Governance of India CCM: Experience of the CCM Vice Chair

[Guest guest]

Governance of India CCM: Experience of the CCM vice chair

[AIDS INDIA Interviewed  Mr. KK Abraham, Vice Chair of the Indian Country

Coordination Mechanism (CCM) of the Global Fund about his experience of

governance of India CCM]

 

The Global Fund  for AIDS, Tb and Malaria  (GFATM) is a revolutionary approach

to financing health, using a Country Coordinating Mechanism (CCM) that requires

the key stake holders of  health and other sectors of the society within a

country mobilise themselves, identify the priorities, request for fund and

implementing grants. This process has galvanised health financing efforts within

countries. But, this also brought unprecedented challenges on issues of

governance.

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) has so far

approved proposals totaling US$ 7 billion. Successful implementation of such

funds will depend on good governance at national level. The CCMs are the key

institutions of stewardship of Global Fund grants at the National level. To

ensure good governance of these funds, the governance practices of the CCM it

self must be under greater scrutiny.

Mr. KK Abraham is the founding member and the current secretary of one of the

largest organisation of People living with HIV- Indian network of people living

with HIV (INP+). He served as the Vice Chair of Indian Country Coordination

Mechanism (CCM) of the Global Fund for four years and over all he was associated

with India CCM for the last seven years.

AIDS INDIA interviewed him about his experience of civil society role in

promoting good governance of the CCM. The following the transcripts of the

interview with him.

 

1. What is your over all experience of working with India CCM?

 

I have an overall experience of working with the India CCM, representing the

best interest of the people living with HIV for 7 years. Out of that, I was vice

chair for last 4 years. I missed only three meeting during my representation.

Over all I have mixed feelings about the role of civil society in CCM.

Some experiences are good, some are encouraging, some times a great learning

experience, some times very upsetting and disappointing and some times it was

even humiliating.

Most of the CC meeting are often overwhelming with technical discussion, though,

 I enjoyed it.  But, over all it is satisfactory. Through my participation in

CCM my ability and understanding about HIV response in India improved

tremendously.

 

2. What is the level of participation of various interest and views of civil

society stake holders, providing all men and women with a voice in decision

making ?

 

The HIV Civil Society constituency is so diverse, in order to maintain that

diversity , improvement is needed the in representation of the civil society

members in the CCM. Many members of the civil society contributed to the better

functioning of the CCM for example Fr. Tomy Kariyilkulam's, (the Administrator,

Bel-Air Hospital, Panchgani, representing the faith based agencies at the CCM)

participation was very exceptional.

He always took extra care to study the documents and  agenda of the meeting well

before the meeting. I have also seen some of Civil Society members sitting at

the back benches during the CCM meeting and did not open their mouth, not even

once for two years.

It is better to have guideline for participation members and make sure that

their inputs has been taken and respected. It should be ensured that the

performance of CCM members must be made accountable

I also noticed that there is a vast difference between the participatory skills

of Delhi based CCM members and rural based members.

 

3. What is the level of transparency in the dealing of CCM?, Was it  built on

 free flow of information with in the CCM ?

The information flow in the CCM is very fixed- limited dose as and when required

basis. There is a TOR of CCM members, it seems it was maintained only as a

policy on paper. However, the ad hoc subcommittees often engineered the

priorities, PR selection and proposal development. The information about the

implementation and outcome was often supplied by the Principal Recipient (PR).

There is very limited mechanism to cross check these information.

Keeping transparency within the stipulated time at National level is always

challenging because of  the GFATM  style of functioning.

The amounts of documents produced in the GFATM project is enormous,  but  this

is gathering at the CCM level is difficult task and that is why  CCM is always

dependable.

In my experience ultimately CCM is pretended to be transparent, rather than

actually it is transparent.

 

4. What is the level of CCM' responsiveness to stakeholders ?

 

The understanding about  the stake holders are vague in CCM. If stake holders

are only the General Body of the CCM  then their role should be established  in

the T.O.R. and that role should be respected.

Now the wider stake holders are being used/ participating only in election and

selection process for the CCM members.

Stakeholders should be empowered for the good governance of the CCM.

Most of the stake holders are busy with the implementation of the Projects. They

have limited time, understanding and venues for regular participation in the

governance of CCM. There is a need to be systematic procedures to be followed,

for getting responses and to and fro

 

5. What is the level of consensus orientation in CCM, how differing interests

are mediated to broad consensus ?

