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ALCS/ CSAT mena Hub, june 2009


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Contents

Acknowledgements .3 Overview .4 Summary of the prsentations ...7 Day 1 I. Opening session: words of welcome from the organisers .7 II. Presentation of the objectives and the program of the workshop 9 III. What is the GF ? ...10 IV. CCM structure and functions .. 11 V. CCM and CS reprsentation : Morocco case study ..13 VI. Civi society involvement in GF grant ...15 VII.Advocacy channels .......17 Day 2 VIII. Presentation of groups sessions ..18 IX. CS involvement in Global Fund grants 20 X. What Ts in available and how to access it 21 XI. Experience of civil society as PR ..22 XII. Community System Strenghtening .. ...22 XIIII. National strategy Application .24 XIV. Experiences with Key affected populations 24 Day 3 XV. Presentation of groups sessions ..27 XVI. Presentation of partners and their rle in support CS .28 XVII. Conclusions and recommendations....31 Marrakech Declaration 31 Report of the evaluation forms 33 Press Release ..40 Acronyms used in this document .42

Acknowledgements
The morocan Association for the Fight Against Aids (ALCS) would like to express its gratitude to Grant Management Solutions (GMS), German Back Up Initiative (GTZ) and Aides France for providing financial and technical support to the grant performance workshop. ALCS would like to extend its thanks to Natalia Ciausova from ICASO (Acting CSAT International Coordinator), Helene Rossert (ICASO Consultant), Lee Abdelfadil (International Hiv Aids Alliance), Africaso and GMS team for their precious inputs, comments and suggestions on the workshop concept note, format and agenda. Implementation of the workshop was possible due to the willingness of civil society participants to voluntarily act as presenters, facilitators and small group moderators during the various case study sessions. The added viewpoint of UNAIDS on Community Sytem strenghtening and the new Tools was appreciated. Thanks as well to ALCS support staff for facilitating finance and administration logistics. Special thanks to the Ministry of Interior Affairs, Kingdom of Morocco, who facilitated the processing of visas on arrival for participants. ALCS expresses gratitude to all its supporters.

Overview
Context in the MENA REGION In the Middle East and North Africa region, civil society organizations still have a limited input into theAIDS response in the MENA region. Among the reasons for this, is their limited capacity and experience in AIDS prevention, care and support. There is also considerable reluctance or appreciation on the part of governments to consider a more active contribution of civil society to national efforts. This is in large part a reflection of the status of the situation of the civil society movement in countries. The poor functioning of, or lack of civil society organizations in this subregion, which is a result of deficient capacity, prevailing stigma and discrimination, and the non-recognition of civil society organizations by governments, has serious crosscutting effects on the response to AIDS at national level. The lack of inclusion of people living with HIV is also a serious impediment to scaling-up. However, some achievements are remarkable in the past few years But most of them are still fragile. Civil society faces a big challenge of shaping the answers within its own constituencies, relying on national and local non-governmental energies. These energies need to be identified and empowered with facilitation, training and funding. There should be an NGO way to excellence The Global Fund and the Mena region The Global Fund has placed emphasis on a greater involvement of civil society in its processes. This is evident by the place of dominance given to Community Systems Strengthening and Dual Track Financing in the Round 8 application literature and various reports and publications. In the MENA region, there are currently no civil society organizations already taking full advantage of those opportunities. At the point of grant application, many civil society organizations report not knowing where to source technical support, how to fund it and more fundamentally what it may take to get involved at the PR, SR, SSR or CCM level. There is an obvious lack of credible information and understandable information. CSAT/ ALCS : the seminar preparation team Civil Society Action Team, CSAT, was created in 2007 to help civil society obtain necessary training and funding to fully participate in the national responses to HIV and AIDS. CSAT is assisting NGOs to assert themselves politically and technically to implement quality contributions to the HIV and AIDS programs. As one of the main organization from the region, ALCS Mena CSAT Hub will help them in the long run to contribute to and even lead in the national HIV response. As such, ALCS through its CSAT hub, hosted a workshop on civil societys Global Fund grant performance and CCM processes. The main thrust wad be to gather civil society organizations together to share their scenarios and positive problem solving experiences with their peers and the larger regional group. The workshop represented an opportunity to come together as civil society supporters, recipients , implementers, and tehchnical support providers to have a look at what it takes to perform well. This is key against the background of new initiatives by the global Fund that allow greater involvement of CSOs such as Dual

Track Financing, Community Systems Strengthening, a focus on key affected populations in a bid to open more channels through which resources will be channelled to those most in need. This forum is one of the initiatives in the effort to support civil society to become more engaged with the Global Fund as credible program implementers and advocates. Criteria participants Application form that was disseminated along with the announcement for the seminar trought CSAT/mena liste serves since february/ March 2009, and we encouraged participation explicitly from the NGO working whith Key population (MSM, Injecting drug users, etc...) or Support Group to apply, and we will choose key people who are part of their national CCM, or sub recipient of GF grants. In some countries, we know that some Key NGO working with key population, or people living with hiv and support groups are exluded from GF Grants, even it they are very active on the field : we will take it into consideration. We tried to have in each country at least 3 representatives, involved in Global Fund processes : an NGO member of CCM, an NGO recipient, a person living with HIV or representing the most affected population. The seminar preparation team found itself with the challenging task of choosing the beneficiaries of the workshop (as we received mre almost 90 completed candidacies for a maximum total of 60 participants). We had to strictly limit the total number of participants because (1) we wanted to be sure this seminar to remained a safe and comfortable space to enable direct exchanges in between the participants and the speakers and (2) we also had to take into account the logistical aspect of enabling full simultaneous interpretation services in between three languages (French, Arabic and English) and the Financial contraints. The workshop was attended by 65 delegates from 15 countries of Middle East and North Africa rgion. For each country, 1 or 2 NGO of HIV/AIDS service organizations was invited as well as a grant implementer who is a civil society CCM member and a people living with hiv aids (if possible) , 4 representatives from GMS, 1 representative from TSF West Africa, 2 from International Hiv aids Alliance , 1 from UNAIDS Geneva, 1 from Unaids Morocco (representing the RST Cairo), 1 from ICASO/ Csat Global and 1 international Health consultant took part in the workshop. Including the members of the preparation team and the CSAT mena Hub team, 86 persons attended the workshop. The attendance breakdown is below: Countries delegates Technical partners ALCS Staff/ CSAT hub Reporter

65 9 3 1 YES 27 26 25 32 NO 17 18 19 7

Membership in CCM Financial support from Global Fund Sub recipients of Global Funds Need of technical support (5 didnt know what technical support is)

Countries of origin of the 45 participants The participants represented a total of 45 different organisations from 14 different countries from across the Middle East and North Africa continent as detailed in the map below. Most unfortunately, we could not invited applicants from Syria, Iran and Iraq (even though we had received several very pertinent applications from these countries) as it became clear during the selection process that we wont be able to deliver visa for the 2 countries, because of political concerns between Morocco and these countries Countries represented : Morocco, Mauritania,Algeria, Tunisia, Egypt, Jordan, Libanon, Soudan, Yemen, Djibouti, Pakistan, Afghanistan, Palestine, Somalia

