Effects of the projects funded by The Global Fund over organizations of PLWHA Partial findings of th

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Effects of the projects funded by The Global Fund
over organizations of PLWHA (Partial findings of
the Global HIV/AIDS Initiatives Networks
Peru-based study) Lessons Learned from the
Implementation of the GFATM-supported HIV/AIDS
Project in Peru. Effects on the Health Sector,
Civil Society and Affected Communities
ALLIANCE FOR HEALTH POLICY AND SYSTEMS RESEARCH
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The GHIN Study in Peru

• Alliance for Health Policy Research and Systems
  Research , called for proposals for study in 2005
• Since March 2006 it is part of the Network GHIN
  (Global HIV/AIDS Initiatives Network)
• Potential usefulness at 3 levels -- Analyze
  strengths and weaknesses of Global Health
  Initiatives (GHI) as a model of cooperation for
  development -- Feedback to the GHI -- Feedback
  to the country (national response)

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Background

• Peru GF has funded 3 proposals on HIV/AIDS
  projects to be implemented between 2003 and 2011.
• The implementation of these large projects
  represents a very significant investment in
  HIV/AIDS in the country, approximately US 76
  million.
• These projects have a relevant impact on the
  interrelationship among the actors involved in
  the AIDS response, redistribution of public
  resources and the quality of care offered to
  PLHA.

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GHIN study (phase 1) had 4 components

• 1) To identify the effects that the GF projects
  has had on (1) key organizations involved in
  HIV/AIDS response, (2) interactions between those
  organizations in the decision-making processes in
  relation to HIV/AIDS
• 2) To explore the potential effects of the GF
  projects in the structure and functioning of the
  Ministry of Health.
• 3) To assess the impact over the sources and
  policies of financing of the national response to
  the AIDS epidemic
• 4) To asses equity regarding access to the
  benefits of GF projects and the impact on stigma
  and discrimination affecting PLHA and vulnerable
  communities.

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Specific objective

• To describe the effects of the GF Projects on
  the organizations of PLWHA (part of component
  one)
• Hypothesis
• The GF Projects have strengthened the
  organizations of PLWHA and their articulation.

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Methods

• Data collection and information
• In depth interviews with actors related to
  HIV/AIDS national response from Ministry of
  health NGOs, Principal Receptor, sub recipients,
  PLWHAs organizations, CCM (CONAMUSA)
• Previous national studies and from other
  countries.

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Findings GF Projects and PLWHA

• Before de GF projects (2002) PLWHA organizations
  were committed to build a National Coordinating
  Organization.
• For GF Projects implementation (2003) Sub
  recipients had to include organizations of PLWHV
  to be qualified
• This had a clear effect on PLWHV organizations.

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Findings GF Projects and PLWHA

• Organizations of PLWHA become part of the sub
  recipients consortiums
• New areas of conflicts emerged in the
  implementation of the GF projects competition,
  managing resources
• In 2006, sixteen organizations abandoned the
  national coordination (Peruanos Positivos) to be
  free and participate in subrecipients
  consortiums.

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2000
GAMS
PROSA
RPMVS
RI GAMS
SOLAS Y UNIDAS (S Y U )
2001 2002
Mesa de Articulación
2003
RPMVS
Coordinadora Nacional de PVVS Peruanos Positivos
2004
Consorcio A
S y U
2005 2006
PROSA
Consorcio B
Consorcio D
Otras ORGs
Consorcio C
2007
Coordinadora Nacional de PVVS Peruanos Positivos
GAMS
Genero Sida
PROSA
RI GAMS
S y U
RPMVS
Alianza en Acción
ASI PO
Plataforma Callao
RPMVS Red Peruana de mujeres viviendo con
VIH/SIDA RI GAMS Red de Información de GAMs
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Conclusions

• The introduction of the GF Projects disrupted the
  process to articulate PLWHA organizations and
  focused some of them on getting some of the GF
  funding through the sub recipients consortiums.
• National organizations were undermined

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• While the projects of the Global Fund are
  operating, organizations of PLHA will not be
  articulated
• Mientras estén los proyectos se va a mantener
  una cierta desarticulación de las
  organizaciones1 PVVS2