14.United Nations Office on Drugs and Crime, Alina Bocai
15.UNAIDS, Eduard Petrescu
16.UNAIDS, Sorana Mocanu
17.National Health Insurance House, Ady Popescu
17.Health Aid Romania, Cristina Enache
19.Institute of Infectious Diseases “Prof. Dr. Matei Bals” , Sorin Petrea
20.Project Management Unit- MO, Antoanela Poenaru
21.Institute of Infectious Diseases “Prof. Dr. Matei Bals” , Odette Chirilă
22.Project Management Unit- MO, Răzvan Vieru
23.Centre for Health Politics Services, Dana Fărcăşanu
24.National Authority for People with Disabilities, Paulian Sima
25.National Authority of Child’s Rights Protection, Ali Cranta
26.Romanian Anti-AIDS Association, Maria Georgescu
27.Project Management Unit- MO, Maria Varga
28People Development Foundation, Angela Sima
29.Romanian HIV/AIDS Centre, Mioara Predescu
30.Romanian HIV/AIDS Centre, Alexandra Mardarescu
Meeting Agenda:
1. TB Grant Round 6: Q6 Report
2. TB Grant Round 6:Planning of Financing Continuation Request for Phase 2
3. HIV/AIDS Grant Round 6: Q7 Report
4. Report on Round 2 closeout process.
5. Presentation on “Advocacy for Implication” Conference organized by RAA at Palace of Parliament in Bucharest.
The meeting was led by UNAIDS representative Eduard Petrescu
1.TB Grant R6 Presentation (Iulia Husar and Dana Marin – RAA)
The stage of TB Grant Implementation, accompanied by the related indicators is available on http://www.fondulglobal.ro/.
After 18 months of implementation (end of Q6) out of a total of 17 indicators- 12 key indicators proved above established values (>100%), 2 targets were notably attained (81-99%) and 3 indicators were partially achieved (50-80%).
Among the most important outcomes there were mentioned:
·Training of 855 family doctors (trained in DOTS strategy, TB case management) and of 600 specialists, components of Pneumology Network (trained in program management, epidemiological surveillance and in financial management).
·13.086 persons belonging to vulnerable groups were reached through information, educational and communication interventions.
·High interest of journalists in participating at “Writing about TB classes” (102 participants versus 80 initially planned).
Partially attained indicators:
·Number of MDR TB patients introduced in the third cohort of DOTS-Plus project (45 MDR-TB patients versus 60 initially planned)
·Number of prisoners who were part of education programs in TB field (7235 informed prisoners versus 10560 initially planned)
·Number of TB cases with positive microscopy detected at homeless persons (51 identified persons versus 80 initially planned).
Eduard Petrescu discusses the advocacy seminar organized by NAP and ARAS during May 20-May 25 which will tackle HIV education and testing methods used is penitentiaries; these issues should not be on the list of concerns of a European Union Country.
PR R6 Representative, Silvia Asandi suggests coming up with a plan of accelerated implementation for the following period of time, with the specification that on a long term a well developed implementation plan included in national strategies, budgets and programs is recommended.
Eduard Petrescu– UNAIDS also suggests introducing a Public Health program in penitentiaries, sustained by MO.
2.TB Grant Round 6:Planning of Financing Continuation Request for Phase 2 (Silvia Asandi)
The presentation reviewed the principles which lie at the basis of the request of financing continuation previously exposed to CCM members during the meetings held in the second half of 2008 and during the meeting in January 2009, as well as guiding principles necessary to GF evaluation on Financing Continuation Request for Phase 2. The Second Phase Financing depends on the programmatic and financial performances (rate of disbursement) achieved during Phase 1. Likewise it has been s-a reiterated the Global Fund Board statement, from November 2008, namely that all requests of financing continuation for Phase 2 would cover revised budgets, with 10% reduced sums than the initially established figures. The application will rely on the assessment of the programmatic and financial progresses in Phase 1 (activities, indicators, disbursement rate).
The application must coincide with the original proposal from the multiple perspectives of budget, of working plan, of indicators and targets plan.
The application must identify possible implementation difficulties and to outline the ways to keep them under control.
Phase 2 application also includes a self assessment of the programme deployed by CCM and outlines the experience gained along Phase 1.
Any difficulty or weakness in implementation must be addressed constantly and not during the final weeks prior to Phase 2 Financing Continuation Request.