The visa and multilingual challenge We take note that securing visas for the participants from MENA was extremely challenging. ALCS is used to organising such international events and therefore we made sure that participants were given ample time to contact the Morocan consulate in their respective countries. Nevertheless, up until the last minute, we had to repeatedly contact each consulate to make sure that the visas would be processed and issued on time. Without the support of the moroccan Minitry of Foreing Affairs , which provided some visa at the airport in Morocco (for reprsentatives from Aghanistan, Pakistan, Djiboutia, and Somalia) we would have not been able to do it. We managed to provide professional simultaneous interpretation services between English, French and Arabic the three days of the seminar. This was in itself a costly investment for sure and we were obliged to take into account the languages spoken by the participants when organising the 3 workshops. Most of the participants would not have been able to participate without this interpretation service. This report was written by Pierre Marie COUPRY and has been compiled and reviewed by Manal BENKIRANE, Othoman MELLOUK and Nadia RAFIF (organizers of the seminar)

Summary of the presentations


In order to download all the prsentation,you can go to : http://www.alcsmaroc.ma/public/index.php?option=com_content&view=article&id =111:csat-mena-marrakech-0904&catid=37:documents DAY 1 1. OPENING SESSION: WORDS OF WELCOME FROM THE HOST AND FROM THE ORGANISERS ALCS Marrakech/ CSAT Mena Hub Othman Mellouk Othman Mellouk, on behalf of all the ALCS Marrakech team, greeted the participants in this rare event for the MENA region. Making possible the assembly of Civil Society representatives coming from countries ranging from Afghanistan to Mauritania was a true challenge. ALCS and the Global fund Chosen to host this event in 2008, ALCS has been involved with the Global Fund for HIV/AIDS, TB and Malaria since it was set up. ALCS has been receiving Global Fund Grants (GFG) since Round 1 and they have made a difference. The Global Fund, an opportunity for MENA region Civil Society Organisations For the first time in the history of foreign aid, the Civil Society Organisations (CSO) in the different recipient countries are involved at all the stages of the Global Fund (GF). We come from a region with a challenging legal and moral environment where HIV/Aids is taboo. For example in Morocco, all the programs that target MSM or Sex workers are 100 % financed with Global Fund money. The Global Fund is at risk In these challenging times, the Global Fund is at risk. It is therefore of the up most importance to show that the Global Fund is working and to maximize the use of the different mechanisms it has created. One way to do this is to follow the lead of the countries that have managed to make the best of the space the Global Fund gives to the Civil Society. This meeting is therefore just a beginning. Its aim is not to evaluate country performances but to explain to all what is happening and to help us understand the Global Fund mechanisms. In order to reach these objectives, we all should share our successes but also our difficulties or our failures.

GMS Grant Management Solutions Terry Anderson Grant Management Solutions (GMS) is a project sponsored by the USAID. Its mission is to help beneficiary countries to better manage their Global Fund money. In 2002, the US federal legislature bodies decided that 5% of the money donated by the United States to the Global Fund would be put aside in order to provide assistance to the countries. GMS Objectives GMS was established in 2007 in order to bring technical support (TS) in the following areas: Organizational Development (including governance and leadership) Program and Financial Management Procurement and Supply Chain Management Monitoring and Evaluation

The purpose of our TS is to improve the functioning of GFG in order to address specific bottlenecks that are causing grants to under-perform. By helping CSOs to show to the Global Fund that the funds they received are being spent as planned, these organisations will gain credibility when applying for other funds. CSAT Global / Icaso Natalia Ciausova CSAT was launched in 2008 and is driven CSOs and organised by the Civil Society. CSOs do not always have the knowledge they need in order to spread decisions taken from the Global Fund board in Geneva to their organisations in the different countries. CSAT is not a provider but CSAT can help you in finding the right provider. CSAT is not a funder but CSAT can help you to link up with funders. Icaso is the global host with 6 regional hubs. This workshop is the second event after Senegal where CSAT members meet to discuss and network. Representatives from 15 different MENA countries1 are attending.

Mauritania, Palestine, Morocco, Egypt, Sudan, Tunisia, Pakistan, Afghanistan, Somaliland, Djibouti, Somalia, Algeria, Yemen, Lebanon and Jordan.

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PRESENTATION OF THE OBJECTIVES AND THE PROGRAM OF THE WORKSHOP

CSAT MENA Coordinator, ALCS Nadia Rafif The Grant Performance & CCM Processes Workshop aims to help the Civil Society in the MENA region to profit from the funding opportunities offered by the Global Fund. Objectives Its main objective is the scaling up the mobilization of national level civil society organizations to engage with Global Fund This workshop should also be a forum

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To inform participating NGOs with reliable and understandable information about GF processes (CCM, PR application, dual track financing, community system strengthening) To provide a forum of discussion on existing experiences (CCM participation, relationships between PR and SR and SSR) To start designing best practices and mapping TS needs

Participants overview 55 participants representing 45 NGOs or support groups of people living with HIV/Aids from 15 countries attended the Grant Performance & CCM Processes Workshop. Their area of work covered Sex workers, MSM, Injecting drug users, women, disabled people, truck drivers etc YES 27 26 25 32 NO 17 18 19 7

Membership in CCM Financial support from Global Fund Sub recipients of Global Funds Need of technical support (5 didnt know what technical support is)

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WHAT IS THE GLOBAL FUND?

GMS Grant Management Solutions Elena Decima Created in 2001, the Global Fund (GF) is a Swiss foundation with its headquarters in Geneva. It is an innovative partnership between governments, private sector, NGOs, international agencies that aim to dramatically increase resources to fight

HIV/aids, TB and Malaria and to direct those resources to areas of greatest need through rounds of financing every year. Global Fund Organizational Structure The GF doesnt implement any policy and doesnt maintain a presence in any country in the world. It is a very lean organization with a very small administrative team. The foundation has in effect externalized part of its structure by contracting Local Fund Agents (LFA) to supervise program, budget & report assessments and to monitor activities. The LFAs are usually large international accounting firms such a Deloitte, KPMG, Ernst & Young or PwC with strong financial know-how. They now should also have technical expertise. An independent Technical Review Panel of disease & development specialists meets to review grant proposals and to make funding recommendations to the Board. Global Fund Principles - Operate as a financial instrument, not an implementing entity - Make available and leverage additional financial resources - Support programs that reflect national ownership with an active participation of CSOs - Operate in a balanced manner in terms of different regions, diseases, and interventions - Pursue an integrated and balanced approach to prevention and treatment - Evaluate proposals through independent review processes - Establish a simplified, rapid, and innovative grant-making process and operate transparently, with accountability Global Fund Grants GFG were traditionally always 5 year grants given in two phases: At the end of Phase 1 (Year 1 & 2), an assessment of the impact made by the grant is done. In order to go to Phase 2, the grant has to meet a certain level of performance.

For the first time, the GF is now testing a 3rd phase that is only opened on invitation to the best performing programs: the Rolling Continuation Channel. The Global fund main innovations: Accessibility Low, low-middle, and middle-income countries are eligible, if they responded to specific criteria. Their proposals are reviewed on technical merit & feasibility and, once obtained, the grants have a national ownership. Scale The Global Fund imposes no ceiling on budget requests and is willing to finance institutional strengthening needed to produce massive scale-up.

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CSOs when planning their programs and preparing their budgets should therefore think big and scale up their programs in the fields in which they can achieve the significant results. Performance based-funding GF provides time-bound grants with quarterly technical and financial targets specified in the grant agreement. The quarterly performance assessment & reporting allows CSOs to build their management structure in order to understand their operations and build the necessary know-how to comply with the GF requirements & be eligible to Phase 2 financing. The GF can and has cancelled or suspended grants for non-performance.

