3 Questions to Richard Feachem by PLWHAs in Nepal

THREE QUESTIONS TO THE EXECUTIVE DIRECTOR OF THE GLOBAL FUND TO
FIGHT AIDS, TB AND MALARIA FROM PEOPLE LIVING WITH HIV/AIDS IN NEPAL

To,
The Executive Director
Global Fund

CC: Chair & Executive Board of the Global Fund

Respected Sir,

We the people living with and directly affected by HIV/AIDS from
different parts of Nepal would like to bring into your notice a few
issues that has been overtly neglected by our government and all the
donors working in Nepal – including the Global Fund to fight AIDS,
TB and Malaria.

Nepal has a concentrated epidemic with around 100,000 estimated to
be living with HIV/AIDS. However, among injecting drug users the
prevalence is staggering 50% - 70%, among sex workers 20% and so on
and so forth. A raging conflict and political unrest for the past
several years has fuelled the HIV epidemic.

Due to the concentrated epidemic scenario in Nepal donors get an
excuse not to fund treatment and care programs as they believe that
prevention should remain the mainstay in a low prevalence context.
This has also influenced the National AIDS strategy which fails to
even mention the word treatment let alone set strategies to treat
and care people living with HIV/AIDS. As a minority, we the
community of people living with HIV are discriminated by the
government and donors. Our needs and our priorities are often
disregarded because we are small in numbers. We are often told that
we will only receive treatment and care services when more people
come out. When we heard about the global fund and its mission 3
years back we had hoped that the fund will address our needs.

However our hopes were shattered when country coordinated proposal
failed to address our needs and priorities as they were based on the
national plan which focuses on prevention because of the reasons
mentioned already. Those who contributed to the proposal were the
NGOs who had experience only on prevention programs. Though Nepal
received funding from the global fund in 2003 the programs are yet
to be implemented. Another major barrier to this delay was instable
political scenario, weak national AIDS coordinating body and limited
international pressure. Again on the other hand we were told that
there are other pressing issues than HIV and AIDS.

Whenever we raise this issue with our own government or the donors
we are told that they are doing their best. Whenever we raise this
issue to the Global Fund, UNAIDS or WHO we are told that it is our
government who is `not working and is not their fault.'

Is it then our fault that we have a raging conflict?
Is it our fault that there is a political unrest?
Is it our fault that our government is in denial?
Is it our fault that we have a weak national plan?
Is it our fault that we have a passive international community?
Is it only our problem that we are living with and affected by HIV&
AIDS?

If yes, then we have nothing to say. However we would like to put
forth a few questions to the Global Fund that had promised not to do
business as usual.

1. What is the fund's strategy to deal with countries in conflict
and political unrest?
2. How does the fund facilitate the process in countries to ensure
that people living with HIV have access to treatment and care
through the GF resources?
3. When a country excludes people living with HIV and vulnerable
communities to apply through the country coordinated proposal how
will the fund help the communities to develop and submit a proposal?

(The government of Nepal has adopted a policy to only accept
applications from organizations that are registered for five years
which excludes several organizations run by people living with
HIV/AIDS, drug users and sexual minorities to apply for funding.)
With these questions laid down for you we hope that the fund will
encourage and assist the communities to develop and submit a
proposal for the 5th round.
_______________
Rajiv Kafle, Former Board Member GNP+, Advisor APN+, Communities
Delegation GFATM, Board Member International Treatment Preparedness
Coalition & National Association of People living with HIV/AIDS
(NAPN)
____________

"Rajiv Kafle"
E-mail: <rajhiv2002@...>