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COMBAT DISEASES OF POVERTY CONSORTIUM THE IRISH FORUM FOR GLOBAL HEALTH BIENNIAL IN ASSOCIATION WITH IRISH AID CONFERENCE Partnership to address health and Diseases of Poverty Challenges November 29th – 30th 2010 At National University of Ireland Maynooth. PAPER PRESENTATION on

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  1. COMBAT DISEASES OF POVERTY CONSORTIUMTHE IRISH FORUM FOR GLOBAL HEALTH BIENNIAL IN ASSOCIATION WITH IRISH AID CONFERENCEPartnership to address health and Diseases of Poverty ChallengesNovember 29th – 30th 2010At National University of Ireland Maynooth PAPER PRESENTATIONon TENSION BETWEEN INTERNATIONAL DONORS/NGOs AND COMMUNITY BASED ORGANIZATIONS ON HIV AND AIDS FUNDS By Lugendo T.A. and Strong, T.

  2. What is all about; • Introduction • Role of Governments on HIV/AIDS • Role of International Donors/NGOs and Indigenous/Local NGOs, and CBOs on HIV/AIDS • The Tension on the ground • What should be done-The way forward

  3. Introduction: • Problems in how vulnerable groups in developing countries, especially people living with HIV, can continue to receive aid through project funds from international donors/NGOs, has emerged. • This paper focuses on tensions between international donors/Non governmental Organizations (NGOs) and Community Based Organizations (CBOs). • The paper is based on personal reflections drawn from my service to the CBO TANOPHA, the Tanzanian Association of Networks of People Living with HIV & AIDS.

  4. Introduction Cont… • Since the discovery of HIV and AIDS globally, different nations introduced various interventions to address HIV and AIDS and its impact. • With all the efforts, HIV epidemic remains a major global public health challenge with a total of 33.4 million people living with HIV worldwide. In 2008 alone 2.7 million people were newly infected with HIV (UNAIDS, 2009).

  5. Introduction cont… • Apart from the efforts of governments, many individuals from the communities established Community Based organizations to support the efforts of the governments in addressing HIV and AIDS. eg TANOPHA, HDT etc. • International donors and Non governmental organizations also cheeped in to support governments in addressing the issue of HIV and AIDS. e.g. Concern Worldwide, Care International, Irish Aid etc.

  6. Introduction Cont… • In providing directives and coordination mechanisms for smooth operationalization of HIV and AIDS interventions and programmes, governments formulated policies, laws and regulations to better address the pandemic.

  7. Introduction Cont… • In the course of implementation, tension has now risen between International donors/NGOs and Community based Organization. • The tension brought by the misappropriation of funds, done by government officials which is felt by International donors/NGOs at one side. • and the tension on the sustainability breakage of HIV and AIDS interventions felt by the local NGOs and CBOs at the other side.

  8. Introduction Cont… • This tension presumably will result to either poor quality services or no service at all to the beneficiaries, especially People living with HIV and AIDS, orphans, widows, elderly and other vulnerable people.

  9. Introduction cont… • This paper reflects the of experience working with these communities. It lends an eye and ear opening to various phenomena which are normally not reported to the donors but in one way or another they affect the good intension of International donors/ NGOs and Community Based Organizations on supporting the vulnerable people in the communities

  10. Role of Governments on HIV and AIDS: • Governments, on addressing HIV and AIDS, formulated policies, laws, regulations, Various Boards and strategic frameworks, to facilitate the implementation of HIV and AIDS interventions. • For example in Tanzania, one of the East African countries, and Sub-Saharan country, there was response to HIV and AIDS since 1983 through number of collaborative strategies and interventions. Initially the response was coordinated by National AIDS Control Programme, under the Ministry of health and Social Welfare. In an effort to better manage and coordinate the national Mult-sectrol HIV response, the Government established the Tanzania Commission for AIDS (TACAIDS,2008).