Floor Q&A Can a CSO from a country that the GF has declared non-eligible for funding apply for a grant through a multi-country proposal? If a country isnt eligible, it is in theory possible to draw a multi country proposal with more than 50% of the members coming from eligible countries. It is a very difficult process in which the issues addressed should be of crosscountry significance. Furthermore, it should be approved by all the CCMs. To our knowledge to date, no multi-country proposal have been declared eligible. Because of regulatory problems, funds are not being provided to help people living with HIV/Aids. How can we know why ? The Global Fund is flexible on some aspects of a grant. During the Pre Grant Agreement signature phase, the Principal Recipient (PR) with Country Coordinating Mechanism (CCM ) negotiate terms & objectives. The Grant Agreement can therefore contain some adjustments made for some countries. In order to have a full understanding of the situation, you should refer to the Grant Agreement that you can download on the Global Fund website (http://www.theglobalfund.org/programs/search/?lang=en). Our country has seen its grant suspended and the Civil Society cannot receive detailed explanations on the reasons that brought the GF to take this decision. Who should we contact ? The CCM and the PR should know the reasons. If they dont, you can contact directly the Fund Portfolio Manager in charge of your country while in the same time informing CSAT of your request. CCMS AND PRS STRUCTURE AND FUNCTIONS

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Country Coordinating Mechanisms and Principal Recipients Terry Anderson COUNTRY COORDINATING MECHANISMS (CCM) Definition CCMs are partnerships comprised of representatives from both the public and civil society sectors who coordinate the submission of one national proposal based on

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priority needs. Additionally, CCMs are responsible to oversee the progress of program implementationThe CCM [is] a central pillar of the Global Funds architecture to ensure country-driven, coordinated, and multi-sectoral processes for leveraging and effecting additional resources to fight AIDS, TB and malaria. Key Principles & criterias As a multi-sectoral partnership, the CCM must give a broad participation to nongovernmental representatives. Through a consensual decision-making, it aims to reach a consensual and transparent agreement on the terms of the national proposal and is in charge of it oversight. It should engage an active communication and consultation with stakeholders. A CCM must fulfil these 6 minimum criterias: 1 2 3 4 5 6 Transparent selection process for CCM nongovernmental members Membership of persons affected by HIV/AIDS, TB, and malaria Transparent and documented process to solicit and review proposal submissions Transparent and documented process for nominating the PR and overseeing program implementation Ensure the input of a broad range of stakeholders Have a written conflict-of-interest plan, especially when the CCM chair or vice chair represents the same institution as the principal recipient

At least 40% of the CCM seats must be held by members of the Civil Society (Education/Universities, NGOs, CBOs, Assoc. of people living w. diseases, Private sector, FBOs and religious leaders). Responsibilities & frequent problems As a national, representative, multi-sectoral governance body, the CCM should govern in the national interest in order to identify national priorities and gaps in different areas eligible to receive GFG, coordinate and ratify grant proposals, designate the Principal Recipients and ensure grant oversight and transparency with the different stakeholders and the Global Fund. The CCM neither manages nor executes Global Fund grants In a number of countries, the CCMs are failing to meet these responsibilities for a number of reasons that range from conflict of interest to a poor or non-existent oversight. PRINCIPAL RECIPIENTS (PR) The choice of the Principal Recipient (PR) is one of the most important responsibilities of the CCM members. If the Global Fund leaves them with a wide choice of structure types, ranging from Government ministries to private-sector organizations or CSOs, a government ministry or agency is usually chosen. Legal responsibility Formally in charge of the negotiations with the Global Fund, the PR is the body that signs the grant agreement, the most important grant document. By signing the grant agreement, the PR becomes legally responsible for program results and financial accountability.

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Functions of a PR -Financial Management: the prime responsibility of a PR -Partnership Coordination -Technical Coordination/Implementation -Procurement Management oversight -Technical monitoring & reporting -General Grant Management 5. CCMS AND CIVIL SOCIETY REPRESENTATION: MOROCCO CASE STUDY

Reorganization of CCMs and voting process Moulay Ahmed Douraidi, ALCS Morocco has been receiving GFG since round 1. In 2003, the Health ministry became PR for Morocco and took the responsibility on the first 5 year grant. Although the funds were wisely allocated, a complete reorganization of the CCM was required in order to solve a number of problems:

A number of key stakeholders werent represented The CCM structure wasnt up to the standards GF required No real exchange of point of views

After months of discussions through 3 different groups, the new formal structure of the CSS was approved. In conformity with what was observed in other countries, it now counts 25 members. The Civil Society now holds 40% of the seats and the national NGOs have 5 representatives (4 from HIV/Aids organizations and one for a TB CSO). Internet: an innovative voting process to revise CSOs membership in Moroccan CCM Fouzia Bennani, ALCS In order to revise CSO membership in the Moroccan CCM, an innovative voting using the Internet was chosen to elect the 4 HIV/Aids organisations representatives. The voting process was organized in partnership with Tanmia.ma, a Moroccan media dedicated to bringing information to NGOs. From the applications to the campaign and the elections, the full voting process was conducted through the Internet and took 8 months to organise. The election of these 2 years terms (renewable once) was supervised by an independent commission and certified by a notary.

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Civil society Information mechanisms within CCMs Fouzia Bennani, ALCS Once elected, the 4 HIV/Aids representatives and ONUSIDA, helped by GMS, tried to understand their positioning in regards to their organisations and to define what was expected from them as members elected by the Civil Society. In order to promote the action of HIV/Aids organisations in the CCM, the information mechanisms will be structured around the 5 functions of a CCM: communications, grant coordination, harmonization, oversight & organisation. The prime recipients of this information will be the organizations that were part of the voting process and those that Sub Recipients (SR) of a GFG. The HIV/Aids organisations that have been elected now face a financial challenge in order to raise the funds needed to fully implement the information mechanisms they have decided on. Floor Q&A Why are TB associations not involved in the information process? There are only 2 CSOs dedicated to TB in Morocco, so it is easier for them to liaise. What is the role of people living with HIV/Aids in the CCM ? Following the Global Fund criterias, they automatically have a seat at the CCM. Setting a coordination process between HIV/Aids NGOs, people living with HIV/Aids and the other members of the Civil Society is desirable but in a separate way in order to keep in place the current information mechanisms set up by the elected HIV/Aids organisations. What is the role of the substitutes and how are they informed? The substitutes are observers at each CCM meeting. They have a proxy in order to vote instead of a CSO member that couldnt attend a meeting.

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6.

CIVIL SOCIETY INVOLVEMENT IN GLOBAL FUND GRANTS

Civil Society Involvement in Global Fund Grants GMS Team : Elena Dcima, Terry Anderson, Mohammed Oubnichou, Meredith Behrens The Global fund has opened all its fund management mechanisms to CSOs. Depending on their size, their experience in managing large grants, theirs areas of focus. CSOs can potentially serve in the CCM, as PRs, as Sub-Recipients (SR), as Sub-Sub-Recipients (SSR) or as contractors or service providers. SUB RECIPIENTS Sub-recipients hold an important position in the implementation of GFG. Their responsibilities are similar to the ones of the PR but on a smaller scale or towards a focused area. These locally based stakeholders can come from a wide variety of structures. The project implementers As project implementers, the SRs - with the SSRs - are the real actors in the Global Fund Grant management. They should normally be selected during the proposal development. This allows them to participate in strategic design, the setting of targets and in the critical time where indicators can still be changed: the final presignature negotiations. In order to fully understand its areas of responsibility, the SR should read the Grant Agreement with the PR. The Grant Agreement should be available on the Global Fund website. Understanding the role of a CSO is crucial but it is also important for an organization to understand if they have the capacity to be a SR or a SSR. In this case, Management quality is the key. Organizations wishing to be selected, as SR should meet some minimum requirements: Finance Program management Unit Clear procedures and documentation

If you feel your organization is not ready to be a SR, it can manage GFG funds at a SSR level or receive support as beneficiary or as a sub-grantee.

