1. NEWS: Important New Data Released Regarding People Needing ARV Treatment

GLOBAL FUND OBSERVER (GFO), an independent newsletter about the Global Fund provided by Aidspan to over 7,000 subscribers in 170 countries.

Issue 94: 17 September 2008. (For formatted web, Word and PDF versions of this and other issues, see

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CONTENTS

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1. NEWS: Important New Data Released Regarding People Needing ARV Treatment

Until recently, there was no publicly available data regarding how many people within each country need ARV treatment, or regarding how many of those people are receiving it.However, this information, with much other health data, is now available at

2. ANALYSIS: CountriesMost in Need of Scaling Up ARV Provision

An analysis conducted by GFO shows thathalf of all countries that are eligible to receive Global Fund grants currently provide ARV treatment to less than 25% of those that need it, and/or have at least 25,000 people who need ARV treatment but are not receiving it.

3. COMMENTARY: Saving Lives: Who Can Claim the Credit?

“The Global Fund says ‘GF-supported programs have provided millions of people with lifesaving services. As a result, at least 2.5 million lives have been saved.’ Well, yes and no...”

4. REMINDER: Global FundLaunches Round9 on 1 October

The Fund will launch Round 9 in two weeks’ time, on 1 October. The deadline for applications will be 21 January 2009.The proposal form and guidelines for Round 9 will be substantially unchanged from Round 8.

5. NEWS: Report Released on Civil Society Contribution to Grant Implementation

The Global Fund and the International HIV/AIDS Alliance have released a report on “Civil Society Success on the Ground – Community Systems Strengthening and Dual-Track Financing: Nine Illustrative Case Studies.”

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1. NEWS: Important New Data Released Regarding People Needing ARV Treatment

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Until recently, there was no publicly available data regarding how many people within each country need ARV treatment, or regarding how many of those people are receiving it.(Such information was available at a global level but not at a country level.)This made it hard to determine which countries are most in need of “scaling up” regarding the provision of ARV treatment, through Global Fund support or otherwise.

However, this specific information, along with much other health data, is now available at helpful site was created by the Kaiser Family Foundation, and is based upon data compiled by a number of international organizations.The value of the site is that all the data has been pulled together and can be accessed through a simple interface.

In the table below, we give examples of the forms of data that the site provides regarding a sample country, Kenya.

There are two ways in which users can see the data shown below.The first option is to go to specify which country and which indicators one wants to see. The second option is to go to Aidspan is publisher of GFO) and specify which country one wants to see, and then choose the option for “Country-Specific Data Sheet on HIV, TB and malaria from the latter case, one doesn’t have to choose indicators – the table shows all indicators.In both cases, one can then download the data to a spreadsheet or to a PDF file.

