Serious concerns have been raised relative to the stakeholders’ meeting that was held on 14-15 January 2014 in the Democratic Republic of the Congo’s (DRC) capital Kinshasa. The meeting was the final country dialogue to validate the content and priorities of the country’s HIV concept note under the Global Fund’s new funding model (NFM). It included representatives from civil society, government, key affected populations, and technical partners. The country dialogue was the first step in the grant application process under the NFM.
While the DRC dialogue bore all the hallmarks of a transparent and consultative process with input from a range of stakeholders into the country concept note for HIV programming, some community representatives have expressed concern at the choice of the principal recipients (PR). Concern has been expressed in both the selection process and the quality or capacity of the PRs. One community representative wonders whether the list of organizations selected to be PR is closely evaluated for their ability and willingness to work with LGBTI groups. The representative explained that the organizations have apparently refused to work with men who have sex with men (MSM) groups, for instance. This discrimination has been on religious grounds. There has also been doubt expressed at their managerial and leadership ability to unite all organizations and actors for ART scale-up and for the three ‘I’s to reduce TB infections.
Another community leader also from the DRC recently observed: “But the real challenge is that we, as the community of people living with HIV, do not trust any of the four PRs selected by Global Fund in the DRC. The so-called civil society (PR) which has been selected has no link with our community (of people living with HIV)”.
These concerns should not be taken lightly. Although there seems to have been an effective mechanism to input into the content of the concept note, there is no guarantee that all deliverables will be met, nor will the stakeholders have any real influence on the program management and coordination of the GF funding once secured. PRs enjoy a degree of autonomy and, some may say, power. If they are of questionable repute, the global fund might do well to pay attention to the community concerns now rather than try to correct mistakes downstream. Experience has taught us that this can be a very expensive exercise and lead to a colossal loss of resources.
UNAIDS has an important role in this matter. UNAIDS’ unique position provides it with a strong convening role to ensure that the issues creating anxiety about the PR are discussed and resolved satisfactorily. If whistle-blowing communities like the ones in the DRC were taken seriously, millions of dollars could still be saved. UNAIDS could use its comparative advantage in-country to convene a further discussion to ensure DRC receives the full complement of prevention, treatment, and care services.
Before any disbursements or negotiations with the CCM are started, all stakeholders might do well to resolve this matter of the four PRs in the DRC and ensure that they are reputable, led by men and women of integrity with a desire to serve its citizens across this beautiful vast land.
The DRC has set enormous targets for itself. But many years of conflict have meant financial resources to fight HIV and provide basic health care for its people have been scarce. The DRC targets are to put at least 50% of an estimated 250,000 eligible people living with HIV on antiretroviral therapy by 2017 and a further 90% PMTCT reduction rate. The country dialogue established priorities and strategies for prevention, treatment and care activities in line with the country’s national strategic plan for all vulnerable populations.