Re: Delay in release of funds from NACO

[Guest guest]

Dear ALL,

The NGO-AIDS Coalition of West Bengal has taken a commendable step in appealing

to the Health Minister (GoI). In consonance with the appeal, let me add that

this time the funds-delay for TIs in West Bengal through WBSAPCS has reached

intolerable levels - in terms of programme delays and the suffering staff

members of all TIs are undergoing. There is however, no let up of programme

pressure from WBSAPCS and no suggestions forthcoming on how TIs will tide over

this funds crisis.

I suggest that we also begin a chain-mail signature campaign and appeal to

PD-NACO and Minister of Health GoI.

Also, the letter to the Hon. Minister was sent on 3 Feb: was there any reply? I

request the NGO-AIDS Coalition (West Bengal) to consider further mobilisation on

this issue URGENTLY: after all, as mentioned - all our programmes are grinding

to a halt, and will stop within the next few days if there is NO redressal.

Maybe we could think of public demonstrations and or addressing the Press on the

issue?

In solidarity and suffering,

Amitrajit

Dr. Amitrajit Saha

Kolkata (India)

E-mail: amitrajitsaha@...

[Guest guest]

Dear Forum members,

I am glad that this issue has been brought up. I think that we all need to think

that how thses things can be sppeded up right from the selection of the NGOs

which takes at least 1-2 years, upto the disbursement of the grants.

A mechanism needs tobe developed because the situation is worsening and all of

us will need to put in a lot of efforts to stop the increase in the epidemic of

AIDS, otherwise we will become like Africa.

Plaese keep us posted on the outcome.

Thanks

Dr Srivastava

E-mail: <kumkumsrivastava@...>

[Guest guest]

Dear Dr. Srivastava and all others interested:

Till today, there is no official information to CBOs/NGOs running TIs under

West Bengal SAPCS - on when they are scheduled to recieve funds that are DUE

to them.

This is really weird, as these funds are committed to the TIs and not a

handout that NACO and SAPCS are providing!

The funds crunch to TIs in West Bengal reminds me of the Bihar situation:

when polio medical officers working with the WHO found to their dismay that

as the Bihar Govt. did not pay salaries and supply costs to the

state/district/rural health services on time, all staff and workers were

apathetic and unwilling to take the " extra " effort for Polio Eradication.

The result is evident: Bihar continues to be one of the polio-endemic

regions in the World!! There's a lesson hidden somewhere.

Are mandarins and apparatachik located at NACO and WBSAPCS listening?

In Solidarity

Dr. Amitrajit Saha

Kolkata (India)

E-mail: amitrajitsaha@...

[Guest guest]

Dear All,

Thanks to Dr Amitrajit Saha for raising such a vital issue.Truely speaking

it is extremely unfortunate to note the level of insensitivity on the

part of the policy makers what seems to be a perpetual problem affecting

most of the states including West-Bengal.[who also receive funds for TI's

from DFID]We have seen how project managers and policymakers alike fervently

argue on minute programmatic issues related to HIV prevention and Care both at

National and International fora.

We spend lot of time in discussing various strategic issues but hardly engage

ourselves on issues of 'ground reality' and what could be the most sensitive

predictor of quality of any intervention program.

It would be important to know how all these small implementing agencies[NGO's]

run their program without paying salary to their staff including the poor peer

workers.[As most of them follow peer outreach approach] Are they put them in a

lay off mode or develop some unique mechanism to maintain the work/quality of

work??What truly happens on the ground??

How community [the key population] feels about this and how they respond

to this sort of challenges? [if at all]. Do we believe that poor peer

workers will go hungry months together and will not indulge in unsafe sex

practices to maintain two square meal for him/her and for their family

members? And who would be made responsible for this outcome??the poor NGO or the

hapless key population or we the people who see ourselves as the great

promoter of HIV intervention program?

Regards,

S.Jana.

E-mail: <sjana@...>

[Guest guest]

Dear Forum,

Dr.Jana raised is an extremely valid point regarding the delay in fund release.

His point of view was mainly from the key population / peer educators’ point of

view. There is another angle to this issue, which is about good management

practises within NGOs.

NGOs are often accused by many including the government for improper management

of financial resources. At one level we speak loud about need for better

management practices within NGOs as far as financial management is concerned and

the same people don’t take necessary steps for releasing the funds in time. It

is an undisputed fact that non-availability of funds in time lead to bad

management practices. We need to make sure that there is better coordination to

ensure a win- win situation i.e. timely release of funds and ensuring better

management practices within NGOs.

Rajesh Divakaran

Project Officer

India HIV/AIDS Alliance

E-mail: rdivakaran@...