Indicator
(Data regarding each indicator is provided at for all countries in the world) / As of / Data for Kenya
(This is provided to illustrate what is available for any country)
HIV/AIDS
People Living with HIV/AIDS / 2007 / 1,500,000-2,000,000
Adults Living with HIV/AIDS / 2007 / 1,400,000-1,800,000
Adult HIV/AIDS Prevalence Rate / 2007 / 7.1-8.5%
Men Living with HIV/AIDS / NA
Women Living with HIV/AIDS / NA
Children Living with HIV/AIDS / 2007 / 130,000-180,000
AIDS Deaths [annual] / 2007 / 85,000-130,000
AIDS Orphans / 2007 / 990,000-1,400,000
ARV Need [i.e. people needing treatment – many of whom do not know they have HIV] / 2007 / 470,000
ARV Treatment [i.e. people receiving treatment] / Dec. 2007 / 177,000
ARV Coverage Rate / Dec. 2007 / 38%
TB
New TB Cases / 2006 / 140,548
New TB Smear Positive Cases / 2006 / 55,934
New TB Case Rate / 2006 / 384 per 100,000
TB Smear Positive Case Rate / 2006 / 153 per 100,000
People living with TB / 2006 / 122,126
TB Prevalence Rate / 2006 / 334 per 100,000
TB Deaths (annual) / 2006 / 26,278
[Plus 11 more indicators]
Malaria
Malaria Cases / 2002 / 124,197
Malaria Case Rate / 2002 / 3.94 per 1,000
Malaria Deaths [annual] / 2002 / 135
Other Diseases, Conditions, & Risk Indicators
Percent Without Water / 2004 / 39%
Access to Sanitation / 2004 / 43%
Population Undernourished / 2001-2003 / 31%
Low Birthweight Babies / NA / 10%
[Plus 5 more indicators]
Programs, Funding, & Financing
PEPFAR Funding / FY 2007 / $368,129,182
PEPFAR ARV Treatment [i.e. people receiving ARV treatment that is funded in part by PEPFAR] / 31-Mar-08 / 192,100
Global Fund Grants for HIV/AIDS / 21-Jul-08 / Yes
Global Fund Grants for TB / 21-Jul-08 / Yes
Global Fund Grants for Malaria / 21-Jul-08 / Yes
Global Fund Disbursements / 21-Jul-08 / $160,144,081
Global Fund ARV Treatment [i.e. people receiving ARV treatment that is funded in part by the Global Fund] / 01-Dec-07 / 166,379
Health Expenditure Per Capita / 2003 / $65
Total Expenditure on Health [as % of GDP] / 2004 / 4.1%
Gov’t Health Expenditure as % of Total Gov’t Expenditure / 2004 / 8.2%
Gov’t Health Expenditure as % of Total Health Expenditure / 2004 / 42.7%
[Plus 5 more indicators]
Health Workforce & Capacity
Physicians / 2002 / 0.14 per 1,000
Nurses / 2002 / 1.18 per 1,000
Community Health Workers / NA
Midwives / NA
Births Attended by Skilled Health Personnel / 2003 / 42%
Hospital Beds / 2002 / 19 per 10,000
Demography & Population
Population / 2007 / 36,913,721
Women / 2005 / 16,600,000
Median Age / 2007 / 18.6
Population Under Age 15 / 2007 / 42%
[Plus 18 more indicators]
Income & The Economy
GDP Per Capita / 2006 est. / $1,200
Population Below $1 a Day / 1997 / 22.8%
[Plus 2 more indicators]

Notes:

1.The data provided at obtained by the Kaiser Family Foundation from UN and other international entities.

2.Explanatory comments in square brackets above are provided by GFO.

3.Another source of data on each country is the WHO’s epidemiological facts sheets on HIV/AIDS, accessible at Access to these fact sheets is also provided via

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2. ANALYSIS: Countries Most in Need of Scaling Up ARV Provision

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An analysis by GFO of data newly provided at (see previous article) shows that 62 of the 126 countries that are eligible to apply to the Global Fund (i.e. 48% of these countries) currently provide ARV treatment to less than 25% of those that need it, and/or have at least 25,000 people who need ARV treatment but are not receiving it.

This suggests that all of these countries, and probably many others, are urgently in need of scaling up treatment through support from the Global Fund or others.

The countries in question are those shown in bold in the following table.Further explanations are provided at the end of the table.

Country
(showing all countries eligible for Global Fund HIV grants) / People Living with HIV/AIDS / HIV Preva-lence / People needing ARV treatment / People receiving ARV treatment / Of which: / People "needing" treatment minus people "receiving" treatment / Coverage
(equals “Receiving” as % of “Needing”)
People receiving ARV treatment with GF support / People receiving ARV treatment with Pepfar support
Global / 32,900,000 / 0.8% / 9,700,000 / 2,990,000 / 1,447,976 / 1,641,000 / 6,710,000 / 31%
Afghanistan / NA / NA / NA / 0 / 0 / 0 / NA / NA
Albania / <1000 / <0.2% / NA / <100 / 0 / 0 / NA / NA
Algeria / 21,000 / 0.1% / 4,900 / 1,000 / 850 / 0 / 3,900 / 20%
Angola / 190,000 / 2.1% / 47,000 / 12,000 / 9,263 / 0 / 35,000 / 25%
Argentina / 120,000 / 0.5% / 53,000 / 38,000 / 0 / 0 / 15,000 / 73%
Armenia / 2,400 / 0.1% / 660 / <100 / 59 / 0 / c. 610 / 12%
Azerbaijan / 7,800 / 0.2% / 580 / <100 / 24 / 0 / c. 530 / 14%
Bangladesh / 12,000 / <0.1% / 2,400 / <200 / 0 / 0 / c. 2,300 / 7%
Belarus / 13,000 / 0.2% / 4,300 / 900 / 643 / 0 / 3,400 / 20%
Belize / 3,600 / 2.1% / 1,100 / 600 / 494 / 0 / 500 / 49%
Benin / 64,000 / 1.2% / 20,000 / 9,800 / 8,633 / 0 / 10,200 / 49%
Bhutan / <500 / 0.1% / <100 / <100 / 0 / 0 / <100 / NA
Bolivia / 8,100 / 0.2% / 2,300 / <500 / 416 / 0 / c. 2,050 / 22%
Bosnia and Herzegovina / <500 / <0.1% / NA / <100 / 0 / 0 / NA / NA
Botswana / 300,000 / 23.9% / 120,000 / 93,000 / 0 / 94,900 / 27,000 / 79%
Brazil / 730,000 / 0.6% / 230,000 / 181,000 / 0 / 0 / 49,000 / 80%
Bulgaria / NA / NA / NA / <500 / 210 / 0 / NA / NA
Burkina Faso / 130,000 / 1.6% / 48,000 / 17,000 / 5,237 / 0 / 31,000 / 35%
Burundi / 110,000 / 2.0% / 47,000 / 11,000 / 8,935 / 0 / 36,000 / 23%
Cambodia / 75,000 / 0.8% / 40,000 / 27,000 / 23,587 / 0 / 13,000 / 67%
Cameroon / 540,000 / 5.1% / 180,000 / 46,000 / 28,773 / 0 / 134,000 / 25%
Cape Verde / NA / NA / NA / <500 / 0 / 0 / NA / NA
Central African Republic / 160,000 / 6.3% / 45,000 / 9,600 / 4,801 / 0 / 35,400 / 21%
Chad / 200,000 / 3.5% / 55,000 / 7,400 / 1,430 / 0 / 47,600 / 13%
China / 700,000 / 0.1% / 190,000 / 35,000 / 28,884 / 0 / 155,000 / 19%
Colombia / 170,000 / 0.6% / 54,000 / 21,000 / 78 / 0 / 33,000 / 38%
Comoros / <200 / <0.1% / <100 / <100 / 5 / 0 / <100 / NA
Congo / 79,000 / 3.5% / 29,000 / 5,000 / 4,066 / 0 / 24,000 / 17%
Congo (DRC) / 400,000-500,000 / 1.2-1.5% / 120,000 / 29,000 / 13,064 / 0 / 91,000 / 24%
Cote d'Ivoire / 480,000 / 3.9% / 190,000 / 52,000 / 46,007 / 39,700 / 138,000 / 28%
Cuba / 6,200 / 0.1% / 1,400 / 3,100 / 2,581 / 0 / -1,700 / >95%
Djibouti / 16,000 / 3.1% / 4,500 / 700 / 725 / 0 / 3,800 / 16%
Dominica / NA / NA / NA / <100 / 0 / 0 / NA / NA
Dominican Rep. / 62,000 / 1.1% / 22,000 / 8,200 / 7,768 / 0 / 13,800 / 38%
Ecuador / 26,000 / 0.3% / 7,600 / 3,200 / 2,317 / 0 / 4,400 / 42%
Egypt / 9,200 / <0.1% / 2,200 / <500 / 0 / 0 / c. 1,950 / 9%
El Salvador / 35,000 / 0.8% / 11,000 / 5,800 / 4,708 / 0 / 5,200 / 51%
Eritrea / 38,000 / 1.3% / 10,000 / 1,300 / 1,890 / 0 / 8,700 / 13%
Ethiopia / 980,000 / 2.1% / 310,000 / 90,000 / 81,819 / 97,100 / 220,000 / 29%
Fiji / <500 / 0.1% / <200 / <100 / 0 / 0 / c. 50 / NA
Gabon / 49,000 / 5.9% / 15,000 / 6,400 / 3,306 / 0 / 8,600 / 42%
Gambia / 8,200 / 0.9% / 2,300 / <500 / 385 / 0 / c. 2,050 / 18%
Georgia / 2,700 / 0.1% / <500 / <500 / 271 / 0 / <500 / NA
Ghana / 260,000 / 1.9% / 87,000 / 13,000 / 10,275 / 0 / 74,000 / 15%
Grenada / NA / NA / NA / <100 / 0 / 0 / NA / NA
Guatemala / 59,000 / 0.8% / 21,000 / 7,800 / 2,937 / 0 / 13,200 / 37%
Guinea / 87,000 / 1.6% / 21,000 / 5,700 / 1,411 / 0 / 15,300 / 27%
Guinea-Bissau / 16,000 / 1.8% / 4,400 / 900 / 517 / 0 / 3,500 / 20%
Guyana / 13,000 / 2.5% / 4,300 / 2,000 / 2,054 / 2,000 / 2,300 / 45%
Haiti / 120,000 / 2.2% / 36,000 / 15,000 / 12,921 / 15,100 / 21,000 / 41%
Honduras / 28,000 / 0.7% / 12,000 / 5,600 / 5,006 / 0 / 6,400 / 47%
India / 2,400,000 / 0.3% / NA / 158,000 / 100,897 / 0 / NA / NA
Indonesia / 270,000 / 0.2% / 43,000 / 6,600 / 6,647 / 0 / 36,400 / 15%
Iran / 86,000 / 0.2% / 19,000 / 900 / 47 / 0 / 18,100 / 5%
Iraq / NA / <0.2% / NA / 0 / 0 / 0 / NA / NA
Jamaica / 27,000 / 1.6% / 8,500 / 3,600 / 4,000 / 0 / 4,900 / 43%
Jordan / <1000 / <0.2% / NA / <100 / 45 / 0 / NA / NA
Kazakhstan / 12,000 / 0.1% / 1,900 / <500 / 342 / 0 / c. 1,650 / 23%
Kenya / 1,500,000-2,000,000 / 7.1-8.5 / 470,000 / 177,000 / 166,379 / 192,100 / 293,000 / 38%
Kiribati / NA / NA / NA / <100 / 0 / 0 / NA / NA
Korea (North) / <100 / <0.1% / 2,900 / NA / 0 / 0 / <=2,900 / 0%
Kyrgyzstan / 4,200 / 0.1% / 610 / <100 / 62 / 0 / c. 560 / 14%
Lao PDR / 5,500 / 0.2% / 690 / 700 / 0 / 0 / -10 / >95%
Lesotho / 270,000 / 23.2% / 85,000 / 22,000 / 17,728 / 0 / 63,000 / 26%
Liberia / 35,000 / 1.7% / 8,500 / 1,400 / 1,157 / 0 / 7,100 / 17%
Macedonia / <500 / <0.1% / NA / <100 / 20 / 0 / NA / NA
Madagascar / 14,000 / 0.1% / 3,200 / <200 / 163 / 0 / c. 3,100 / 4%
Malawi / 930,000 / 11.9% / 290,000 / 101,000 / 79,398 / 0 / 189,000 / 35%
Malaysia / 80,000 / 0.5% / 20,000 / 6,800 / 0 / 0 / 13,200 / 35%
Maldives / <100 / <0.1% / <100 / <100 / 0 / 0 / <100 / NA
Mali / 100,000 / 1.5% / 30,000 / 12,000 / 12,814 / 0 / 18,000 / 41%
Marshall Islands / NA / NA / NA / <100 / 0 / 0 / NA / NA
Mauritania / 14,000 / 0.8% / 3,600 / 800 / 531 / 0 / 2,800 / 23%
Mauritius / 13,000 / 1.7% / 1,500 / <500 / 0 / 0 / c. 1,250 / 22%
Mexico / 200,000 / 0.3% / 76,000 / 43,000 / 0 / 0 / 33,000 / 57%
Micronesia / NA / NA / NA / <100 / 0 / 0 / NA / NA
Moldova / 8,900 / 0.4% / 800 / <500 / 451 / 0 / c. 550 / 58%
Mongolia / <1000 / 0.1% / <100 / <100 / 2 / 0 / <100 / NA
Morocco / 21,000 / 0.1% / 5,300 / 1,600 / 1,400 / 0 / 3,700 / 31%
Mozambique / 1,500,000 / 12.5% / 370,000 / 90,000 / 78,236 / 88,200 / 280,000 / 24%
Myanmar / 240,000 / 0.7% / 76,000 / 11,000 / 0 / 0 / 65,000 / 15%
