The Global Fund expert shares experience on GF work in Turkmenistan
22 Mar 2017 by Nazik Myradova
Valeria Grishechkina, Fund Portfolio Manager for Eastern Europe and Central Asia of the Global Fund to Fight AIDS, Tuberculosis and Malaria
UNDP: What is GF? Why was it established?
Ms. Grishechkina: The Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is an international financing institution created in 2002 to raise and invest the money to respond to these three of the deadliest infectious diseases. It raises and invests nearly US$4 billion a year to support programs in countries most in need.
The Global Fund is a platform for cooperation amongst governments, international development institutions (including UN agencies and the World Bank), civil society, the private sector and communities affected by the diseases.
We are based in Geneva, Switzerland, and do not have offices outside of the country. To implement the Global Fund grants, countries select the Principal Recipients who are responsible for implementing it and who also take on the financial and programmatic responsibilities over it.
UNDP: What is the criteria for selection of the principle recipients?
Ms. Grishechkina: The Principal Recipients of Global Fund grants could be local legal entities from the public or private sector or civil society. In some cases, the responsibilities of being a principle recipient could be taken by local office of an international, which is also the case of Turkmenistan, where the GF TB grant is implemented by UNDP since 2010. The main criteria which we are looking for is the ability to successfully implement the grant contributing to the global fight against HIV/AIDS, TB and malaria.
UNDP: What is the overall impact and result of GF work around the world?
Ms. Grishechkina: As of today, there are 461 active grants in over 100 countries globally. The Global Fund has been able to achieve the following impact:
· In countries where the Global Fund invests, the AIDS-related death rate declined more than 45 percent, from 1.9 million in 2004 to 1.1 million in 2015.
· There was a rapid increase in access to antiretroviral (ARV) therapy in countries supported by the Global Fund, from 3.3 percent coverage in 2005 to 21 percent in 2010 and 45 percent in 2015.
· In countries supported by the Global Fund, between 2000 and 2015 the number of HIV infections declined by 37 percent. Partners express optimism that the rate of averting infections can accelerate more sharply if funding continues to grow. Another important factor is the expansion of national coverage of prevention of mother-to-child transmission, reaching 49 percent coverage in 2010 and 76 percent in 2015.
· In countries where the Global Fund invests, the number of deaths from TB declined 31 percent between 2000 and 2015.
· The number of deaths from TB in 2015 would have been more than three times higher in the absence of interventions funded by the GF.
· Globally, between 2000 and 2015 the number of deaths caused by malaria declined by 48 percent.
· The innovation of a long-lasting insecticidal mosquito net, at a relatively low cost, has greatly expanded protection for children and families. With more than 713 million mosquito nets distributed as of mid-2016 (in countries where the Global Fund invests), people at risk for malaria who gained access to mosquito nets grew from 7 percent in 2005 to 35 percent in 2010 and 62 percent in 2015.
UNDP: How does GF assess the progress in fighting TB in Turkmenistan?
Ms. Grishechkina: I would like to note significant progress made by Turkmenistan in fighting TB and the country’s commitment to increase domestic investments in TB program. In particular, it is important to highlight the following achievements:
· Turkmenistan successfully implemented DOTS (Directly Observed Treatment Strategy) with full coverage of the civilian sector by the end of 2007 and penitentiary sector in December 2009.
· In 2013, the country started treatment of first MDR-TB patients and as of end of 2016, the number of confirmed MDR-TB cases enrolled on treatment exceeded 611.
· Three reference laboratories (in Mary, Lebap and Dashoguz) have been renovated and introduced full spectrum of investigations: culture, DST, inclusive rapid methods, which significantly contributed to the diagnostics and treatment success.
· Patient support programme has been introduced with the grant support. MDR-TB patients receive social support and psychological counselling for treatment adherence. This component is implemented by the National Red Crescent Society of Turkmenistan.
· From 2016 the Government of Turkmenistan started to procure first-line and second-line TB drugs from WHO-prequalified manufactures through UNDP procurement mechanisms.
UNDP: What is the scale of current work and what are the perspectives of work in Central Asia region?
Ms. Grishechkina: Under the current allocation period (2017-2019), all the countries of the Central Asia are eligible for Global Fund Funding based on disease burden and income level, however the amount of funding is significantly lower than previously. Except Turkmenistan, all Central Asian countries will apply for both HIV and TB components. The available funding for Central Asia is over USD 98 million, including USD 12,5 for Kazakhstan, USD 23,4 for Kyrgyzstan, USD 22,6 for Tajikistan, and USD 35,5 for Uzbekistan.
Considering the fact that Turkmenistan is an upper middle income country (according to World Bank classification) and achieved success in fighting the TB epidemic, it is no more eligible to receive funding from the Global Fund. However, to ensure smooth transition, Turkmenistan is eligible for the last time allocation to support the full transition of TB-related activities currently funded by the GF to the local financing. The amount of funds available for Turkmenistan for this transition is USD 3,956,665 (TB) and it can be used during the period 1 July 2018 – 30 June 2021. These funds are to help the country to transition to local financing and to also ensure that it maintains and scales up the respective services provision to achieve impact and stop the TB epidemic.