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FLOOR Q&A Arent all these levels of recipients costing too much & depriving people on the ground level of resources? In many countries, there are umbrella organizations (coalitions) that will look out for SSRs in their constituency. In a way, its an effort to put down costs but it does create overhead. Can the Global Fund assess directly the work of SSRs by bypassing the SR or the PR? Our understanding is that the Global Fund doesnt go directly to check the SSR work. The LFA is in charge of checking how finance is being used but it will only seldom go down to the SSR level. What actions would you suggest to countries that have seen their proposals rejected by the Global Fund? You should try to understand if the PR doesnt lack some management capacities. In some circumstances, this has been a concern for the Global Fund. In one case, a country had only person at PR level managing the funds. Allocating more qualified human resources to fund management was the solution in this case. Another common cause of rejection, especially in the MENA region, comes from the lack of long term vision or from the fact that the countrys global proposal doesnt answer to a consistent strategy. Technical assistance FROM Civil society TO Civil society PNAC - Pakistan Nacional AIDS Consortium

For the last 7 years, Pakistan hasnt been able to get HIV/Aids grants from the Global Fund for numerous reasons. The countrys CCM had no elected representatives and was a government stronghold. For political reasons, NGOs were pressured into signing proposals that were presented to them at the last moment and that never took in to account their comments. In order to help CSOs play their role more effectively in the CCM, PNAC has been working with its member organisations to inform them on the upcoming CCM elections, to help them prepare their candidacy and build up support. As a lot of

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CSOs in Pakistan do not have easy access to the Internet, PNAC has been disseminating information through the Internet or through hard copies. Since the 2008 CCM elections, 5 PNAC partners are now representing the CSOs in the CCM. PNAC offers technical assistance to its 350 partner organizations and conducts advocacy. 7. ADVOCACY CHANNELS

Advocacy channels Khalil el Ouadighi, Coalition + In many occasions, the Global Fund has proved to be receptive to appropriately designed advocacy campaigns. Global GF advocacy will try to improve policies for example while local GF advocacy will aim to redress injustices or to correct dysfunctions in grant implementation, monitoring, and oversight or even grant design. Appeal targets In order to achieve the goals of your advocacy campaign, different appeal targets can be contacted. The best road to success is to present your case through the normal communication channels before scaling up your advocacy towards GF representatives or even international media. Appeal actions If you do not manage to get your voice heard in the national institutions, you should contact your country portfolio manager at the GF and the civil society liaison officer for your regions. Although the Portfolio managers are very busy, you can usually join them by phone. They should be informed of the problems your organization has encountered. When communicating with the Porfolio managers, you should always be ready to send him a written statement on the situation. Without such a letter or email, he will not be able to engage with high-ranking personalities such as the CCM chair, the PR or the LFA. If this doesnt work, prepare a Press Release and send it to the GF some time before contacting the press. The GF pays great attention to what is said of them. In order to prevent a negative article, the odds are they will be ready to listen to you. FLOOR Q&A - Because of social conservatism in certain country, the CSOs working with people living with HIV/Aids might lose funding if they bring their case to the media. How can advocacy work for them? Numerous cases prove that advocacy towards on national problems will not freeze the grant money allocation. In Senegal, the local PR was failing to manage adequately the GFG. A CSO coalition tried to no avail to negotiate with the countries different stakeholders. By going to the press, it was able to talk directly with the government and succeeded to implement Dual Track Financing.

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In Zimbabwe and in Nigeria, the Global Fund ceased its funding to the PR after been asked to by the local CSOs. In order to keep its support towards the grass root organizations, the GF there again chose the Dual Track financing solution. Activism, TB & HIV integration Perfaiz Tufail In order to speak against something, to ask for a right or to disseminate information, activism is a powerful tool if used adequately in a carefully designed strategy. Depending on your goals, you have the choice between the types of action: hard, soft and passive activism. You should select the most appropriate strategy after assessing the situation with the correct knowledge.

DAY 2 8. PRESENTATION OF GROUP SESSIONS

Global Fund and Civil Society as grant implementers Group 1 The MENA region doesnt count any NGO with PR status. In the region, most PR are government ministries or agencies. 9 NGOs participating in the group are SR or SSR of GFG while 3 werent receiving GFG support. As SRs and SSRs in the MENA region, these NGO face a number of challenges and difficulties:

Payment problems: The programs concerning key populations can be affected by the fact that the funds are not always disbursed on time. No legal framework: The absence of legal framework for some of the programs targeting key populations having a negative effect on their output. The grant agreement terms are not in phase with the program needs: For example, the training will be financed by a GFG but not its implementation

The different members of the group consider that CSOs in the region need technical assistance in the following fields:

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Assistance in writing draft proposals Capacity building: Monitoring, Project Management, Finance, GIPA, Computer science

Advocacy towards Global Fund Group 2 All members of the group fully understood that advocacy is an instrument to change something or to bring an evolution in the environment. The group tried to understand clearly the scope of advocacy in the MENA region by studying the different issues, the audiences to engage, the strategies that should be employed and the targeted results. The different members of the group felt that an advocacy campaign in the Mena region could yield interesting results by focusing on two main issues : the existing laws that are not implemented Access to prevention, treatment and care, free treatment of PLHIV) and the laws that do not exist (Rights of PLHIV and positive prevention). Concerning issues against the law, such as MSM, IDUs or Sex workers, a number of members of the group reflected that the MENA Region societies were not ready to hear the arguments. In order to tackle these issues, it was widely felt that a workshop on advocacy in the Region would be required. In general, it was felt that the CSOs shouldnt advocate for general interests but for human rights & shouldnt advocate for a special status but to claim equality. Country CCM Analysis regarding GF requirements and participation of civil Society in CCM. Group 3 The members participating in this group came from CSO participating to the CCM in 8 countries. If they thought that the selection of CSOs in their CCM was generally transparent, 7 out of 8 regretted the lack of transparency in the selection of the PR that was automatically the Ministry of Health. For the time being, the CSOs in Mena region participating to the CCM are not communicating and coordinating their actions with the other CSOs. In order to improve CSO involvement in the CCM, they feel that they should reinforce themselves and build up capacity while working to ensure transparency and democracy during the process of selection of CSOs to the CCM. Ensuring the voice of Key affected populations in the CCM seems particularly challenging in the Region for the criminalized populations. If most members believe their representation should evolve from CSOs representing the voice of to direct representation, it is felt the Civil Society must act with caution in order to allow some