Namibia / 200,000 / 15.3% / 59,000 / 52,000 / 43,694 / 52,800 / 7,000 / 88%
Nepal / 70,000 / 0.5% / 20,000 / 1,400 / 1,240 / 0 / 18,600 / 7%
Nicaragua / 7,700 / 0.2% / 1,700 / 500 / 531 / 0 / 1,200 / 30%
Niger / 60,000 / 0.8% / 16,000 / 1,500 / 1,907 / 0 / 14,500 / 10%
Nigeria / 2,600,000 / 3.1% / 750,000 / 198,000 / 4,832 / 162,500 / 552,000 / 26%
Pakistan / 96,000 / 0.1% / 20,000 / 600 / 361 / 0 / 19,400 / 3%
Panama / 20,000 / 1.0% / 7,200 / 4,000 / 0 / 0 / 3,200 / 56%
Papua New Guinea / 54,000 / 1.5% / 5,900 / 2,300 / 1,546 / 0 / 3,600 / 38%
Paraguay / 21,000 / 0.6% / 4,800 / 1,100 / 0 / 0 / 3,700 / 22%
Peru / 76,000 / 0.5% / 23,000 / 11,000 / 10,610 / 0 / 12,000 / 48%
Philippines / 8,300 / <0.1% / 1,100 / <500 / 170 / 0 / c. 850 / 31%
Rwanda / 150,000 / 2.8% / 68,000 / 49,000 / 44,395 / 52,400 / 19,000 / 71%
Saint Lucia / NA / NA / NA / <100 / 0 / 0 / NA / NA
St. Vincent & Grenadines / NA / NA / NA / <100 / 0 / 0 / NA / NA
Samoa / NA / NA / NA / <100 / 0 / 0 / NA / NA
Sao Tome & Principe / NA / NA / NA / <100 / 0 / 0 / NA / NA
Senegal / 67,000 / 1.0% / 12,000 / 6,700 / 2,270 / 0 / 5,300 / 56%
Serbia and Montenegro / 6,400 / 0.1% / NA / NA / 481 / 0 / NA / NA
Sierra Leone / 55,000 / 1.7% / 13,000 / 2,600 / 1,623 / 0 / 10,400 / 20%
Solomon Islands / NA / NA / NA / <100 / 0 / 0 / NA / NA
Somalia / 24,000 / 0.5% / 6,300 / <500 / 201 / 0 / c. 6,050 / NA
South Africa / 5,700,000 / 18.1% / 1,700,000 / 460,000 / 115,142 / 435,100 / 1,240,000 / 28%
Sri Lanka / 3,800 / <0.1% / 780 / <200 / 0 / 0 / c. 680 / 14%
Sudan / 320,000 / 1.4% / 87,000 / 1,200 / 1,480 / 0 / 85,800 / 1%
Suriname / 6,800 / 2.4% / 1,600 / 700 / 656 / 0 / 900 / 45%
Swaziland / 190,000 / 26.1% / 59,000 / 25,000 / 21,670 / 0 / 34,000 / 42%
Syria / NA / <0.2% / NA / <100 / 0 / 0 / NA / NA
Tajikistan / 10,000 / 0.3% / 1,300 / <100 / 94 / 0 / c. 1,250 / 6%
Tanzania / 1,400,000 / 6.2% / 440,000 / 136,000 / 96,936 / 114,200 / 304,000 / 31%
Thailand / 610,000 / 1.4% / 250,000 / 153,000 / 93,839 / 0 / 97,000 / 61%
Timor Leste / NA / NA / NA / 0 / 0 / 0 / NA / NA
Togo / 130,000 / 3.3% / 41,000 / 8,000 / 3,389 / 0 / 33,000 / 19%
Tonga / NA / NA / NA / NA / 0 / 0 / NA / NA
Tunisia / 3,700 / 0.1% / 1,000 / <500 / 0 / 0 / c. 750 / 29%
Turkmenistan / <500 / <0.1% / NA / 0 / 0 / 0 / NA / NA
Uganda / 940,000 / 5.4% / 350,000 / 115,000 / 46,642 / 131,200 / 235,000 / 33%
Ukraine / 440,000 / 1.6% / 91,000 / 7,700 / 4,060 / 0 / 83,300 / 8%
Uruguay / 10,000 / 0.6% / 3,100 / 1,800 / 0 / 0 / 1,300 / 56%
Uzbekistan / 16,000 / 0.1% / 1,400 / <500 / 277 / 0 / c. 1,150 / 24%
Vanuatu / NA / NA / NA / <100 / 0 / 0 / NA / NA
Viet Nam / 290,000 / 0.5% / 67,000 / 17,000 / 2,927 / 11,800 / 50,000 / 26%
W. Bank & Gaza / NA / NA / NA / NA / 0 / 0 / NA / NA
Yemen / NA / <0.2% / NA / <200 / 0 / 0 / NA / NA
Zambia / 1,100,000 / 15.2% / 330,000 / 151,000 / 122,684 / 151,900 / 179,000 / 46%
Zimbabwe / 1,300,000 / 15.3% / 570,000 / 98,000 / 8,634 / 0 / 472,000 / 17%

