interventions. The process now

underway calling for proposals is an effort by the CCM to bring together all

stakeholder aspirations.

Whether performance in the previous grants have been upto speed is not something

I would comment on based on 'thin slice' sampling over 2 visits to one

particular location. Whether the current proposal will be successful is

something that I would not wish to speculate on based on thin slice impressions.

I would only say that performance oversight is once again a responsibility of

the CCM, and that members and constituencies of the CCM need to be vigilant in

ensuring that the grants deliver on the ground, so that lives are saved, and

that the performance does not become a deterrant to future grants to the

country.

Regards,

Bobby

e-mail: <bj@...>

[Guest guest]

Concept Note on inputs to HIV Component of GFATM Round-6 Proposal

After successfully managing two phases of the National AIDS Control Programme, India is in the process of developing the Implementation Plan of the Third National AIDS Control Programme [NACP III] (2006-2011). The overall goal of NACP III is to halt and reverse the epidemic in India over the next 5 years by integrating programmes for prevention, care, support and treatment. This will be achieved through four strategic objectives namely:

1. Prevention of new infections in high risk groups and general population through:

a) Saturation of coverage of high risk groups with targeted interventions (TIs)

Scaled up interventions in the general population

2. Increasing the proportion of people living with HIV/AIDS who receive care, support and treatment.

3. Strengthening the infrastructure, systems and human resources in prevention and treatment programmes at the district, state and national levels.

4. Strengthening a nation-wide strategic information management system.

NACP III will provide a range of preventive services i.e. behaviour change communication, treatment of STIs, condom promotion, Integrated Counselling and Testing, PPTCT, supply of safe blood and infection control. The focus of NACP II was on prevention along with low cost treatment for Opportunistic Infections. It was only in 2005 that the government initiated the provision of ART. While the emphasis on prevention will be retained, NACP III will also lay stress on care, support and treatment services integrated with prevention. This will include management of opportunistic infections; control of Tuberculosis in PLHA; clinical diagnosis, ART, community outreach for treatment adherence and psycho social support; safety measures; positive prevention; impact mitigation programmes; and establishment and support of Community Care Centres etc. ART is now made available in 71 centres and it is proposed to scale them up. 37686 persons have been placed on ART as on 31st March 2006.

The India – Country Coordinating Mechanism (India-CCM) for the GFATM at its last meeting on 11th May 2006, has resolved to focus the entire Round-6 proposal on care, support and treatment. The strategies to be adopted in the proposal will be in line with the framework developed for NACP III. The strategies will include:

Prophylaxis and management of opportunistic infections

Prevention of Parent to Child transmission

Anti- Retroviral Therapy

Diagnostics and resistance monitoring including supply and maintenance of CD4 and PCR machines

Paediatric Anti-retroviral therapy

Community outreach for treatment literacy and adherence

Establishment and support of Community Care Centres

Support and training to PLHA

Palliative care

Impact mitigation

The institutional arrangements, capacity strengthening, technical support and monitoring and evaluation systems will be configured to support these interventions.

These interventions will be delivered in collaboration with private sector, academic/research/training institutions, civil society organisations (CSO), and PLHA networks. NACP III envisages contracting to private providers and civil society organisations in the provision of services through public-private partnership.

Appropriate financing mechanisms such as voucher scheme implemented in Gujarat under RCH programme will be developed. Under NACP III 500 Community Care Centres are proposed to be set up. These will be managed by CSOs.

Innovative mechanisms for treatment monitoring, community based approaches for care and support, models for successful integration of prevention in care and support, models for impact mitigation are some of the other areas where proposals from the private sector and civil society organisations will be welcome.

Potential areas of collaboration in which proposals are invited for GFATM support are highlighted below:

Component

Private Sector

Civil Society Organizations*

PLHA Network

Academic/ Research/

Training

Institutions

1

Prophylaxis and management of opportunistic infections

ü

ü

2

Prevention of Parent to child transmission

ü

ü

3

Anti- Retroviral Therapy

ü

ü

4

Diagnostics and resistance monitoring

ü

ü

5

Paediatric Anti-retroviral therapy

ü

ü

6

Community outreach for treatment literacy and adherence

ü

ü

7

Community Care Centres

ü

ü

8

Support and training to PLHA

ü

ü

ü

9

Palliative care

ü

ü

ü

10

Impact mitigation

ü

ü

11

Capacity Strengthening

ü

ü

ü

ü

13

Technical support

ü

ü

ü

ü

14

Monitoring and evaluation

ü

ü

ü

ü

* Includes Faith Based Organizations

Dr.Ashok Rau

Executive Trustee/CEO

Freedom Foundation-India,

(Centers of Excellence- Substance Abuse & HIV/AIDS)

Senior Research Fellow, The Terry Sanford Institute of Public Health, Duke University (USA)

Visiting Faculty, Yale University (USA)

Phone (O) +91 80 25440134, 25449766,

e-mail: