Governments of wealthy countries will be meeting to discuss the future budget of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Romanian civil society organisations have sent them an open letter, warning of catastrophic consequences if they fail to allocate adequate funding for HIV prevention measures, in a country which has been badly hit by the epidemic.<\/p>\n
Dear Members of the Global Fund Board,<\/p>\n
Please find attached a Joint Statement of Romanian Civil Society Organizations in advance to the Thirty Sixth Meeting of the Global Fund Board which calls to allow the Romanian NGOs to prove the country eligibility for HIV funding within NGO rule and urges you to prevent zero allocation for the HIV component for Romania for the next three years.<\/p>\n
Joint Statement of Romanian Civil Society Organizations in advance to the Thirty Sixth Meeting of the Global Fund Board<\/p>\n
08 November 2016<\/p>\n
Successful Replenishment and the Risk of Zero Allocations for a resurgent epidemic<\/p>\n
At the 5th Global Fund Replenishment Conference in September, US$12.9 billion was raised for the 2017 \u2013 2019 Allocation\u00a0Period — the largest replenishment amount ever in the Global Fund\u2019s history. At the end of October, the Global Fund published its 2017 Eligibility List identifying which country components are eligible for funding during the during the 2017-2019 funding cycle, noting that eligibility does not guarantee an allocation. According to this list, Romania\u2019s HIV\/AIDS program is only eligible for funding for HIV\/AIDS under the NGO rule, the criteria for which is detailed in the Global Fund Eligibility Policy.<\/p>\n
In advance to the upcoming 36th Meeting of the Global Fund Board on the 16th and 17th of November, we \u2013 representatives of Romanian civil society organizations, including people living with HIV and TB and key populations – would like to express our deep concern about the potential disconnect between a successful replenishment and the small or non-existent allocations that will be made available for countries like Romania and upper middle income countries with HIV epidemics that are still not controlled. We believe that there is a high risk that the allocation for the HIV component for Romania for the next three years could be zero \u2013 the same as it was the previous allocation period. In this circumstance, even if we, as civil society, work hard to show that we meet the criteria of the NGO rule, there will be no funding available for us to apply for.<\/p>\n
Some unfortunate history<\/p>\n
The last Global Fund HIV grant for Romania came to an end on 30 June 2010. In 2011 the Romanian CCM developed an HIV proposal for submission to the Global Fund for Round 11, which we all know, was cancelled. At the same time, the 23rd meeting of the Global Fund Board adopted new country eligibility criteria that resulted in Romania becoming ineligible to apply for another grant owing to its classification as an ‘Upper Middle Income’ (UMI) country with a ‘moderate’ HIV disease burden.<\/p>\n
However, in 2013, Romania’s HIV disease burden was increased to ‘high’, making it again eligible for an HIV grant under the New Funding Model (NFM) through the ‘NGO rule’. A targeted concept note was developed and submitted, but was not supported by the Global Fund. The Fund’s ‘Eligibility and Counterpart Financing Policy’ states that one of the conditions necessary to receive an allocation for HIV under the NGO rule is that the applicants must provide confirmation that the \u201callocation will be used to fund interventions that are not being provided due to political barriers and are supported by the country\u2019s epidemiology\u201d.<\/p>\n
At that time, Romanian NGOs working on HIV, harm reduction and human rights, tried to prove that indeed, there were serious and insurmountable political barriers to the delivery of HIV prevention services for key populations that take the form of:<\/p>\n
1. \u00a0the lack of a strategic HIV framework since 2007;
\n2. \u00a0the lack of national human rights strategy focused on vulnerable groups;
\n3. \u00a0the lack of targeting by the National HIV Program on prevention measures for people who inject drugs (PWID) and men who have sex with men (MSM) even though official data indicates that these are the most affected key populations;
\n4. \u00a0the ongoing lack of government funding for harm reduction interventions even after the government made a commitment to provide such public funds;
\n5. \u00a0the lack of political will to publicly address the steady increase of HIV among MSM;
\n6. \u00a0the lack of sexual and reproductive health education strategy and legal attempts to criminalise sex education in the public school system; and
\n7. \u00a0the lack of capacity of Romanian Government to address and implement the recommendations issued by the UPR in 2013 and the recommendations issued by the Committee on Economic, Social and Cultural Rights[1].<\/p>\n
However, such issues were viewed by the Global Fund Secretariat as a ‘lack of funding or political will rather than political barriers’, per se[2]. Unfortunately the same barriers still remain, and this sad history is resulting in catastrophe for people living with HIV in our country:<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0HIV prevalence among PWID in Romania rose from 1.1 to 4.2 percent between 2008 (when we still had a Global Fund grant) and 2010;
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0The prevalence among PWIDs then shot up to an estimated 49.2% in 2013 before falling back somewhat to 27.5% in 2014[3] due to the efforts of NGOs including mobilization of some support from the EU (structural funds), Norway and a few private foundations;
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0It was noted in a January 2016 article in the International Journal of Drug Policy that “a specific HIV outbreak among drug users (around 2011) has been directly linked to the significant decline in harm reduction services following the Global Fund transition out of the country[4]”;
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0While estimated 18% MSM in the capital city had HIV in 2014[5], even country\u2019s UNGASS report acknowledges lack of any HIV prevention among MSM with exception of volunteer sporadic actions;[6]
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Although the Romanian government is supporting HIV treatment and partially funds some\u00a0\u00a0opioid substitution therapy, almost zero governmental funding has been allocated on HIV prevention activities among key affected populations in recent years;
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0People from key populations remain highly stigmatized and marginalized, for example, criminal law punishes possession of \u2018high risk\u2019 drugs with up to 3 years of imprisonment. While the legislative and policy environment in Romania does provide for harm reduction and other services targeted to key populations to maintain some services, the Government has shown little commitment to fund such interventions, especially needle and syringe programs;
\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0At the same time HIV prevention services are still being partly funded in Romania by the Global Fund through its current TB grant, which while extremely helpful, only funds a small part of our population affected by both TB and HIV.<\/p>\n
The key barrier to a sustainable HIV prevention program and HIV\/AIDS sector in Romania is the lack of political will to fund the program by the Government.<\/p>\n
We hope that members of the Global Fund Board understand the decision before you at your November meeting to apply your new allocation methodology may result in allocations of zero in communities facing a re-emerging HIV crisis. This stands in contradiction to commitments to keep the Global Fund global by introducing a differentiated investment approach in which funding decisions are guided by considerations of need and impact. As we fight against government inaction on HIV, the Global Fund must also live up to this commitment. Our live and the lives of the people we work with depend upon it.<\/p>\n
Yours sincerely,<\/p>\n
ACCEPT Association (LGBT, SW), Romanita Iordache \u2013 Vice President
\nALIAT Association\u00a0\u00a0(IDUs),\u00a0\u00a0Bogdan Glodeanu \u2013 Executive Director
\nARAS – Romanian Anti AIDS Association (PLHIV, IDUs, SW, MSM, other), Monica Dan \u2013 Project Coordinator
\nCARUSEL Association (IDUs, Roma, homeless people, SW, PLHIV), Marian Ursan \u2013 Executive Director
\nCOPAC – Coalition of Organizations of Patients with Chronic Diseases (18 NGOs), Radu Ganescu \u2013 President
\nCRJ – Centre for Legal Resources (Human Rights), Georgiana Iorgulescu \u2013 Executive Director
\nECPI – Euro-regional Center for Public Initiative, Florin Buhuceanu \u2013 Executive President
\nFONPC – Federation of Non-governmental Organizations for Children (82 NGOs), Bogdan Simion – President
\nPARADA Foundation (Homeless and other vulnerable groups), Ionut Jugureanu \u2013 Executive Director
\nRomanian Angel Appeal Foundation (PLHIV), Silvia Asandi \u2013 General Director
\nRHRN – Romanian Harm Reduction Network (IDUs)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Dragos Rosca \u2013 Executive Director
\nSave the Children Romania (Homeless people, other vulnerable groups), Liliana Bibac \u2013 Project Coordinator
\nSECS – Romanian Society for Sexual and Contraceptive Education, Iustina Ionescu – President
\nSens Pozitiv Association (PLHIV, IDU, SW, MSM), Alina Dumitriu \u2013 Executive Director
\nUNOPA – National Union of Organizations of People Living with HIV (22 NGOs) Iulian Petre \u2013 Executive Director
\nYouth for Youth Foundation (young people),\u00a0\u00a0Adina Manea \u2013 Executive Director
\nPSI Romania (MSM\/LGBT), Patricia Mihaescu \u2013 Operations Manager<\/p>\n
[1] \u201eConcluding observations on the combined third to fifth periodic reports of Romania\u201d, 9 December 2014, pct. 22, Sexual and reproductive rights, available at https:\/\/tbinternet.ohchr.org\/_layouts\/treatybodyexternal\/Download.aspx?symbolno=E\/C.12\/ROU\/CO\/3-5&Lang=En
\n[2] The Impact of Transition from Global Fund support to Governmental Funding on the Sustainability of Harm Reduction Programs. A Case Study from Romania. Eurasian Harm Reduction Network. 2016.
\n[3] EMCDDA (2016). Statistical Bulletin. Table on HIV Prevalence accessed at: www.emcdda.europa.eu\/data\/stats2016#displayTable:INF-108
\n[4] https:\/\/www.ijdp.org\/article\/S0955-3959(15)00236-4\/fulltext
\n[5] EU-funded project Sialon II. Report on a Bio-Behavioural Survey among MSM in 13 European Cities. Accessed at:https:\/\/www.sialon.eu\/data2\/file\/133_Sialon%20II_Report%20on%20a%20Bio-behavioural%20Survey%20among%20MSM%20in%2013%20European%20cities.pdf
\n[6] Romania: Country Progress Report on AIDS Reporting period January 2015 \u2013 December 2015. Bucharest, April 2016. Available at: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/ROU_narrative_report_2016.pdf<\/p>\n","protected":false},"excerpt":{"rendered":"