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“Guyana pays much more for drugs than other countries, and why it happens is because certain rules are not followed,Wholesale Jerseys,” says UNAIDS Country DirectorBy Neil Marks Funding for programmes to combat HIV/AIDS over the next two years has been approved by the Global Fund, but a final green light depends on Guyana ensuring greater transparency in the procurement of medical supplies.The original funding from the Global Fund to fight AIDS, Tuberculosis and Malaria was US$13M. While some US$4M was already released,Wholesale NFL Jerseys, the Global Fund has mandated that the remainder of the funds be used in a way that meets global standards on transparency and other benchmarks.“The recommendation on transparency from the Global Fund is specific to Guyana,” said Roberto Campos,Cheap Jerseys From China,” the Country Director of the joint United Nations programme against AIDS (UNAIDS).This means that the programmes already approved for funding be re-organised to meet three benchmarks,Wholesale China Jerseys, Campos said in an interview at his Georgetown office Wednesday.The re-organising of Global Fund programmes is in keeping with its new funding model.While the Global Fund’s grant approval committee met on January 8 and recommended the Guyana funding for programmes stretching from now till March 2017, it is not an “automatic process” for the Fund’s Board to approve, Campos said.“The Global Fund is really worried about the process of procurement of supplies in general and ARVs (Anti-Retroviral Drugs) drugs in particular,” Campos said.In Guyana, ARVs are provided free of charge for persons who need the treatment. The National AIDS Programme Secretariat (NAPS) has reported that all who need it can receive antiretroviral therapy. According to NAPS’ 2014 progress report, there were 4,054 persons actively receiving antiretroviral therapy at the end of 2013.Dr Campos said that there needs to be clear guidelines developed by the government for the procurement and supply of drugs – procurement manual that the Global Fund can be satisfied is followed stringently.The country’s main opposition party has welcomed the move.“I am happy that it is clear for all to see that the constant nagging about the need for transparency is not an obsession of the opposition,” said Dr George Norton, a leading executive with APNU.He said that programmes of the Global Fund in Guyana have been very important in fighting the spread of HIVs, and he is now even more enthused on its new funding model dictates transparent processes.Dr Campos said that decision making process of the ministries of Health and Finance, and even Cabinet, needs to be aligned towards a strict model for procurement.“The problem is lack of transparency with all of the processes; the Global Fund has its internal rules and Guyana must meet up to those rules to be more transparent.”One of the concerns, Dr. Campos said, is that oftentimes drugs are requested on an ad hoc or emergency basis, and this drives up costs.“Guyana pays much more for drugs than other countries,Cheap NFL Jerseys China, and why it happens is because certain rules are not followed.“If you start the process one year before, you know you will need ‘X’ amount of drugs, and so you purchase those drugs in lower prices; if you delay the purchase you need to buy in emergency way so the price will go up.”Further,Cheap NFL Jerseys, Dr Campos said that the emergency requests for supplies mean that a single supplier is chosen.“Transparency means a competitive way. Guyana needs to open up the possibility for different providers.”Dr George Norton, quoted earlier,Cheap Jerseys NFL, said that single-sourcing of drugs has been happening over the years despite strong opposition. He said that he has been suspicious of the repeated need for supplementary budgetary funding to meet emergency demands for drugs.“I believe that in many instances, artificial situations have been created.”  To compound matters, highly-priced drugs are also often brought in with a short shelf life, and so a large quantity of supplies has to be dumped, he said.Campos was adamant that Guyana needs to solve the procurement inconsistencies “as soon as possible.”The Global Fund has also recommended that other benchmarks be met. Other than an insistence on transparency, it is significant that the Fund wants programmes geared towards so-called “key populations.”  He said that half of the funding will go towards programmes to meet sexual and gender minorities and commercial sex workers.The Society Against Sexual Orientation Discrimination (SASOD) has welcomed the increase investments in programmess that address human rights-related barriers in accessing treatment and care.“We think that human rights must be the centre of any HIV response. If you cannot protect people’s rights and ensure they are really living in dignity, you will not be able to stem the disease,” said Joel Simpson, co-chair of SASOD.He said that a lot of what is fuelling the epidemic is stigma and discrimination, and so the new funding model of the Global Fund is welcomed for its focus on allowing key populations to access badly needed resources.However, he warned that sometimes resources dedicated to sexual and gender minorities are funneled to bureaucratic bodies and consultancies.As such, Simpson said the resources needs to reach “the ground,” being channeled to community-based organisations, managed by key populations and whose work focus on equal access and the prevention of stigma and discrimination.Dr. Shanti Singh, the Progamme Manager of the National AIDS Programme Secretariat said that interventions geared towards sexual and gender minorities would be implemented in line with NAPS’ strategic plan. She said such interventions would be implemented with funding going towards sub-recipients of Global Fund resources.The country has up to the end of this month to ensure that the Country Coordinating Mechanism (CCM) includes a representative each of key population groups: men who have sex with men, commercial sex workers and the transgender community.“The Country must accomplish this; the composition of the CCM Board must change,” said Dr. Campos. He said that the representatives of these sexual minority groups must be selected through a fair and transparent process. The selection of these representatives is expected to be done this Monday.The CCM is the body which the Global Fund country team engages with in order to prepare projects that could eventually get funding.SASOD said that the need for representatives of sexual minority groups on the CCM Board is something that it has long advocated for.“It is unfortunate that, that you have to wait on an insistence by the Global Fund to see this happen,” Simpson said.Based on the UNAIDS 2012 estimates, Guyana’s adult HIV prevalence is 1.3%.NAPS have reported a steady reduction in the prevalence of HIV among the general population from 2004, when it was 2.4 percent.In addition, surveillance data from the Ministry of Health shows a decline in the number of reported HIV cases. At the end of 2013, 758 cases were diagnosed, a decrease of more than 50% when compared to the 2009 figures.