RAA has already sent to SRs the notifications concerning programmatic and financial ratings, attached to each implemented project, as well as the templates and instructions regarding the procedure of annex fill in, which constitute the basis of Round 2 programmes.
PR is preparing the application draft and its annexes.
It is proposed that a small technical group, working on the final form of the application, be formed as soon as possible. Along the process of application writing members will agree or bring new ideas concerning the form of the draft, either during a new meeting or by e-mail.
Eduard Petrescu-UNAIDS asks for volunteers who will be part of the technical group. The activity within this group for TB Grant should be similar with the HIV one.
The activity will be supported by CCM Secretariat, which will provide the group with previous meeting minutes in bilingual format, and will centralize the voting situations, along with eventual modifications and comments.
3. Round 6 HIV/AIDS Grant: Q7 Report (Nicoleta Manescu and Dana Marin – RAA)
Implementation stage of HIV/AIDS programme is available on GF website www.fondulglobal.ro
After 18 month of implementation of HIV/AIDS Programme out of the 14 key indicators, 9 were exceeded; indicators which follow the established targets, aiming at HIV transmission prevention among SWs reached 70%, HIV prevention among prisoners- 47%, HIV testing of vulnerable groups-43% and condom distribution- 33%.
„38 Initiative” programme- prisoners in penitentiaries also benefited of HIV/AIDS prevention programs. The testing indicator was suppressed at 43% in penitentiaries, because of NAA’s reorganization.
Silvia Asandi – RAA specifies that difficulties in penitentiaries programs are outcomes of deficient funds coordination. Money from NAA accounts were returned to PR R6 accountslate (May 2009); NAA representatives don’t have signature authority anymore, thus the seminar organized by ARAS and Round 6 PR will focus on finding reasonable solutions for program implementation in Penitentiaries as well as prisoners’ HIV testing and counselling sessions.
This problem will influence Phase 2 Grant.
Eduard Petrescu- UNAIDS suggests maintaining a good collaboration level between CCM and NPA, taking in consideration the achievements of the last seven years.
Dr. Dana Fărcăşanu (CPSS) proposes sending a full report on the situation in penitentiaries to the Parliament together with a request for Parliament representatives to support the project.
3. Report on Round 2 closeout process.
Antoanela Poenaru - PR R2Coordinator explains that an answer to the solicitation for closeout period extension by May 30 has not yet been delivered. There is the possibility of disruption of communication between CCM and Round2 PR, as National Institute of Public Health is in full reorganization progress and PMU has been moved to a room which temporarily has no internet or phone access.
SRs closeout activities are following GF guidelines. Although requests of closeout procedure singing were addressed to MO this replied rather late.
Not all SRs have sent activity reports to PMU.
Maria Varga – PMU PR R2 Financial Coordinator announced the existence of an unspent sum of money (50.000$) which must be handed back by all SRs to GF.Considering that money for the final phase was send late a request for money disbursement period was forwarded to GF, though without any reply so far.
The initial letter from GF specified two periods of time for close out procedures - 9 months for PR and 6 months for SRs.
If SRs sent all the final reports and unspent money by May 30, 2009 PR R2 can end closeout procedures in due time (June 30, 2009).
For TB R2 Grant the only formality about to end is achieving the audit report.
Although a change in the management position of the audit company occurred, this one will send all the necessary documentation to R2 PR by May 30, 2009.
Dana Fărcăşanu CPSS outlines that the probability of receiving a positive feedback to the closeout period extension request is low. One must also consider that the date is advanced and that there is no real time to spent 4 month destined money in just ten days, following basic procedures.
CCM members are asked to get involved in this particular matter, as there are still many procedures to achieve, among which stocktaking of goods purchased all throughout this period; archives must be taken over by some other CCM member; audit reports for the last 6 months of activities are not ready yet.
Antoanela Poenaru – announces the decision of MO to hand the Archives to National Archive Service, as there is no budget available for this transfer on behalf of R2 PR.
As regards to audit procedures it is mentioned that the selection of the company performing the audit for the HIV programs was already made and that it will be followed by a report. Răzvan Vieru PMU R2PR – clarifies some aspects connected to the selection of the audit company: in July, 2008 a contract with an audit company (Deloitte) was signed for an exterior audit analysis for both HIV and TB Programs, coordinated by R2 PR PMU. The audit for the TB Program was selected for PMU and for four of the SRs’ of the program of financial activity in 2007, during January 1st 2008 and July 31, 2008.
