CIVIL SOCIETY ORGANIZATIONS IN VENEZUELA CONCERNED THEY WERE NOT CONSULTED FOR THE MALARIA FUNDING REQUEST

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Download PDF Several Venezuelan civil society organizations (CSOs), former ministers of health, and academics wrote an open letter to the Global Fund to express their concern about the lack of participation of CSOs in the development of the country’s funding request to the Global Fund for the malaria grant. The letter, dated 20 June 2020, was addressed to the Global…

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The country is experiencing a resurgence of malaria while battling with political instability and an economic crisis

ABSTRACT Several Venezuelan civil society organizations (CSOs) expressed concern about the lack of participation of CSOs in writing the malaria funding request for the 2020–2022 cycle. The Global Fund Secretariat responded, saying that Venezuela is a challenging operating environment and is managed under the Additional Safeguards Policy, which allows the Secretariat to make those decisions. Nevertheless, the Secretariat stated that it engaged the International Council of AIDS Service Organizations (ICASO), an international CSO, to consult CSOs and included their inputs in the funding request.

Several Venezuelan civil society organizations (CSOs), former ministers of health, and academics wrote an open letter to the Global Fund to express their concern about the lack of participation of CSOs in the development of the country’s funding request to the Global Fund for the malaria grant. The letter, dated 20 June 2020, was addressed to the Global Fund Secretariat, the Board members, and the Technical Review Panel. In a response dated 15 July, the Secretariat explained that due to the polarized situation in Venezuela, it engaged an international non-governmental organization to involve the CSOs. Aidspan received a copy of both letters.

The signatories of the CSO letter are pleased with the Global Fund’s support but are concerned that CSOs did not participate in writing the funding request in the absence of a Country Coordinating Mechanism. The signatories also asked the Global Fund to support the creation of an Independent Malaria Oversight.

Venezuela previously ineligible for Global Fund grant

Venezuela, an upper-middle-income country in Latin America, was previously not eligible for Global Fund grants. The country is highly dependent on oil and the drop in the oil price in 2014 precipitated an economic decline. The 2018 presidential election was hotly contested, with some segments of society and observers claiming that the president’s re-election was fraudulent, according to the Global Conflict tracker. The combination of political and economic crises since 2015 has resulted in the migration of an estimated 4 million Venezuelans to neighboring countries, and a strained health system with a shortage of medicines, including antiretrovirals. A resurgence of malaria has compounded these issues.

In 2018, the Global Fund donated $5 million to the country to fill in gaps in access to antiretroviral treatment for HIV. In August 2019, the Global Fund Board agreed to provide Venezuela with a malaria grant for the first time. Later the Board approved a grant of $6 million for 2020 to procure “critical HIV, TB, and malaria health commodities” and to monitor the grant.

Secretariat refutes claim

The Global Fund’s Head of Grant Management responded on behalf of the Executive Director on 15 July 2020. The letter stated that Venezuela is classified as a challenging operating environment because of the polarized situation in the country. The Global Fund defines a challenging operating environment as a country “characterized by weak governance, poor access to health services, and manmade or natural crises.”

The Global Fund manages Venezuela’s grant under the Additional Safeguards Policy, which provides an array of risk management tools. In particular, this policy allows the Secretariat to choose implementers and make decisions for the grants. The Secretariat chose international non-governmental organization International Council of AIDS Service Organizations (ICASO) “as the focal point for CSOs, raising relevant issues to the Secretariat and providing inputs.”

The Secretariat stated that it consulted CSOs widely both in and outside Venezuela, and included their inputs in the funding request (see below). In addition, the Secretariat asked a national CSO called ACCSI (Acción Ciudadana Contra el SIDA) to write, with ICASO, an annex on the human rights situation in Venezuela, which was attached to the funding request. The annex built on ICASO’s 2018 report on Venezuela’s situation, which argued that Venezuela is under a triple threat of resurging epidemics, a broken health system, and global indifference to its crisis.

The Pan American Health Organization was the technical partner in developing the malaria funding request.

Among the CSOs’ suggestions included in the funding request are the following:

• “Establishment of a Technical Assessment Group of experts, including academia, with the role of national experts and leadership reinforced
• Review and modification of strata and adjustments on logistic support for field operations in strata with rural communities
• Adjustment of the number of community health workers (agentes comunitarios) based on feedback from CSOs
• Improvements in actions to approach severe malaria (pre-treatment and capacities in hospitals)
• Removal of long-lasting insecticidal nets (LLIN) distribution in Sucre
• Reduction of the amount budgeted for microscopy and increase of the number of rapid diagnostic tests (RDTs) to procure
• Reduction of the number of interventions under strengthening of community systems … to focus on key malaria actions in the context or re-emergence.”

The letter does not outline the conditions of implementation of the malaria grant.

The Global Fund Secretariat should publish the funding request and the Technical Review Panel’s evaluation to allow those who did not participate in the process to better understand the extent of the Global Fund interventions in Venezuela.

 

Further reading

• ICASO report; Triple threat: Resurging epidemics, a broken health system, and global indifference to Venezuela’s crisis, October 2018