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representatives of criminalized populations to enter the CCM. Capacity building of their communities is particularly required in order to help some leaders emerge. FLOOR Q&A - How can a CCM be changed in order to offer wider representation to key affected populations, PLHIV and remove hand picked CSOs ? The Global Fund requires the CCM to fulfil 6 criterias. If your CCM doesnt follow them, your country will not be getting any GF money. In most cases though, the criterias are formerly followed but the representation doesnt truly represent the communities. In this case, you should engage a dialog with the CCM chair, build coalition strength with the members of the Civil Society and constitute a country network (CSAT can invite people that know how to build them). If the dialog doesnt work, you can engage in other forms of advocacy. In the CCM, the governments have more seats than the Civil Society. How can CSOs get their voice heard? When the CCM was designed, the minimum amount of 40% of seats dedicated to the Civil Society was set in order not to frighten the governments but also to allow coalitions to be formed in order to request a vote on a specific issue as authorized in the CCM statuses. In general, the governmental representatives hate votes and want decisions to be taken by general consensus. By building alliances with academics, with the private sector and with others CSOs, by preparing the CCM meetings, building your argumentation and not be afraid of requesting a vote, CSOs can transform their apparent weakness in strengths. It is of outmost importance that a representative fully understands his rights in the CCM in order to maximize his seat impact. In order to help CSO representatives to optimize their seat in the CCM, specific training would be welcome. How to help criminalized populations enter the CCM? In the perspective of reforming the representation of a CCM, it is interesting to invite stakeholders coming from a very large scope of the society without restricting oneself to the CSO community. While giving their voice to the key affected populations, the CSOs should also be ready to support these communities, inform them, train them and help them find the leaders that are willing to speak out without pushing them to do so. The CSOs can also take part in early negotiations with the authorities in order to make sure the leaders of criminalized key affected populations wont be prosecuted. CIVIL SOCIETY INVOLVEMENT IN GLOBAL FUND GRANTS

9.

Capacity requirements for PRs and SRs in grant management Elena Dcima - GMS With as focus on results through a performance based funding strategy, the Global Fund seeks to find efficient PRs and SRs without restricting itself to any specific type.

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This approach encourages grant recipients to focus on results and timely implementation, rather than on inputs and processes alone. It ensures accountability and transparency, which facilitates external reporting and resource mobilization. Capacity requirements To be a PR or a SR, an organisation must have the required minimum capacities in: Financial Management Systems Institutional & programmatic capacity Procurement & supply chain management Monitoring & evaluation systems

An assessment of a potential PR or SR is made in order to understand if it has the minimum systems, management arrangements, and capacity to assume responsibility for activities? This assessment will identify critical gaps that may need to be addressed and will define if the organization meets the minimem capacities & systems required, needs to acquire additional capacities or is not qualified. Most SR or SSR do not have all the capacities in place at the beginning of the grant. The grant can subject the improvement in some capacities with quarterly reporting of the progress made. 10. WHAT TECHNICAL SUPPORT IS AVAILABLE AND HOW TO ACCESS IT

Making the most of Technical Assistance Elena Decima, Terry Anderson GMS Grant Management Solutions (GMS) is a project sponsored by the USAID that has for only mandate the improvement of GFG. It has defined 4 areas of expertise in which it provides technical assistance: organizational development, programmatic and financial management, pharmaceutical & Supply Management & Monitoring, Evaluation & Reporting. Depending on the need, GMS can intervene in 3 different ways: diagnosis, urgent intervention with deadline & short term interventions. GMS intervention is limited to 90 person days & mostly worked during it first year of activity in helping CCMs. Floor Q&A Are Regional Networks eligible to TA by GMS? Yes, but each proposal must be linked to one specific grant. We provided TA to a group of countries that had a mandate to do a corridor procurement. Who pays for the TA? GMS supports all the TA expenses How do we request for TA? The TA request should come from the CCM but the PR can approve your demand if you feel more comfortable with them.

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11.

EXPERIENCE OF THE CIVIL SOCIETY AS PR

Experience of the Civil Society as PR Lee Abdelfadil HIV/Aids Alliance International Alliance always tries to find a Local Organization in the different countries it works in. Only if it cant find a suitable local partner, it sets up an office. Alliance has PR experience in 3 different countries and was selected in 3 different ways. In Ukraine, the GF contracted Alliance through a stewardship grant. Unfortunately the stewardship grant didnt go well, and Alliance had to go through the entire grant. In India, Alliance won a competitive selection & in Senegal through Dual Track Financing. Being PR is not an easy job. In order to do the job effectively, a CSO has to undertake huge changes in its management systems, in its Human Resource requirements and so on. It also should be ready to see its nature change to become more a grant manager than a grass root organization. A CSO can also achieve fantastic performances. The GF ranked our PR work B1 in India & in India and A2 in Senegal. 12. COMMUNITY SYSTEM STRENGTHENING

Community System Strengthening and how to integrate it into proposals for funding Natalia Ciausova Icaso/CSAT Lee Abdelfadil, - HIV/Aids Alliance International With Round 8, the GF opened a new opportunity for CSOs to strengthen their structures. The objective is to enable the communities the most affected by the epidemic to access to prevention, treatment, care and support or to advocate for their rights to employment, education, and healthcare. This should be used as an opportunity to diversify funding sources. The GF can fund Capacity building (Infrastructure, Organizational development, Technical expertise & Human resources) and Partnership building (government, private sector, civil society, and international agencies) as long as you can prove your organization will be achieving results. In order to receive GF funds, the CSS projects must be included in the grant proposal sent by the CCM. CSOs cannot request CSS funds directly from the GF.

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CSS in the Round 8 proposal form As there is no specific CSS section in the GF form, it is important to read the Global Fund guidelines regarding CSS to better understand what to write about CSS and where to include CSS analysis and planning in the form. It is also important to read the Global Fund fact sheet on CSS. The relevant excerpt of the guidelines is annexed to this document, specifies theAlliance International framework for analysing and organising data regarding community system strengthening in Round 8 . Community System strengthening tools Catherine Bilger Unaids Geneva In order to get CSS funding for your organization, it is imperative to spend time to fully understand the GF funding processes. 12 steps country proposal To be able to have an influence on the CSS financing by the GF, your CSO must be member of the CCM and integrate the working writing group. Once the Analysis Epidemiological profile and the Strategic GAP analysis are completed, it will be possible to undertake the CSS gap analysis. The CSS gap analysis derives from the national strategic plan. With the help of the epidemiological data, you will identify the target communities and evaluate the needs of the future beneficiaries. This will enable you to calculate the funding GAP between the national strategic plan and the organisation needs. Once you are able to justify the GAP & the needs, you must find a way to track the results with a set of indicators and adapted monitoring systems. Global Fund Fact Sheet CSS funding by the GF is not new but Round 8 brought a clear, transparent and official methodology. The Global Fund Fact Sheet on CSS and its explanation guide state precisely what can and cannot be funded. Floor Q&A Can a same country submit 2 separate proposals? All the GF funding process is aimed to get the different stakeholders work together. There is therefore only one way to submit a proposal: through the CCM. Our CCM and our PR dont seem to be aware of the GF CSS funding opportunity. How can we inform them? A CSS funding must be linked to a national strategic plan that normally should include a civil society section. The GFG is there to finance the funding GAPs. Different international agencies, like UNAIDS, can help in introducing this funding opportunity to your national bodies and representatives.

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13.