Technical notes:

1. Further details regarding the columns are:

• Country: All countries that were eligible to apply for Global Fund HIV grants in Round 8.

• People Living with HIV/AIDS: Adults and children living with HIV/AIDS, 2007.

• HIV Prevalence:Percentage of adultswho had HIV/AIDS in 2007.

• People needing ARV Treatment:Estimated number of people needing ARV treatment, 2007.(Note: ARV treatment is usually not needed until several years after infection with HIV.)

• People receiving ARV Treatment: Estimated number of people receiving ARV treatment, December 2007.

• People receiving ARV treatment with GF support: People receiving ARV treatment from programmes supported by the Global Fund, as of 1 Dec. 2007.(Original source:

• People receiving ARV treatment with Pepfar support: Number of people receiving ARV treatment from programmes supported by Pepfar, as of 31 March 2008.

• People “needing” treatment minus people “receiving” treatment: The difference between “people needing ARV Treatment” and “people receiving ARV Treatment”.

• Coverage: Those “receiving” as a percentage of those “needing”, December 2007.

• The number in the GF column or in the Pepfar column sometimes exceeds the total number shown for people nationwide treatment, because of data being gathered at different points during 2007.

1. Countries are shown in bold in cases where Coverage is less than 25%, and/or where people “needing” treatment minus people “receiving” treatmentis greater than 25,000 people.

1. It should be noted that the people shown as needing but not yet receiving treatment will not be known to themselves or to anyone else if they have not been tested and are not yet symptomatic. And even if such people are known, the country may need to invest in health systems before such treatment can be provided.

1. All data were obtained in August 2008 from a website created by the Kaiser Family Foundation.Data provided at this site are primarily obtained from the Global Fund, UN agencies, Pepfar and other international entities, rather than from individual implementing countries, and therefore do not always represent the most recent data available at the country level.

1. A more detailed spreadsheet-based version of this analysis, compiled by Aidspan in the course of writing this article, is available at

1. In countries where the Global Fund (or Pepfar) provides substantial support on a national scale for things like clinics, testing facilities, and distribution and logistics systems, the Fund (or Pepfar, as the case may be) sometimes publishes numbers (reproduced in the relevant columns of the above table) stating that all people in the country who are receiving treatment are doing so with GF/Pepfar support.Thus, for most countries, the numbers in these two columns overlap substantially if not entirely.(This point is discussed further in the Commentary, below.)

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3. COMMENTARY: Saving Lives: Who Can Claim the Credit?

by Bernard Rivers

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The Global Fund’s fact sheet “Results at a Glance: 2008” says “Global Fund-supported programs have provided millions of people with lifesaving services. As a result, at least 2.5 million lives have been saved.”

Well, yes and no.The lives have been saved as a result of the programs, but not necessarily as the result of the Global Fund financial support for those programs – because in many cases, money from the Fund represented only a small part of the overall cost.

Don’t get me wrong: nobody is playing fast and loose with the numbers. But claiming credit for saving lives is tricky territory.For instance, the table discussed in the previous article shows that in Guyana, the number of people receiving ARV treatment at the end of 2007 was 2,000.And the number of people receiving treatment with Global Fund support was...2,000.And the number of people receiving treatment with Pepfar support was... 2,000.And probably the number of people receiving treatment with government support was also 2,000.Who is saving the lives?Either “everybody”, or “nobody”, depending on how one defines the term.

In nine countries (Djibouti, Eritrea, Guyana, Indonesia, Jamaica, Mali, Nicaragua, Niger and Sudan), the number of people for whom theGlobal Fund says it is supporting ARV treatment is equal to all of the people whom UNAIDS and WHO say are receiving treatment within the country. And in nine of the fifteen countries where Pepfar operates (Botswana, Ethiopia, Guyana, Haiti, Kenya, Namibia, Rwanda, Uganda and Zambia), the number of people for whom Pepfar says it is supporting ARV treatment is again equal to all of the people whom UNAIDS and WHO say are receiving it in the country.

