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the Global Fund to fight AIDS, Tuberculosis and Malaria
Issue 35 - 8 January 2014

Global Fund News Flash

Funding Application Materials Now Available

On 20 December 2013, the Global Fund made available a new funding application template, called a concept note, to enable applicants to prepare requests for funding in 2014. The submission of a concept note begins the process of applying for a grant. In March, the Global Fund will launch the full implementation of its new funding model, which is designed to make access to funding more predictable, flexible, and streamlined.

The new funding application documents, posted in the ‘new funding model’ section of the Global Fund website, www.theglobalfund.org/en/fundingmodel, include a template for the Standard Concept Note for HIV, tuberculosis and malaria, as well as core tables and instructions. Right now, a version in English is available. Versions in French, Russian and Spanish will follow in the coming weeks.

The Global Fund plans to publish all application materials by the end of January 2014. These will include Non-Standard Concept Notes (for example, for joint HIV/tuberculosis applications and for health systems strengthening) along with an optional “Expression of Interest” template to be used for regional applications.

Remembering Rangarirai Chiteure

Rangarirai Chiteure, coordinator for the Country Coordinating Mechanism in Zimbabwe, passed away on 24 December 2013. A dedicated health professional in Zimbabwe, Chiteure worked tirelessly to build access to health services for hard-to-reach communities and for all those in need. He was 45.

Celestino Basera, Coordinator of Global Grants in the Ministry of Health and Social Welfare of Zimbabwe, said after his passing: “Chiteure was a hard-working and dedicated person who left no stone unturned until results that would benefit the community were achieved."

HIV activist Martha Tholanah said the death of Chiteure was a huge loss. "We will miss all the lively debates and discussions we would have with him. He was so passionate about his job and worked well with civil society," she said.

Chiteure had been working in the health and social development field for 20 years. He started working with the Global Fund as a member of the Country Coordinating Mechanism in 2006. Acting as liaison among all stakeholders and partners, Chiteure ably coordinated proposal development, grant negotiation and signing, and program oversight. Chiteure was also part of the Eastern and Southern Africa delegation of the Board of the Global Fund. He played a pivotal role in Zimbabwe’s application as early applicant for the new funding model of the Global Fund.

The Global Fund sends its condolences to Chiteure’s wife Rachel and his three children. Chiteure will be greatly missed.

A Quiet Revolution in Bangladesh

Darshana Chakma peers through a microscope, a hot breeze from the rice paddies blowing through the open windows of her small clinic. A girl suffering from chills and a bad headache waits nervously with her family to find out if she has malaria. Darshana gets the results – negative – and the news is met with cries of joy from her family, before Darshana makes a record in a worn notebook. “It is only a fever, but make sure the children sleep under the mosquito nets,” Darshana tells the family. “Cover your arms when you go to the hills and if the fever continues, come to see me again in a week.”

Darshana is a community health worker in Rangamati, a remote district of Bangladesh. She is one of the unsung heroines behind a quiet revolution that is transforming countless villages and hamlets in this country. Despite being one of the poorest countries in the world, with relatively low healthcare spending, Bangladesh has made strides in a number of human development areas, including child and maternal mortality, women’s literacy and life expectancy. Bangladesh is turning into an example for the region.

The British medical journal, The Lancet, recently called Bangladesh’s success “one of the great mysteries of global health.” Health experts say the accomplishment is largely explained by its community-based approach to health - and in particular by the mass deployment of community health workers.

BRAC, Bangladesh’s oldest nongovernmental organization, and the Ministry of Health have trained tens of thousands of community health workers, who are playing a leading role in reducing the burden of malaria and TB and improving local health systems, with support from the Global Fund. The program is made up exclusively of women who are selected from their own villages. Acting as the eyes and ears of their communities, this army of nurses, lab technicians and volunteers provides basic health care and delivers prevention and treatment services village by village. “I know these communities very well,” says Darshana, 37, a lab technician for 16 years. “I see many cases of malaria and TB. They know me so they come to the clinic. I feel very proud of what I do because I am serving the community.”

Malaria is one of the major public health problems in Bangladesh. Out of the country’s 64 districts, 13 districts are highly-endemic areas. With its lush vegetation, wide rivers and poor roads, Rangamati poses particular challenges. But the district cut the number of overall malaria cases from 28,000 in 2008 to 8,000 in 2012, and has reduced the number of malaria deaths from 24 to 1 in the same period.

To reach some remote villages where electricity is rare, the women sometimes go on long solitary trips on foot, or even in canoes during the monsoon season, carrying their microscopes and mobile pharmacy. Rapid diagnostic kits mean that a simple pin prick can deliver a diagnosis on the spot, allowing patients to start taking artemisinin-based combination therapies, the latest-generation drugs for malaria. Dr. Moktadir Kabir, senior malaria program manager for BRAC, says Bangladesh’s nongovernmental organization sector owes much of its vibrancy to the empowerment of women. “Women are agents of change and development in Bangladesh. Women have played a central role in community building.”

The participation of women in civil society lies in the very birth of the country. When Bangladesh broke away from Pakistan in a bloody war in 1971, much of the country’s administration was wiped out, so nongovernmental organizations filled the gap. Partnerships between governments and non-governmental organizations flourished, and women stepped in, first distributing emergency war aid and then expanding to family planning and disease control.

While malaria threatens most of Bangladesh, the risk is greatest in the east and north-east, areas bordering India and Myanmar, such as Rangamati. Indigenous people and migrant workers who cross the porous borders are among the most vulnerable groups, and have become a special focus of the health workers.

Diana Chakma, a community health worker, says prevention services including teaching the correct use of insecticide-treated nets are vital to fighting the disease. After a ride by bus and then by rickshaw, Diana treks uphill to reach the village of Khamarpara, a cluster of 100 houses made of bamboo that lives off the harvest of rice, sesame, ginger and maize. Almost all the hill women work at plantations, making them and their children easy prey for the mosquitos that thrive in the alluvial valleys. A group of women and children gather in a circle and listen as Diana and a shasthya shebika, or health volunteer, start their presentation. To let everyone cool off from the heat, they hand out coconuts cut by machete and served with a straw to the apas, or sisters, as the community workers are referred to. “Sometimes I have to walk far, but I get a lot of love and respect in return,” Diana says. “There is nothing better than seeing the smile of a malaria patient who has been cured.”

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