NATIONAL STRATEGY APPLICATION

National strategy application, what does it mean? Natalia Ciausova Icaso/CSAT The National strategy application (NSA) is a new channel started in April 2009 from the Global Fund that constitutes an alternative to the Round-Based system. The GF invited 8 countries to submit their NSA for fighting the different diseases. In those 8, MENA countries are well represented with Algeria and Djibouti for HIV/AIDS and Morocco and Somalia for TB. Role of the Civil Society in the NSA The NSA is a collaborative work between the government, the private sector and the civil society directly connected with the work of the National AIDS Committees and the CCM. In theory, the CSOs should work with the other stakeholder to include civil society as key implementers into the National Strategy and promote issues of key affected populations and community systems strengthening. In practice, certain observers fear that the CCM will be marginalized and create a situation where the government will finance projects without CS participation. To avoid such a situation, CSOs should assert their role from the start in the formalization process of the National Strategy. 14. EXPERIENCE WITH KEY AFFECTED POPULATIONS

Experience with Key Affected Populations, example from Afghanistan Farid Bazger - Khatiz Organization for Rehabilitation Afghanistan has one of the lowest numbers of registered HIV cases in the world with 506 official cases (2 to 3000 estimated) but faces important challenges. A large number of Afghans are refugees and has over 1 million migrant workers in high prevalence countries. The country also has 60 000 truck drivers (some of them IDUs) that can engage sexual intercourse with the rising number off Sex workers or have homosexual relations with the younger conductors, a rising number of IDUs and a lack of blood safety.

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DAY 3 15. PRESENTATION OF GROUP SESSIONS

Participation of Key affected populations within the CCM Participation of Key affected populations in the Global Fund (implementation, CSS, GIPA principles...)

Key Affected population within the National CCMs As requested by the GF, PLHIV have seats in all the CCMs of the Region. In some countries, people living with Malaria also have a seat. In most countries, these representatives are hand picked by the ministry of health. Sex workers, MSM & IDUs do not have any representation in the different CCM of the Region. Furthermore, there seems to be no real debate on accepting vulnerable populations (criminalized or not) within the CCM level. A lively debate was open by the members of CSO on the opportunity of pushing for their representation within the CCM. A sizeable minority rejected the idea of direct representation of Sex workers, MSM & IDUs in the CCM because of the risk of seeing them rejected, while most considered the current context as not auspicious for a representation of these key affected populations in the CCM. They in particular believe Faith based organizations would be hostile towards such an idea. Key affected population level of implication within the CCM The current level of implication of Key affected populations in the CCM is low, mostly because most of the vulnerable populations are members of criminalized groups. If there is no obvious way to get those populations to participate within the CCM, innovative solutions can be found. In Egypt for example, an NGO providing services to the most vulnerable populations is representing them. With the high HIV prevalence in certain population, the Civil Society must be on the forefront of the dialog and advocate for a greater implication of these key affected populations on the grounds of Public Health. What should be done to give key affected populations a better representation?

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For the different groups a larger implication of these key affected populations is necessary. The Civil Society should in particular work intensively with these groups, try to identify leaders and ensure their representation in the CSOs decision-making structures. Different advocacy campaigns should be implemented in order to ensure key affected populations representation in the CCM but also to initiate an evolution of legal environment of the criminalized groups. 16. PRESENTATION OF PARTNERS & THEIR ROLE IN SUPPORT OF CS

UNAIDS Mr Kamal ALAMI Unaids Morocco UNAIDS is not a donator but the coordinator of the different United Nations agencies efforts to fight HIV/Aids. The role of the organization is to show leadership in the fight against HIV/AIDS, to improve the availability of strategic data, to help monitor and evaluate, to engage with the Civil Society, the governments and the other stakeholders and help mobilize resources. UNAIDS can provide Technical Support for it expertise areas. In order to request it, you should go to your national office. TSF West and Central Africa (TSFWCA) Yvonne Ouattara Financed by UNAIDS, TSFWCA covers 25 West and Central Africa countries and provide a short-term high quality Technical Assistance to organisations fighting HIV/Aids. TSFWCA supplies Technical Assistance in different areas of expertise such as Operational and strategic planning, Finance or Monitoring. TSFWCA technical assistance is available on a fee basis. If your organization is eligible, the mission costs can be covered by the Technical Assistance Fund (TAF). TSFWCA is reactive and can send a team very quickly on a mission. In the event your technical assistance request is financed by TAF, it will take maximum 3 weeks for your request to be approved. German BACKUP Initiative Kristina Kloss - GTZ Launched in 2002, the German BACKUP Initiative aims to support governmental and non-governmental partners, particularly organisations and networks of vulnerable

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groups and women & girls to effectively use global health financing mechanisms to respond to AIDS, TB and malaria. In order to increase partners capacities and enable them to have access to global resources, scale up effective programs and improve quality of program implementation, the BACKUP Initiative believes in country ownership and relies on existing structures. It provides 3 types of technical support modes: Fast-access, consultancy & project. To be eligible to BACKUP funds, technical support requests must meet certains criterias. It must be inline and contribute to National Strategy and Programmes, be linked to global financing processes & be based on a needs assessment for technical support. Your request must be supported by your CCM or your PR. Alliance West Africa Hub & Global Fund Grant support team Franceline Cabor Headquartered in Burkina Faso, the Alliance West Africa Hub is dedicated by bringing technical support to West African organisations receiving GFG funds. The Alliance West Africa Hub fields of expertise cover different aspects of capacity building such as CSS, grant management, advocacy or Monitoring and reporting systems. A certain number of HIV specific programs are also available. Your Technical Support request should be sent by email to the headquarters in Burkina Faso with details of your needs. The Hubs Technical Assistance is fee based. Although funding can be an issue, the Hub provide you with in order to find the money. Grant Management Solutions Terry Anderson Grant Management Solutions (GMS) is commited to the improvement of the performance of the Global Fund grants, CCMs and all recipients and provides urgent, short term technical support, creates local capicity ans strenghtens the organizational capacity of civil society for participation in GF programs. GMS provides Technical Support in 4 areas : Governance, Grants management/financial management, Procurement and supply management & Monitoring, evaluation and reporting (PRs, CCMs). The Technical Support provided by GMS only allows for 90 person days allowed for international or regional consultants in the country and up to 50 days allowed for a local consultant. In order to receive Technical Support from GMS, you must prepare your request and get the support of your CCM or of your PR. If approved, the Technical Support is free. FLOOR Q&A In some countries, going through the CCM or the PR can be a hassle because they ignore our rights. How can we get Technical Assistance without going

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through them? Although the context in some countries can be complicated, CSOs need to get to the level of multinational and binational organisations by building there organisations and networks and get your voice heared by your CCM. If you are not able to deal with your CCM, you are not ready either to deal with Global Fund Technical Support providers. If you are in conflict with your CCM or your PR, you should find creative solutions such as a common TS project with some allied CSOs that have better relationships with those key stakeholders. It is urgent for the MENA region to have its own TSF. Would it be possible for the CSAT and the TSFWCA to negociate a MoU on Technical Support partnership ? TSFWCA can already provide TS to Mauritania. For the other countries the complexity lies in the Technical Assistance Fund. As for the idea of the partnership MoU, the question should be studied. MEETING CLOSING AND RECOMMANDATIONS

17.

