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Concerns over Cambodia’s HIV funding

A Cambodian health official takes a blood sample from a villager during a screening for HIV in Kandal province in February last year. AFP
A Cambodian health official takes a blood sample from a villager during a screening for HIV in Kandal province in February last year. AFP

Concerns over Cambodia’s HIV funding

A group of anonymous civil society organisations, people living with HIV and others has raised “grave” concerns regarding funding from the Global Fund, the largest donor to the fight against HIV/AIDS, TB and malaria in the Kingdom – as well as Cambodia’s allocation process to support services over the next three years – according to emails obtained by The Post.

The group sent an email to Global Fund official Thuy-Co Caroline Hoang, in which it also aired dissatisfaction with the management of the Community Coordinating Mechanism (CCM) – a national multi-sectoral committee in charge of facilitating Global Fund activities for the fight against HIV/AIDS, tuberculosis and malaria in the Kingdom.

The email alleges that civil society representatives in the group have little say in decision-making, with the Ministry of Health and National Center for HIV/AIDS, Dermatology, and STD not factoring their concerns.

“They all [civil society organisations] want to step down (resign) from this symbolic body,” the email reads.

Those behind the email only identified themselves as “KAPs [key affected populations], PLVHIVs [people living with HIV] and CSOs [civil society organisations]”. Emails sent by a reporter to the anonymous “KAP advisor” email address went unanswered yesterday.

A member of the CCM, who requested to remain anonymous because of the sensitivity of the issue, said based on observation the participation on the committee from the “Cambodia side is weak”.

“The decision-making is mostly [coming] form the international side,” the CCM member said. “CCM should improve the management and the Cambodian side should take more responsibility.”

Representatives from the World Health Organization, UNAIDS and USAID are also on the committee.

The email also outlined the group’s concerns that the CCM does not allocate enough funding to support activities for key affected populations, or groups infected with HIV, malaria or tuberculosis. The group also claims that much of the funding is going to international NGOs – rather than local NGOs that operate at a grassroots levels – with a few of them, such as Sihanouk Hospital Center for HOPE, receiving “automatically [sic] pre-approval” without having to submit an expression of interest. Sihanouk Hospital did not respond to request for comment.

Gretchen Lyons, a spokeswoman for the Global Fund, confirmed the fund’s secretariat had received several questions from an anonymous group of civil society organisations regarding the country-led budget and allocation process in Cambodia.

The secretariat referred them to the CCM, which Lyons described as the “cornerstone of the Global Fund partnership”. “The CCM Executive Committee is planning a consultation with representatives of these groups to discuss their concerns in a transparent manner in the coming weeks,” she wrote in an email.

Out of the Global Fund’s HIV allocation of $41.6 million to Cambodia for 2018 to 2020, 27 percent has been budgeted for NGO-led activities, totalling about $10 million, Lyons said.

Choub Sok Chamreun, executive director for Khana, said that while his organisation was not part of the anonymous group, the CCM should take their concerns into consideration and should try to find solutions.

“We can’t say whether [their concerns] are valid or not, but it’s more important that their voices are not undermined,” he said.

Soth Sotheariddh, national coordinator for Cambodian People Living with HIV Network, said his organisation was also not part of the anonymous group, but he had heard about the issues.

He said his organisation has two representatives on the CCM, and said the representatives’ voices are heard, “but the problem is how they move into practice”.

But Ly Penh Sun, deputy director for NCHADS, claimed that the key populations are always represented in the process.

Before the Pchum Ben holiday, a Global Fund team came to Cambodia, and made changes to funding to reallocate more funding to key population activities. He said the Global Fund recently added about $600,000 to a $4 million budget earmarked for key populations from 2018-2020.

“I think the NGOs are overreacting,” he said. “If they are not satisfied, the Global Fund can investigate.”

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