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Source: pvvihsida_red_hispana

By: Javier Hourcade Bellocq

January 27, 2020 (Toronto, Canada and Caracas, Venezuela) – On January 16, 2020, the Global Fund sent a letter to the Venezuelan Ministry of Health, informing the allocation of a $19.8 million USD grant for three years to fight against malaria.

This is the first time that the GF has allotted resources to Venezuela. The allocation is the result of a decision of the World Fund Board in May 2019 considering that Venezuela, a high middle income country (according to the World Bank’s rating), was exceptionally eligible to receive funds against malaria¹. The exception is due to the significant increase in malaria cases in the country; the possibility that this outbreak will further deter the health situation, with a significant increase in cases in 2019; the impact it is having on the sub-region and the lack of national capacity to respond to this outbreak.

In 2018, the World Health Organization (WHO) estimated approximately 471,995 cases of malaria in Venezuela (404,492 confirmed), compared with 57,926 in 2010. More recent data shows that, between January 1 and June 22 2019, 208,027 cases of malaria were reported in 21 states. Venezuela currently accounts for 51% of all cases of malaria in the Americas. It is estimated that another 14 million people are at risk, and the number of deaths from this disease has increased almost eight times since 2010.

ICASO and ACCSI applaud the news of malaria allocation for Venezuela. Grant resources will provide treatment and prevention services that will save the lives of thousands of people, and will significantly strengthen the laboratory and surveillance capacity of the health system.

However, there is a potential and significant financial gap that is a cause for concern. The Master Plan of Venezuela (which guides work on HIV, TB and Malaria with GF and other resources) for the period 2020-2021, estimates that the total financial needs for the two years in response to malaria in Venezuela are of $ 32.3 million US dollars. Beyond the Global Fund investment, there are no other internal or external resources available. The anticipated deficit represents more than $ 12.5 million and may be one of the causes of the deepening of the malaria crisis in Venezuela and in neighboring countries.

Likewise, there are barriers to the meaningful participation of civil society and the affected communities concerned. The humanitarian emergency in Venezuela is highly politicized and is used as a government strategy for repression. Police has raided HIV service organizations and there are persecutions and arrests of human rights defenders and activists. In this context, the implementation of allocated funding and the supervision of this grant are quite unlikely to include multiple stakeholders, ensuring that they are democratic in nature. In fact, the letter of assignment to Venezuela indicates that “the Global Fund will coordinate the development of the financing request”, not a Country Coordination Mechanism. Alternative governance mechanisms of the Global Fund are needed to ensure that civil society and communities participate meaningfully in the design and delivery of the malaria grant, in the context of countries in crisis.

Finally, more support is needed for civil society and communities to influence and promote a request to the government for accountability. The lessons learned from the Fund’s recent investment to respond to HIV in Venezuela (another exceptional investment) proved the Importance of community monitoring. The Venezuelan Network of Positive People (RVG +) has documented numerous irregularities in the storage and distribution of different medications throughout 2019. Likewise, community monitoring ensured that the drugs donated by the Global Fund will reach people living with HIV, as approved. For all this, reserved funds should be allocated in the new Global Fund malaria grant to fund community monitoring activities. Other partners must also invest in these vital controls, to ensure that the resources of the Global Fund in Venezuela are used effectively, efficiently and appropriately.

Mary Ann Torres, Executive Director of ICASO showed her approval for global solidarity towards the malaria crisis in Venezuela. “The allocation for malaria is a significant milestone in the sustained advocacy efforts of technical experts and community activists from Venezuela, and their allies throughout the world,” Torres said. “Together, we put pressure on the Global Fund to make an exception to the eligibility policy. Now, we will continue to support our partners in the country to ensure transparency and accountability for these resources, which have cost so much to ensure”.

Alberto Nieves, Executive Director of ACCSI, declared: “We are very happy with the GF decision to support initiatives against malaria, and thus protect the lives of some of the most vulnerable people in our country. We are pleased that our efforts in community monitoring are being valued and we are committed to continue monitoring the situation. We also welcome the decision of the Global Fund to invest directly in Venezuela, where an emergency is taking place”.

“Even though providing resources from the Global Fund for malaria will help alleviate the situation, significant additional financial resources from other sources will be needed. Existing resources will not be sufficient to contain this bout; in addition to the necessary changes in the political situation, the only tools for malaria to be again under control in Venezuela,” stated Javier Hourcade Bellocq, a member of the Latin American and Caribbean delegation to the Global Fund Board .

ICASO is a Canadian organization acting as a global voice on HIV issues that impact diverse communities around the world. Our political advocacy will lead the leadership of civil society and key populations in a joint effort to end the AIDS epidemic. We do this through partnerships with people and organizations in all regions and with various sectors, always with the vision of serving and empowering communities. www.icaso.org

Citizen Action Against AIDS (Acción Ciudadana Contra el SIDA, ACCSI) is a Venezuelan organization that works to ensure effective and coordinated strategies to protect, promote and defend the human rights of people living with HIV and other key and vulnerable populations. www.accsi.org.ve

1 The Global Fund Eligibility Policy uses the WHO malaria burden data for the year 2000 to determine eligibility for high-middle-income countries (since data from this period is the best metric to assess the potential of a country for malaria transmission intensity). Based on these metrics, Venezuela would not be eligible to receive malaria funds from the Global Fund. In May 2018, the policy was revised to include a clause that allows technical partners to recommend to the Global Fund Secretariat that a country be eligible for a malaria allocation for a specific allocation period, in case of a significant increase in Malaria cases in a not eligible middle-income country. This clause was successfully invoked to make Venezuela eligible for malaria financing in 2020-2022.