Before closing this there three days workshop, Othman Mellouk reads the Declaration of Marrakech. The declaration gets a unanimous endorsement of the MENA Region representatives and will be presented during the Amman UNAIDS region meeting. During the 3 days, lively debates and exchanges of information took place between the different participants. As everyone hoped, this workshop gave to all the opportunity to learn more information about The Global Fund and is grant processes, on the CSAT or other Technical Support organizations and was a great forum to exchange experience from different countries. If this meeting wasnt able to solve any specific problems, it gave all the participants the basic information, the tools and the leads to understand their situation and to imagine solutions. Follow up for CSAT :

Finalize documents from Marrakech meeting: Declaration and the Report Broadly disseminate these documents to civil society, UN agencies, WHO and technical support providers

Use these documents to advocate at the global, regional and country level for more support to civil society in MENA region to engage with the Global Fund pro

Compile and disseminate to civil society tools prepared by partner agencies on proposal preparation and grant implementation

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Develop and implement a follow up to this workshop with measurable indicators to monitor how the situation changed in the countries in 3 months, 6 months and 1 year. Identify needs for support and facilitate relationship with technical support providers Facilitate cross-country training and experience sharing on advocacy, program implementation and representation on decision-making mechanisms

Connect with the Global Fund Board delegations to strengthen representation of MENA region and to defend eligibility criteria for middle-income countries with concentrated epidemic

Promote stronger representation of MENA region at the international level

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Marrakech Declaration April 16, 2009, Marrakech We, the representatives of 55 civil society organizations (CSOs) from 15 countries of the Middle East and North Africa region gathered by Civil Society Action team / ALCS in Marrakech from April 14 to -16, 2009 declare: After years of devotion working in care and prevention of HIV, TB, and malaria for the most vulnerable communities, we now want to contribute more effectively to the structures of the Global Fund to Fight AIDS, Tuberculosis and malaria through CCMs, PRs and SRs in our countries and to have the means to do our work to control these epidemics; However, given the following challenges: ! The lack of transparency in most of our CCMs, especially in the writing of proposals, the choice of PR and grant oversight, The process of handpicking representatives of NGOs or people living with HIV or TB, and the absence of key affected populations on CCMs, The lack of involvement of key affected populations in program design and implementation, The criminalization of some individual behaviors in the transmission of HIV, which pushes persons to be clandestine or jailed rather than being provided with care, The lack of acknowledgment of effective prevention strategies regarding condoms distribution and harm reduction policy, The lack of continuity in the funding disbursed by our PRs, Because of these challenges, our programs are in jeopardy or underused by target populations. Our work to reach out to communities at risk for infection of HIV, TB, and malaria or to those already infected in our region will require better support through Global Fund funding and greater involvement by key affected populations. In order to accomplish our task we want to be more involved in all aspects of the Global Fund in our countries through:

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The genuine implementation of the frameworks that already exist in the Global Fund requirements and guidelines that govern civil society contributions in CCMs, and Community systems strengthening (CSS) within national strategies to combat HIV/AIDS TB, and malaria through the Global Fund grant application and grant negotiation processes. Given the features of the epidemics in our region we are now reaching a point at which civil society will be the most strategically positioned to deliver effective services to key affected communities. To this end, we recommend that:

A legal framework be put in place to deliver effective prevention services that guarantee human rights, Our services be expanded and funded accordingly, Access to technical support, which will be facilitated by all PRs, and technical partners in our countries. We commit ourselves

! !

In every country of MENA region, to convene a meeting of NGOs and key affected populations involved in fighting the diseases and convey to them the information and outcomes of the workshop in Marrakech, To organize transparent elections of our representatives on the CCMs To establish mechanisms for civil society representatives in our national CCMs to be accountable to their constituents, and To promote community systems strengthening to be integrated into our national plans to fight the three diseases, in future grant proposals to the Global Fund, in grant negotiations, and in Phase II renewals. We call upon: ! Donor countries to uphold their commitment to fully fund the Global Fund

! !

! The MENA region representatives on the Global Fund Board to defend the eligibility for Global Fund grants of all middle-income, low-prevalence countries with concentrated epidemics ! The Global Fund Secretariat and donors to audit CCM compliance with requirements ! UNAIDS country offices to support meaningful involvement of civil society in the MENA region in all Global Fund processes, to intensify its effort in promoting community systems strengthening, and to create a technical support facility in the MENA region

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! WHO/EMRO and other technical partners to fund and provide technical assistance to civil society organizations that access Global Fund grants ! Our governments to develop programs with evidence-based interventions that are epidemiologically relevant. On sign : Charitable Society for Social Welfare (CSSW), Yemen Pakistan AIDS Control Federation (PNAC), Pakistan Orphan, Refugees and AID (ORA) International, Afghanistan Khatiz Organisation for Rehabilitation (KOR), Afghanistan Agency for Cooperation and Research in Development (ACORD), Sudan PLHIV support group, Jordan Street, Pakistan Rahma des PVVIH, Tunisia ATL, Tunisia Life impulse association, Yemen Bushra Centre, Jordan APCS, Algeria Somaliland Progressive Women Association, Somaliland Somaliland HIV/AIDS Network (SAHAN), Somaliland Friends of life, Egypt Shehab, Egypt Espoir et vie, Mauritania BADBADO Umbrella, Somalia Ahfad University for Women, Sudan Iraqi Anti TB Society and chest disease, Iraq EMEL, Mauritania NWFP AIDS Consortium, Pakistan Organisation PanAfricaine de Lutte contre le SIDA (OPALS), Morocco ALCS, Morocco AMSED, Morocco Social Services Association, Yemen Alliance Djiboutienne contre le sida, Djibouti Oui la vie, Djibouti Caritas, Egypt Plus Foundation, Pakistan Bridge Consultants Foundation, Pakistan Secrtariat excutif national de lutte contre le sida, Mauritania ONG STOP SIDA, Mauritania Sudan Family Planning Association, Sudan Juzoor Foundation for Health & Social Development & Youth Parliament, Palestine Medical Relief society, Palestine

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Quantitative Evaluation
1= Very bad 5 = Excellent Objectives : 1- Offer a forum for discussion to CSOs from the region to know more about the Global Fund and obtain solutions for their implementation challenges.

2- Improve the knowledge of participants about how to use technical assistance

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3- Share useful information about the participation of civil society in CCM and their opportunities to become PRs

Achievement of workshop objectives The primary aim of the workshop was to provide a forum useful to CSO participation at the Principal recipient, Sub recipient and CCM levels. The objectives were as follows: 1-Offer a forum for discussion to CSOs from the region to know more about the Global Fund and obtain solutions for their implementation challenges. 2- Improve the knowledge of participants about how to use technical assistance 3- Share useful information about the participation of civil society in CCM and their opportunities to become PRs From the evaluation forms, most participants rated the workshop as having achieved its objectives to a high degree. No-one gave ratings of very unsatisfactory in this section. Objective 3 received the widest extreme of ratings, with 54% respondents ranking its achievement as excellent. More than 73% of the respondents found that Objective 1 was achieved to a high degree, with ratings of very good to excellent. Objective 3 had the most agreement from participants on how well it was achieved, with most people having a higher range view surrounding very good (54%). See chart below for results by objective.

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Group work

Session 1: Group 1: Global Fund and civil society as grant implementers: how is it going in your country?

Group 2: Advocacy towards Global Fund: What are your advocacy channels and how do you want to address them?