 

There is imbalances in the consensus building. The so called consensus are not

based on wide based consensus building process among the constituencies. Often

the so called consensus of the CCM is consensus derived from a few.

 

6. How gender and social equity is promoted in CCM?  Do all men and women and

other at risk population groups have opportunities to become involved?

 

This is depends upon the organisational policy who stands for represents in the

CCM. I don't think CCM has any control on the same , but my experience women are

the better performers in the  India CCM  Meetings.

 

7. What is the level of effectiveness and efficiency of CCM, the process and

institutions to produce results that meet  needs  while making  best use of

resources?

 

This is the question  of  documents verses  Lives. Often on paper  it shows high

results. We need to look  at the  difference in the people life. Though,  all

the PR s are doing impact assessment as part of the project.  I think we need to

more transparency in  this process.

Even though, there are external Local Fund Agents (LFA) are in place,  the

 process has to be  strengthened. Further innovations are needed for this  area.

The Global Fund- Funding is for five year then that also divided into two phases

and again divided into quarterly based. Which means implementers are highly

pressured for meeting targets, there is always uncertainty and insecurities

there. (Please see the 3 idiots Hindi Movie to understand some of these issues

related to pressure for performance versus capacity !).

 

8.  What is the level of accountability of CCM decision-making  to stake holders

There are process and procedures for the decision making in CCM.  But, this is

an evolving process. There fore, there is chances for favouritism, conflict of

interest and fear to challenge the powerful.

Within the limitations of the CCM, CCM is trying to maximise the accountability 

all the time.

 

9. Is there is a strategic vision for CCM, do they  have broad and long term

perspective on an effective HIV response in India ?

 

CCM is a project based, funding round based and TOR based. Therefore efforts to

articulate an cohesive vision and purpose are restricted. But still it is a good

model and there scope for strengthening  the health systems.

 

10) What is your recommendations for strengthening the governance of CCM?

Foremost the CCM must maintain its independence.  It should resist any pressure

to endorse pre determined decisions. Ensuring a transparent election process for

is essential.

The Principal Recipients (PR) should not be a member of the CCM (at least  in

the case of Civil Society). The selection of PR must be based on their talent

and passion and it must be through a transparent process.

/

[Guest guest]

28th January 2010

Re: /message/11114

Dear Editor AIDS INDIA,

My heartfelt appreciation for taking such an initiative in bringing out the

experience of Vice-chair of CCM.

His responses seen at the first few questions must be rightly understood by the

officials concerned and should be given priority.

Those words not only reflect the real concern for the growth of CCM but a

straight forward analysis of the current scenario.

Similarly I wish that taking K.K.Abraham as a role model, PLHAs across the

nation must keep themselves equipped with day to day knowledge in the field of

HIV.

The representation of PLHA in CCM must mark a record, everytime

making CCM team feel proud about the presence of PLHA with abundant

knowledge and true vision for bringing change in lives of PLHA in India.

I am proud to address myself as an ex-employee of INP+. Of my 50 months

experience in INP+, it has always been a platform to learn and know more on the

happenings in the field.

During my presence, i have always felt that there was always been a never ending

quest by Mr. Abraham in getting a team of second line leadership from the vast

networks spread across the country functioning as the widespread branches of

national network called INDIAN NETWORK FOR PEOPLE LIVING WITH HIV/AIDS.

There has always been a long term vision in him to take this

movement to great level where INP+ should become a role model to many. As on

date it is one and only community based organization in the world to obtain ISO

standard for the quality of services rendered.

A good quality of a leader would be to remain a neutral and accessible

person to all his fellowmen. K.K. has always ensured to remain the same.

None of the known faces to KK will ever address him as a representative from

southern region. He is always seen and felt as a national representative of

INP+.

Unfortunately, only very few members have come forward to support his

vision. Understanding the vision, my sincere prayer would be " Many should come

forward as a representative of INP+ not as a representative of single state

level network in the board of INP+.

Such growth in number will prove as a dual benefit process. One is that the

experience of KK will encourage as well as guide the new comers and on the other

way the presence of such new comers and their support will motive KK - the man

of vision, in developing his visionary for the welfare of PLHAs in India.

Three cheers to KK, INP+ and its entire state level chapters for their

presence and work. Keep the good work going on.

Regards

P. Anjanalakshmi

e-mail: <anjana.lakshmi@...>