Professor Michel Kazatchkine, Executive Director, GFATM

1. What do the trends in HIV & AIDS in Asia indicate?
    HIV & AIDS is a human tragedy and a real and growing threat to Asia’s economic prosperity. National HIV infection levels in Asia are low compared with some other continents, notably Africa. However, the populations of many Asian nations are so large that even low national HIV prevalence means large numbers of people are living with HIV. Risky behavior continues to sustain serious AIDS epidemics in Asia. Especially the poor and vulnerable population in the region is badly affected by HIV & AIDS; groups at higher risk of HIV infection in the region include young people, commercial sex workers, people who inject drugs and men who have sex with men. The disease can become a serious burden on households, many of which get into debt because of loss of income and the medical costs. Despite new and encouraging prevalence estimates from Asian countries like India, the epidemic in the region is still growing.

    2. Where does Asia fi gure in the GFATM response?
So far, the Global Fund to Fight AIDS, Tuberculosis and Malaria has approved grants worth approximately US$ 2.8 billion over fi ve years to programs in Asia and the Pacifi c fi ghting HIV & AIDS, tuberculosis and malaria. Of this amount, more than US$ 875 million dollars has already been disbursed to the region. Of the US$ 2.8 billion approved to Asia over fi ve years, the Global Fund has committed more than US$ 1.3 billion – almost half of the total amount – to programs fi ghting against HIV & AIDS.

    3. What are your strategies to improve the CCM structures to ensure effective governance at country levels?
Country Coordinating Mechanisms (CCMS) are central to the Global Fund’s commitment to local ownership and participatory decision-making. CCMs are country-defi ned, country-driven bodies that develop and submit grant proposals to the Global Fund based on priority needs at the national level. After grant approval, they also oversee progress during implementation.
I believe strongly that we must never lose sight of that principle of country ownership. Much of the CCMs’ progress in governance is a result of their own doing, responding to basic principles that were designed from the beginning.
In April 2005, the Board instituted six minimum requirements of governance that CCMs had to meet in order to be eligible for funding. Because of these requirements, the CCMs have greatly improved their own governing processes making them more transparent and participatory. For example: CCMs have been addressing confl icts of interest and developing appropriate policies to mitigate them; CCMs are composing themselves as truly multi-stakeholder bodies—much like the Global Fund’s own Board—where NGO representatives are defi ning their own processes for self-selection; Many CCMs have developed high quality by-laws/governance manuals to guide their decision-making processes. We share those documents, and others, on our website for all to see and take advantage of. But of course, there is still room for improvement. That is why the Global Fund has embarked on ambitious efforts with our partners to provide in-depth technical support to improve CCM governing processes. We are also working with our own Board to improve our policies that provide support to CCMs, making funding of basic administrative costs easier and more fl exible.
The Global Fund also documents lessons learned and shares these widely through our comprehensive website. For example, we are currently studying the CCM model, through 25 case studies and our 5 year evaluation.

    4. How do you rate government response in Asia?
The government response to HIV & AIDS varies widely across the region. We have already seen some promising commitments by India and China in the fi ght against this disease. Other countries like Thailand and Cambodia e.g. have been leaders in reducing HIV infection rates and fi ghting the disease in general. A number of countries need to do more, however, particularly by showing a stronger political commitment.

    5. What are your strategies in terms of resource mobilization for the Global Fund?
Developing effective fundraising strategies has become a core part of the Global Fund’s work. To fi nance the fi ght against the three pandemics, the Global Fund relies on fi nancial contributions from public and private donors, including governments, foundations, corporations and individuals.
The Global Fund is currently preparing for its second replenishment meeting, which will be hosted on 26 to 28 September 2007 by the German Government in Berlin. During the meeting donors will assess the resource needs and the available funding in the light of latest forecasts. The voluntary replenishment mechanism brings donors together periodically to discuss progress and expectations of the Global Fund and to help donors better plan their fi nancial commitments on a multi-year basis.

    6. What is your message to the world leaders particularly to the G8 countries?
The Global Fund was established in 2002. Now, a bit more than fi ve years later, the Global Fund has saved an estimated 2 million lives in 136 countries spanning the globe through supporting more than 450 programs fi ghting HIV & AIDS, tuberculosis and malaria. In addition, other successful initiatives, like UNITAID, an international drug purchase facility; the US President’s Emergency Plan for AIDS Relief and many other bilateral initiatives are all saving many more lives.
Backed by the people implementing the programs in the fi eld and strong technical partners like the World Health Organization, the Roll Back Malaria Partnership, the Stop TB Partnership and UNAIDS, we are having an impact on so many people infected with and affected by HIV & AIDS, Tuberculosis and Malaria.
These three diseases together still kill 6 million people every year. In order to continue saving many more lives and contain the further spread of these diseases, we depend on the goodwill of rich countries to donate more resources to this common fi ght. These countries should prioritize the fi ght against infectious diseases as they continue the substantial increase in their development assistance budgets that we have witnessed over the past few years.

    7. Your message to Asia
The Global Fund is saving lives, thanks to the people in the many organizations treating and caring for people infected with and affected by HIV & AIDS, tuberculosis and malaria in all countries where we have grants.
With the help of the people implementing programs on the ground and the many strong partners involved in this common fi ght, I am hopeful that we can reach universal access to AIDS treatment and prevention, roll back malaria, stop TB and save millions more lives.