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- Group 3: Country CCM analysis regarding GF requirements and participation of civil society in CCMs

Session 2: Participation of key affected population within the CCM and in the Global Fund

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Session 3: Assessment of CS technical assistance needs and how to write a technical assistance request: follow up and action plan

- Time management

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- Workshop location

- Logistics: quality and preparation of the workshop

Report on session quality and deliberations Participants gave feedback on the evaluation forms regarding the quality of the session organization. Regarding the time allocation, it is significant that almost a quarter of participants were not satisfied. Indeed, many sessions were cut short due to the time constraints, which in the end prevented quality small group discussions for some and for others, prevented any small group discussions. The majority rated the session conduct and interaction of presenters and facilitators with participants as very good to excellent. And more than 63% found excellent Logistics, quality and preparation of the workshop.

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Qualitative evaluation

Most of the participants said that their expectations were met through the workshop; they learnt many things about CCMs and GF. Especially informations concerning CCM structure, CCM performance and Global Fund proposal development and the necessity of including key affected population within the all Global Fund processes. The theme that the participants liked the most was advocacy, probably because they had few opportunities to get exposed to it. One additional day would have been very appreciated. And they particularly appreciated informations given on Key affected population and how to establish CCM in their countries if not, or to reinforce it if existing. My great learning was advocacy and activism : participants will try to incorporate it into their work. Most of the people want to see the Marrakech Declaration implemented and to be included on the follow up. Most of the participants said that their expectations were met through the workshop; they learnt many things about CCMs and GF. They appreciated the cases study and sharing countries experiences, and learned for instance from the Moroccan experience including NGOs in CCM. The multicultural aspect of the workshop (15 different countries) was really valuable and work into network and coalition was an new idea appreciated by most of them. Some of them expected to have more insights on experiences of others countries on how they challenged the cultural taboos and were able to implement the projects. and wished they could have more time to interact and exchange experiences with other countries. Some participants (especially the ones from Somalia, Palestine), coming from nonCCM country expressed the fact that not much was applied in our context, especially that our political situation is very different than any other country. Some of them learnt what exactly capacity building and technical support meant, and how to reach technical support providers and write a technical assistance plan. For more than 90% of the participants, none would change something if they had to organize a similar workshop. They were all thankful and grateful for this opportunity and they said for the majority that it was an excellent learning opportunity. Getting ticket and visa in a very short time was highly appreciated. Some of them would like to duplicate it into their own country, and organise some meeting with key NGOs in their countries in order to disseminate lessons learnt in Marrakech and work jointly.

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Communiqu de presse Marrakech le 13 avril 2008 : LALCS organise une rencontre de la socit civile de la rgion MENA sur le thme du Fonds Mondial de lutte contre le sida, les 14 -15 et 16 avril 2009 Marrakech Soixante participants de quinze pays de la rgion Afrique du Nord Moyen Orient (MENA) se retrouveront Marrakech du 14 au 16 avril 2009 linitiative de lAssociation de lutte contre le sida (ALCS) pour discuter de la participation de la socit civile dans le processus du Fonds Mondial de lutte contre le Sida, Tuberculose et Paludisme. Ce regroupement rentre dans le cadre des activits rgionales de lALCS. En 2008, lassociation a t dsigne, par un consortium dONG internationales, pour hberger linitiative CSAT (Civil Society Action team) dans la rgion MENA. Lobjectif de cette initiative tant de renforcer la participation de la socit civile dans le processus du Fonds Mondial. Selon Nadia Rafif, charge de la coordination du CSAT auprs de lALCS : Cette rencontre est unique. Pour la premire fois, plusieurs ONG de la rgion, de la Mauritanie jusquen Afghanistan, vont avoir loccasion de discuter de leurs proccupations durant deux jours dans un cadre purement associatif. Le troisime jour sera consacr un dialogue avec des officiels du Fonds Mondial et de lONUSIDA qui feront le dplacement de Genve . La runion est supporte par le programme de coopration Amricain Grant Management Solutions (GMS), la coopration technique Allemande (GTZ) et lassociation franaise AIDES. Elle sera loccasion pour les reprsentants de la rgion de partager leur exprience avec le Fonds mondial. Elle vise galement informer les ONG sur les possibilits de participation du secteur associatif dans le processus et renforcer les capacits des participants dans la mise en oeuvre des programmes de prvention, de soutien et de prise en charge des personnes vivant avec le VIH soutenus par le Fonds. Le rle de la socit civile dans la riposte lpidmie est primordial, surtout dans notre rgion o le dni, les tabous et la stigmatisation restent encore fortement prsents. Nous souhaitons avec cette rencontre aider les ONG jouer pleinement ce rle , affirme Othoman Mellouk, charg des relations internationale lALCS. Le Fonds Mondial est aujourdhui le plus important mcanisme de financement de la lutte contre le sida dans le monde. Durant les 4 dernires annes, il accord environ 651 millions de dollars de subventions 16 pays de la rgion MENA y compris le

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Maroc. En Afrique du Nord et au Moyen-Orient, lONUSIDA estime 35 000 le nombre de personnes qui ont t infectes par le VIH en 2007, ce qui porte 380 000 le nombre de personnes vivant avec le virus. On estime que 25 000 personnes sont dcdes de maladies lies au sida la mme anne1. Toujours en en 2007, on estimait 150 000 le nombre total de personnes vivant avec le VIH qui avaient besoin dun traitement antirtroviral dans la rgion. Seulement 7% de ces personnes recevaient un tel traitement, ce qui est considr comme le taux de couverture le plus faible au niveau mondial dans le classement rgional de lOMS.

Contacts presse : Nadia Rafif Coordinatrice CSAT-MENA Tel : 06 68 88 64 23 E-mail : alcsmarrakech@gmail.com

Othoman Mellouk Prsident ALCS Marrakech Tel : 06 66 45 28 11 E-mail: o.mellouk@gmail.com

Lieu de la runion: Htel Andalous, Hivernage, Marrakech

1Rapport Mondial de lONUSIDA, Dcembre 2008 2 Rapport Mondial de lOMS sur laccs au traitement du VIH, Juin 2008

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List of useful terms

ALCS : Association marocaine de Lutte Contre le Sida ART : Antiretroviral therapy ARV : Antiretroviral CBO : Community based organization CCM : Country Coordinating Mechanism CCP : Coordinated Country Proposal CRP : Coordinated Regional Proposal CSW: Commercial sex worker CS : Civil Society CSAT : Civil Society Action Team CSO : Civil Society Organisation DAT : Dispositif dAppui Technique DTF : Dual Track Financing FAC : Finance and Audit Comitee FMP : Fund Portofolio Manager GFATM : Global Fund to fight AIDS, Tuberculosis and Malaria GMS : Grant Management Solutions IDU : Intravenous drug-user IEC : Information, Education, and Communication (often used to refer to HIV prevention campaigns) LFA : Local Fund Agent M&E : Monitoring and Evaluation MSM : Men who have sex with Men, a term used to classify men who engage in sex with other men, NSA : National Strategy Application OI : Opportuninistic Infection STI : Sexually Transmitted Infection PLWHA: People Living with HIV/AIDS PR : Principal Recipient PSC : Policy and Strategy Comittee PSM : Procurement and Supply Management RCC : Rolling Continuation Chanel SR : Sub-Recipient SSR : Sub Sub-Recipient TB : Tuberculosis TC : Testing and Councelling TERG : Technical Evaluation Reference Group TRP : Technical Review Panel TSF : Technical Support Facility UNAIDS : Joint United Nations Programme on Hiv/Aids VCT : Voluntary councelling and testing

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Thanx !
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