A national network of people living with HIV, which has been key in helping coordinate anti-HIV services at the grassroots level, is now being excluded from a new Global Fund grant, raising “deep” concerns, according to NGOs and a leaked internal email sent to government officials.
The development comes on the heels of issues raised in October by an anonymous group of civil society organisations and people living with HIV who were concerned their voices were not being taken into account by the Cambodia Coordinating Committee (CCC), which facilitates the international philanthropic behemoth’s activities in the Kingdom.
On December 28, Sorn Sotheariddh, national coordinator for the advocacy network CPN+, renewed those worries in an email to several key stakeholders, including Ieng Mouly, chair of the CCC and the National Aids Authority; Ly Penh Sun, the head of the National Center for HIV, AIDS, Dermatology and STDs (NCHADS); and members of the Selection Panel, which decides what NGOs get Global Fund support. Several officials confirmed the authenticity of the email, which was obtained by The Post last week.
“The People Living with HIV Network plays an important role in working with the government, development partners, and civil society organisations in responding to HIV, and especially to ensure the sustainability of care and support services for the people living with HIV in the future and explore new infection cases,” a letter included in the email reads.
Cambodia has had one of the most successful HIV responses since its peak in the 1990s. But the country’s success has resulted in external funding dwindling since 2010, raising fears that the country’s response could see a backslide.
In the letter, CPN+ asks government officials to take their concerns into consideration.
Tia Phalla, vice chair of the National Aids Authority, said a HIV Steering Committee decided the components of the grant, and the Selection Panel selected the NGOs to implement those activities. Local NGO Khana submitted a grant proposal, along with two networks of people living with HIV – CPN+ and AUA – as its partners. International NGO Catholic Relief Services (CRS), along with four local NGOs, also submitted a grant proposal.
The HIV Steering Committee agreed both of the networks should be kept on board, Phalla said. However, the Selection Panel awarded the grant to CRS, later deciding that the international NGO had to incorporate both networks into its program.
On December 26, CRS decided to only include AUA, excluding CPN+, Phalla said.
In an interview this week, Sotheariddh said the 30,000-member network already has provincial coordinators – whose role is similar to a social worker – in 39 of the 67 antiretroviral therapy (ART) clinics nationwide. The network pays their salaries and the hospitals provide the space in exchange for their support. Only 140 of the members are paid.
The model, he said, is cost effective, efficient and sustainable, but is now at risk with the network’s exclusion from CRS’ grant.
Sotheariddh said this is not a “funding fight”, but about concerns over service coordination from the national level down to rural villages, which he doubts the NGOs would be able to reach.
“The program [network] is to increase the level of support service coordination,” he said. “We are not trying to lobby for funds, but we are trying to support the government for service support, especially during [a] funding gap.”
Chum Sopha, executive director of the NGO Health and Development Alliance and a member of the CCC, said “it’s not fair” that the Selection Panel chose an international NGO instead of a local NGO with built-in networks. He added that CPN+’s structure ensures sustainability as it involves people living with the disease.
Ung Polin, with UNAIDS, said that as a member of the Selection Panel who had signed a confidentiality agreement, he could not comment on the panel’s deliberations publicly. Though, he added that the panel’s recommendations were forwarded to the CCC for final approval.
Mouly, chair of the CCC, said his committee was already responding to the complaints, setting two conditions for CRS to fulfil. One is to amend its partners’ arrangement to ensure a “strong partnership” with organisations led by people living with HIV and those already present at the ART clinics. The second condition is for the budget to stay the same.
According to documents in a separate leaked email, the grant award for treatment and care support is $4.3 million.
The AIDS Authority’s Phalla said the concern now is overhead costs, as CRS will have to adjust the budget to incorporate the two networks.
“They [networks] are very important,” he said, but questioned where the funding will be pulled from. Jennifer Hardy, with CRS, referred questions to the Ministry of Health and NCHADS.
But NCHADS Director Penh Sun said he had “no authority” over the issue as it fell under the CCC.
Choub Sok Chamreun, executive director of Khana – which did receive funding for different services – said it was disappointing to see that the network didn’t receive funding to continue its important mission for HIV response in Cambodia.
“We understand there is not enough funding,” he said in an email. “However, the role of the CPN plus and their presence at the community . . . have contributed to the increased case detection [and] providing support to those newly enrolled in HIV treatment.”
The network’s presence has also helped fight stigma and discrimination, he added, and its absence from supporting HIV-related service delivery is a “great loss of voice of HIV activism”.
Gretchen Lyons, spokeswoman for the Global Fund, said it may be that the sub-recipient organisations change over time, but the CCC remains committed to including participation from people living with HIV in the grant activities.
“In addition to treatment, care and support services, the grant also includes a component to support community response and systems, including coordination of national PLHIV [people living with HIV] networks.”