The GF’s and Pepfar’s methods of counting the number of people for whom they support ARV treatment includes counting people who receive treatment at sites where GF/Pepfar might have only financed, say, training or quality assurance, but not, say, drug provision or staff salaries. In some countries, people are included even if GF/Pepfar have provided no financing at all for the site where those people received treatment, but have provided financing at the national level for things such as testing facilities or logistics systems (in the case of the GF) or policy development or management information systems (in the case of Pepfar).(See and The Fund does describe its methodology clearly, and does make it clear how it works carefully with Pepfar to avoid double-counting.)

Thus, although the treatment numbers may be technically correct based on the methodologies that the GF and Pepfar use for computing them, the fact remains that those numbers are somewhat misleading, because many of the people who have been included have had most or all of the direct costs of providing treatment paid by their government or employer.In the case of Pepfar, the methodology used suggests that, in an extreme case, a modest financial contribution by Pepfar to national policy development could be counted as supporting all of those receiving treatment in that country.

So what would I like the Fund to say?Something like “Programs financed by the Global Fund, and usually also by other donors, national governments, and employers, have provided millions of people with essential services, leading to the saving of at least 2.5 million lives.” It may not be a sexy sound-byte.But at least it’s unlikely to be mis-interpreted.

[Bernard Rivers ()is Executive Director of Aidspan and Editor of its GFO.]

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4. REMINDER: Global Fund Launches Round 9 on 1 October

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The Global Fund will officially launch Round 9 in two weeks’ time, on 1 October, as previously reported in GFO Issue #93. The deadline for applications will be 21 January 2009.The Fund says that the proposal form and guidelines for Round 9 will be substantially unchanged from Round 8.At the time of the launch, the Fund will clarify what is involved in re-submitting a Round 8 proposal.

Because so little will change from Round 8, Aidspan, publisher of GFO, is not planning to revise “The Aidspan Guide to Round 8 Applications to the Global Fund,” and thus advises potential applicants to use the Round 8 guide for their Round 9 proposals.

“The Aidspan Guide to Round 8 Applications to the Global Fund”comes in two volumes.“Volume 1: Getting a Head Start” provides information and guidance to help potential applicants decide whether or not to apply, and, if they decide to apply, to assist them with the proposal development process (including the process of soliciting in-country submissions for possible inclusion in the national proposal). Volume 1 also discusses factors for potential applicants to consider if they plan to submit a regional or non-CCM proposal. Finally, Volume 1 includes an extensive analysis of the strengths and weaknesses of proposals submitted in previous rounds of funding (based on comments by the Technical Review Panel).

“Volume 2: The Applications Process and the Proposal Form” outlines the applications process, describes what was new for Round 8, and provides step-by-step guidance on how to fill out the Round 8 proposal form.Volume 2 is available in two versions, one for single-country applicants and one for multi-country applicants.

Both volumes are available in English, French and Spanish at

In preparing for Round 9, applicants may also want to use Aidspan's documents for in-country submissions, released in December 2007 (see announcement in GFO Issue #82). These documents, which are designed to assist CCMs with the in-country submissions process, are available in English, French, Spanish and Russian at

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5. NEWS: Report Released on Civil Society Contribution to Grant Implementation

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The Global Fund and the International HIV/AIDS Alliance recently released a report on “Civil Society Success on the Ground – Community Systems Strengthening and Dual-Track Financing: Nine Illustrative Case Studies.” The 48-page, undated report is available (in English only) at (Warning: the file is very big.)

The report provides case studies of substantial civil society participation in grant management and service delivery.Each case study describes a different way in which civil society organisations (CSOs) have been involved.The case studies involve CSOs in Cambodia, India, Mongolia, Peru, Senegal, Somalia, Thailand,Ukraine and Zambia.

All nine case studies examine HIV grants, but the examples are also illustrative of tuberculosis and malaria grants. Most of the programmes described in the case studies were implemented with money from the Global Fund.

The report focuses on civil society contributions to community systems strengthening (CSS), and dual-track financing (DTF).However, the case studies also describe CSO activities that integrate HIV services with sexual and reproductive health (SRH) services. The report also provides useful information on a number of other topics – such as the use of CSOs as sole PR; Non-CCM proposals; attempts to involve the private sector; and the importance of programmes to provide substitution treatment for injection drug users.

The next three sections of this article discuss what the report had to say about CSS, DTF and SRH integration. This is followed by some examples of lessons learned from the case studies, as described in the report.