[Guest guest]

Dear FORUM,

I quote the document " Targeted Interventions Costing Guidelines & Resources " -

NACO 2004 posted on the " new look " NACO website.

quote--

6.1 Fund release:

The key need in fund release is to ensure that the interventions always have

money

for expenditure. Each AIDS Control Society should set up systems to ensure that

there is no delay in funding. And that there is adequate funding available at

all times with the TI to carry on its functioning.

----unquote

Regards

Gunashekar

-----------------------------------

C. R. Gunashekar

Options for Development

21, Padmavati Nagar, Opp. i Nagar

Station Road, Agraharam

Korattur, Chennai - 600 076 INDIA

Ph: +91 44 26512584 Mob: +91 9884266945

Email: development@...

[Guest guest]

Dear Amirtrajit,

Our country is very powerful in various field. It becoming superpower.But it is

very unfortunate that our union and state agecies which has given the

responsibility of managing HIV/AIDS are unable of dealing or managing this

virus.

We talk about the politics of HIV way back in early 90s where pepole in Manipur

suffering with virus. The response of govt come late. Only in 1997.

Finally it is the people who are going to take the final responsibility of the

epipidamic where our govt fail to understant it.

Beaucracy approaches are excellent only to screw up the civilians but they

cannot manage the virus. They are criminalizing the victims or survivor of the

epidemic. Our country need to go far away from such process.

NGOS are not mearly contractors to distributes condoms or medicine or syriges

like the road, dam, or well construction.

It is time for us to go forward for porper strategy to defeat the epidamic.

Nobo

E-mail: csd@...

[Guest guest]

Hi to the Forum readers,

It is still apparent that NACO does not have the skills or the know how to

be able to make timely funding decisions and it should realise why and stop

trying to control the funding which is the key to any and all useful

stragegic interventions.

India is a complex country. In fact when I travel it seems like 29 countries

in some sort of federation with Central Government.

My view back in 2001 was that NACO can't know what affected and infected

communities need and I don't want to labour that point in this memo. It just

can't.

SACS committees MUST however, and if they lack interest or a sense of

urgency they should reconstitute the SACS committees so that they can and

do.

It is not hard for NACO to determine a proportional distribution percentage

on a State by State basis. Of course these percentages could be revised from

time to time but at least it could start with populations and prevalence

data and if this data is published in advance it should be able to be agreed

on by all recipient States.

When funds are available NACO should distribute the money to all SACS

requiring only that they document its expenditure, report regularly on best

practice and allocation priorities and ensure that the situation continues

to improve.

Much greater representation of affected and infected communities need to

exist at the SACS level than at present. Sometimes communities might second

staff from a particularly useful NGO or CBO if they don't feel confident in

making representations but the nomination should come from the communities

themselves and not from NACO or SACS unless it is to fill a casual vacancy

or perhaps to include some specialised expertise from time to time.

NACO should monitor national best practice and become much more informed

about what works well and what groups might need to have services provided

for them. It should also liaise with other central government ministries

like transport, education, home affairs and health to ensure that

integration and standards are maintained.

NACO could and should set standards for advertising and monitor the material

that is used in the States and even the scripts of movies and bill board

signage to ensure it remains accurate and non discriminatory.

Once the funding has been transferred to SACS, NACO should monitor the

distribution and ensure that grievances around focus testing and preferred

outcomes are measurable and effective. This may require NACO members leaving

Delhi occasionally.

Communities should be developed and affected and infected community members

should be encouraged at the SACS level to embark on capacity building that

identifies the peculiar needs and communitarian differences in the

prevalence areas so that they can be accurate in the way that programs are

focussed. Communities then can engage relevant and competent NGO's to work

with and for them to facilitate change.

We should cease forthwith considering any SACS area to be LOW PREVALENCE.

Once upon a time all of India was low prevalence and by a process of

structured ignorance we managed to generate some areas of higher prevalence

without fully undertanding how and why and who and when.

If these principles (GIPA) were followed communities will be enabled to deal

with the risk reduction strategies necessary and ensure that not only do we

reduce the rate of STI's but we also reduce the rate of unintended

pregnancies.

Inherrent in managing the society for those already infected, will be,

improvements in sanitation, water quality, nutrition and the whole community

health outcomes should improve.

What is essential is to talk about all the risk reduction strategies not

just the ones that are affordable. Far too little general knowledge about

risk management and handling emergencies is available to the general

community. In 2005 the message should be that being HIV positive is a

serious health problem but positive people need never reach the stage of

acquiring AIDS. Sero discordant couples should be able to practice skills in

sexual behaviour that doesn't lead to bad outcomes but who is going to teach

that. Post Exposure Prophylaxis must be more readily understood and

available to all those who have had an accidental or criminal risk exposure.

Young people should be totally conscious of what sexual behaviours are

inherrently risky and what ways they can be sexual without taking

unnecessary risks. Who is teaching that in India ?