  11. Roles of International Donors /NGOs and CBOs on HIV/AIDS: • International NGOs (INGOs) are NGOs, which have their head offices abroad and obtain support from those offices. • Their role to foster and promote the capacities of national or local NGOs rather than implementing at grass root level (Tanzania NGO code of conduct) • Local NGOs are NGOs, established in the country by either civilians or non-civilians.

  12. Roles cont… • Community Based Organizations (CBOs) are voluntary organizations established with the commitment to help disadvantaged or marginalized sectors of society • They are not-for-profit (not self-serving) organizations, established to support and help less fortunate communities and members of society with little or no income. • They are Non Government Organizations established in such a way that any support they appeal for or secure is undertaken independent from government.

  13. Tension • In the cause of implementation the problem arise. (tension) • The tension has emerged on the side of International Donors/NGOs on how they can continue supporting the governments of developing countries, indigenous or local NGOs and CBOs while there is misappropriation of funds.

  14. example 1: Tanzania • “Almost US$1 million worth of anti-malaria drugs are missing or have expired in Tanzania's medical warehouses”. • “The routine audit, whose findings were published in June, revealed that Artemisinin combination therapy (ACT) drugs worth $819,000 are missing and another $130,000 have expired. It highlights problems with internal control mechanisms and raising the possibility of serious fraud”. (The routine audit report, Global fund, June 2010)

  15. example 2:Kenya • “The government of Kenya, investigates allegations of corruption in programs funded by a U.N.-backed agency to treat patients with AIDS, malaria and tuberculosis”. • “The Geneva-based Global Fund to fight AIDS, Tuberculosis and Malaria said it suspects that some lists of patients treated in earlier programs were fictitious”.

  16. example 3:Uganda • “U.Sh 960 million meant for investigation of people implicated in the embezzlement of money from the Global Fund for AIDS, tuberculosis and malaria, has disappeared from Bank of Uganda.” (Auditor General's financial report, June 2007)

  17. example4:Zambia • “The Global Fund has suspended funding to Zambia's Ministry of Health because of fraud in the ministry. This is a second time that donors are freezing funding to the ministry in about one year. The Swedish and Dutch governments in May 2009 froze aid to the Ministry of Health following reports about embezzlement of public funds including monies from donors. According to a report issued by The Global Fund's Office of the Inspector General (OIG)

  18. As a result • INGOs decided to violet policies and went down to the grass root to implement. • Coalition between INGOs, LNGOs and CBOs

  19. Tension to Local NGOs and CBOs • It has been observed that a number of INGOs are now operating at grass root level and accessing locally available funds which would be accessed by local organizations. Contrary to the Act requirement for them to promote capacity of local NGOS.

  20. Example: • The Presidents Emergency Plan for AIDS Relief (PEPFAR), whereby a significant amount of funds has been accessed by US based Organizations. • Since then there has been a trend of US based organization to reregister as local NGOs in Tanzania, (Tanzania LNGOs press Statement, 2010)

  21. As a results: • A greater part the funds will be spent by US based organizations thereby limiting the sustainability and capacity building strategy which is centrally guiding principals of the aid and country NGOs operation modalities.

  22. Results: • Weak capacity of local NGOs and CBOs • Increased competition for the available resources that will result into limited accessibility by local NGOs, • and Lack of sustainability and ownership of interventions at all level of operations, (Tanzanian NGOs press release statement, November, 2010).

  23. What should be done? • It is high time for the misappropriation of funds to be taken as global issue, not simply a local problem. • International donors should initiate forums with developing countries to address issues of - -misappropriation of funds, -setting boundaries of servicing the communities between International NGOs, LNGOs or CBOs, -setting fair criteria for funding.

  24. What should be done? • INGOs should continue operating as INGO and foster partnership with local NGOs or CBOs (as Concern worldwide do in Tanzania) so that the capacity of the later is build and skills are transferred for sustainability. • Governments should enforce the implementation of the act so that all NGOs are adhering to the code of conduct in order to have broad based development and efficient and accountable NGOs.

  25. Thanks for your Attention Asanteni Sana Karibuni Tanzania Hakuna Matata

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