Masambo Fund ERNA 2004, Krakow

1. Masambo Fund ERNA 2004, Krakow

2. Summary • Masambo Fund Purpose • Federation Governing Board decision • Name of the Fund • Scope • First Selection Round • Review and Programme Development • Legal Issues • Finances and Fund Raising • Sustainability • Structure • Masambo Fund Board • Masambo Fund Selection Panel • National Societies Obligations • What Masambo Fund Grants fund • What Masambo Fund Grants do not fund

3. Masambo Fund Purpose Organizational survival Ensure the survival of RCRC humanitarian workers so as to maintain organizational capacity to deliver humanitarian assistance • The Masambo Fund is a strong and unprecedented move in the history of the Federation, which enables the Federation to be a good role model for other organisations

4. Federation Governing Board decision: • Pursue greater access to lifesaving drugs for all who need them. • A fund for access to lifesaving drugs (ARV) for RCRC staff and volunteers • Requested all National Societies to raise a voluntary annual contribution using the equivalent of 1% of that Society's statutory contribution (bareme) as a minimum annual fundraising target.

5. Name of the Fund • Masambo was a long time staff member of Zimbabwe Red Cross • Masambo produced a video with a testimony she wanted to leave just before dying of AIDS • If Masambo had been able to access treatment, she would probably still be with us. • Masambo’s work and situation symbolises all this fund seeks to address.

6. Scope • A fund of last resort when no other funding option is available. • Will only be able to operate effectively where certain minimum conditions exist. (See Guidelines for National Societies preparing to nominate candidates) • It is not an easy solution – requires an active NS.

7. First Selection Round: • Offers 20 places limited to the 10 hardest hit countries as defined by the World Bank’s least developed countries category with the highest adult prevalence rates. • The 10 countries are: Lesotho, Zambia, Malawi, Mozambique, Central African Republic, Djibouti, Rwanda, Burundi, United Republic of Tanzania and Sierra Leone. • Ideally, two grantees would be chosen from each Society: • 1 staff and 1 volunteer • 1 man and 1 woman

8. Review and Programme Development • “Guidelines for National Societies preparing to nominate candidates ” to be reviewed on a regular basis • Given stigma and other practical barriers, uptake of places may be quite limited • It is likely that partnerships will need to be developed country-by-country to ensure all eligible National Societies in the hardest hit countries can eventually effectively nominate candidates for treatment.

9. Legal Issues • Foundation established under the Federation’s Status Agreement in Switzerland • Statutes and Rules of Procedure set out the composition and function of the Board and Selection Panel • Fund not to guarantee funding beyond the amounts actually received • Model agreements governing the Grants payments Fund to NS, & NS to beneficiary • NS fully responsible for the management of Grant and fulfilment of terms and conditions, including financial reporting

10. Legal Issues • Masambo Fund accepts no liability re side-effects, misuse, the transmission of drug resistant HIV • Continued funding dependent on the contractual conditions being met and the availability of Foundation funds • All medication prescribed and supervised by suitably qualified health professionals • Much legal liability and responsibility falls on NS, assure compatibility with national laws, and cover own liability

11. Finances Provide treatment for 500 people CHF 2.5 million for 5 years

12. Fund Raising • National Societies to raise a voluntary annual contribution using the equivalent of 1% of that Society's statutory contribution (bareme) as a minimum annual fundraising target. • The Foundation, in accordance with its statutes has the possibility to raise funds from external partners in accordance with the resource mobilization policies of the Federation • The Secretariat has established a mechanism for automatic payroll deduction to the fund • National Societies could establish a similar mechanism for staff contributions

13. Sustainability • Reserve funds to sustain the supply of drugs for up to 5 years i.e. before a recipient is accepted, the Fund requires CHF 5000 CHF 1000 (estimated cost of treatment per year) x 5 (years) • NS must work to improve access within the country, so that all beneficiaries can move over to another source of support • After 5 years, applications for extension can be made - priority to existing beneficiaries who are still volunteers or staff of RCRC • All grants and extensions are subject to the availability of funds

14. Foundation Board Governs the Foundation -Grant Allocation Rules -Amount of Funds Disbursed -internal procedures Selection Panel Decides the allocation of Funds Secretary Grant Agreement Submits Application National Societies Responsible for Grant Management Beneficiary Agreement Structure of Masambo Fund Staff/Volunteers

15. Masambo Fund Board Composition: • Prof. Mamdouh Gabr, Masambo Fund Chairman (V.P. Africa) • Mr. Tom Buruku • Ms. Yiyi Gong • Mr. Ahmed Mohamed Hassan • Mr. Freddy Karup Pedersen (Chair of Health Commission) • Mr. William Usher (Chair Finance Commission) Secretary Functions: • Governing body • Conflict of interest policy • Selection criteria • Determine grant amounts and frequency of funding rounds • Model agreements • Mobilize resources

16. Masambo Fund Selection Panel • A PLWHA recommended by GNP+ • A National Society person knowledgeable about HIV treatment (recommended by Health Commission) • A National Society representative – hardest hit countries (recommended by Health Commission) Secretary Functions: • Select grant recipients as per guidelines, including amount • Recommend changes to “Guidelines for National Societies preparing to nominate candidates”

17. National Societies Obligations • Fair and transparent selection process • Identify quality medical care • Drug procurement system – best price • Active: • Treatments advocacy • Workplace programme • Anti-stigma campaign • Prevention education • Preparation of nomination including medical check up, treatment of opportunities infections, psycho-social support and nutrition plan • Management of grant • Agreement with each beneficiary

18. What Masambo Fund Grants fund: • The cost of anti-retroviral drugs for treating HIV/AIDS, best price • The absolute minimum laboratory tests to initiate ART as recommended by WHO being: • Confirmatory HIV antibody test if needed • Update of haemoglobin or hematocrit level • A pregnancy test for women • The basic recommended tests to monitor ARB therapy as recommended by WHO being: • Regular total white blood cell count and fifferential tests from the commencement of therapy • Serum alanine or aspartet aminotransferase level • Serum creatinint and/or blood urea nitrogen • Serum glucose • Up to six visits to the doctor per year for clinical monitoring • Although it is not currently a WHO basic recommended test, an annual CD4 cell count test if available

19. What Masambo Fund Grants do not fund: • Costs associated with the nomination, including the initial base line assessment of at least a HIV anti-body test, a total white blood cell count , and a haemoglobin or hematocrit level • Treatment of opportunistic infections and sexually transmitted diseases • Sophisticated laboratory monitoring including viral load tests, and WHO desirable tests such as bilirubin, amylase and serum lipids, or costs to transport samples to a laboratory • Transport costs to attend medical appointments • Food security • Condoms • Community support • Treatment of family members

20. “This fund is an emergency measure for us until global efforts to increase access to treatment are truly up and running. We simply cannot afford to lose any more of our people.” Razia Essack-Kauaria, Governing Board Member of the International Federation and Secretary General of the Namibian Red Cross, 27 November 2003.