If NACO followed this prescription funding delays would be overcome at

Central Government level and SACS can negotiate priorities for care support

treatment and prevention, in that order please, in their respective

catchments.

Remember these key elements to an effective education strategy :-

AIDS must be seen to be a personal threat to all sexually active people

AIDS is preventable There must be a belief that you can manage the life style

changes required You must always have peer support.

For the historians amongst us I might just reiterate some principles that

date back to the start of the epidemic in around 1986 when the Ottawa

Charter for Health promotion released these principles for health promotion.

Build good public health policy

Create supportive environments

Strengthen community action

Develop personal skills

Reorienting Health Services.

I hope that this encourages more discussion and debate vis a vis NACO and

the infected and affected communities

Geoffrey

E-mail: <gheaviside@...>

[Guest guest]

Re: Delay in release of funds from NACO

Dear Forum,

Thanks a lot to Dr. Amitrajit Saha and the Forum for bringing the issue of

financial delay for discussion. The situation in the Targeted Interventions (TI)

projects in Kerala is also not different.

DfID, for years, has been passing the responsibility/blame to the State

authorities, but forget the fact that they are responsible to the British tax

payers and also to the communities they are offering services!

DfID must take specific initiatives to ensure that the funds are reaching the

target with our unreasonable delay. Delay in the distribution of funds is

severely compromising the quality of service delivery in al most all the TI

projects.

The current situation demoralises the program staff and provides a fertile

ground for corruption.

To meat the program objectives of targeted intervention, a transparent and

efficient, funds dispersal system is essential.

Regards

Tito (Adv)

Director, CSRD.

Kozikode, Kerala

E-mail: <titothomas@...>

[Guest guest]

Dear Forum members,

I have been studying the role of NGOs in targeted HIV prevention in India for a

while. From my work and as can be seen by the discussion that has been provoked,

I understand that this problem does not only affect the State AIDS programme of

West Bengal, .

Fund delays affect not only the ability to deliver the interventions and those

factors described by Dr Jana - but also the ability to plan and therefore to

progress and innovate. Importantly it affects the delicate relationship of trust

with, in most cases, particularly sensitive communities.

Funding gaps mean that some projects are simply closed down while the NGO

awaits the next fund instalment - leaving a gap in services and support.

When the intervention can finally operate again it may have to take on and train

new staff, it may take months to rebuild trust with the communities that are

likely to feel betrayed. Finally, it prevents the NGOs from concentrating on

what they do best (and importantly what the government has contracted them to

do!)- work with their communities - rather they are spending time chasing up

funds and plaguing, in many cases, innocent SACS - who in some cases are

struggling themselves to obtain their ownbudgetary commitments. It also appears

that in spite of signed contracts between the SACS and the NGOs, the NGOs have

no real recourse to the legal system if funds are not delivered - the courts are

slow, expensive and working against the government in this way does not do an

NGO many favours.

I was very pleased to hear this issue raised on the forum. I hope that it can be

taken up further and leads to a succesful lobby for smoother fund flows from the

national level.

Lorna Guinness

London School of Hygiene & Tropical Medicine

Research Fellow, Keppel Street London WC1E 7HT

Tel: +44 20 7927 2008 fax: +44 20 7637 5391 mobile: +264 81 2937045

E-mail: lorna.guinness@...

[Guest guest]

Two messages: Combined posting (Moderator)

1) Sibichan varghese " <amminikuttysv@...>

Dear Forum,

Some of the views expressed in the forum are far from the truth. We

need to take a collective look at the reason for dealy. While I may

agree with the fact that delay from NACO causes serious concerns at

the state level as expressed by some of us, the project holders

at the state level are also responsible for the delay as the don't

do the prerquesites for the early realease of funds from the state

society. So when we look at such issues of national importance, we

may not drag in the state issues as they are very specific to

each state and it would be unfair to publish such one sided views

without taking all aspects into consideration.

I agree with the fact that DFID needs to take initiatives to create

a system for timely release of funds from NACO and also from the

State Societies to the project holders.

Sibichan Varghese

Kerala

E-mail: <amminikuttysv@...>

2) Indian Institute of Development Management " <iidmbpl@...>

Dear Members of the Forum

The delay in release of funds is an attitudinal & competence issue.

Both could have been settled if theare are effective pressure

groups. Its not only NACO but at SACS the situation is worse than

NACO. For example MP ACS unable to handle the issue. They are

incopetent to take decisions so delay- dallying is adpted with a

hope the successor will solve the issue. Who is bothered to monitor

the output of SACS & NACO. While distributing the funds to SACS the

NCAO simply should not look into the past expenditure by SACS but

look into the persons manning the positions.

Dr S K Trivedi Bhopal

E-mail: <iidmbpl@...>