Audit for HIV/AIDS was selected for PMU and for five of the SRs UMPFG for the financial activity of 2007.
The activity of external audit (Deloitte Audit SRL) started in August 2008; since the TB Programme was finalized and the contracts for the closeout period had not yet been signed, the auditor contacted only a part of the SRs. On November 22, 2008 close out contracts were signed with availability till November 30, 2008. In December, 2008 the management of the external audit was restructured. Therefore during August–November 2008, the auditor’s activity couldn’t follow the initial plan; in November 2008, the auditor informed PMU that by May, 2009 his activity will deploy with difficulties, because contracts signed in the first half of 2008 had to be honoured, thus at the beginning of 2009 Deloitte hadn’t yet released any report for PMU.In respect to the external audit for 2008 and for the HIV/AIDS closeout period, procedures for contracting an audit company were initiated in March, 2009 and as of April, 2009 all the documentation was sent to approval to State Secretary, Mr. Liviu Manaila and to Minsitry of Health.
At the time of CCM meeting(20.05.2009) a proposal for external audit service engagement was again sent for approval, together with the answer form Legislative Department and Juridical Assistance in Ministry of Health, regarding the person authorized to sign all the contracts between MPU and their suppliers.
Maria Georgescu ARAS – discuses the lack of interest of MO representatives regarding activities deployed by CCM programmes and proposes the replacement of the mechanism’s president- The State Secretary, MO representative with someone.
CCM President who also occupies the function of State Secretary doesn’t have the necessary time to get involved in CCM’s activities, therefore administrative and organizational problems spring out of the permanent competition between stat institutions and non-governmental ones.
Eduard Petrescu- UNAIDS – outlines the danger of compromising an entire program because of management problems shown up at its very end, and of politics related issues, exterior to the CCM’s purpose. A mature tackling at this point is very necessary. The impasse produced by the closeout procedures must be solved internally considering that GF might ask an external audit, which could lead at the compromise of future programs as well. MO has to be informed about the present malfunctions regarding the closeout process, in order to help take a correct decision.
CCM members also express their discontent about R2 PR’s manner of organizing the closeout procedure, namely the late briefing about the issued problems. PR’s seven year experience should have served avoiding such problems. Also CCM could organize a meeting with MO Representatives in the efforts of finding a viable solution for unblocking the closeout process.
Antoanela Poenaru – Replies that over 30 addresses were sent to CCM President regarding the final phase of the project and that most of the answers came three weeks afterwards.
Răzvan Vieru – adds that although the closeout procedure had had been sent to GF at December 10, 2008 the first clarification notes arrived on January 16, 2009, whereas the letter of procedure approval was sent on February 23, 2009.
Antoanela Poenaru UMP PR R2 sustains that the only person that she had to inform about any troubles was CCM President and the manager of PMU.
Dana Fărcăşanu CPPS advises CCM to launch a final evaluation request to R2 PR which presupposes that all SRs will hand in the activity reports by May 30, 2009. CCM likewise has to form a technical group entirely focused on closeout procedure for R2.
Dana Fărcăşanu CPSS – reiterates the idea that an external audit could endanger future programs with foreign financing, therefore a joint effort to overcome the impasse is needed.
Antoanela Poenaru – asks CCM to forward a request to MO, in which it solicits the extension of R2 closeout period, with one month and no additional costs.
Eduard Petrescu UNAIDS offers his support to the technical group abovementioned and stresses that this situation should not have been reached in the first place if R2 PR could have overcome any political or local disagreements and also if it had allowed CCM to develop a safety measure plan in due time.
3. Presentation on “Advocacy for Implication” Conference organized by RAA at Palace of Parliament in Bucharest.
Silvia Asandi RAA – makes a brief presentation of the conference and specifies that out of a total number of 178 Parliament representatives invited, approximately 20 were present, by rotation. The main conclusion is that currently the awareness level concerning politician’s involvement in health programs is still low. However their mere presence, even in a small contingency is reassuring for the future.
The occasion also marked the launch of “MP’s Guide” which considers the implication in the national response to HIV/AIDS and TB. A full report of the meeting will be sent to CCM members and to Parliament representatives.
Mihaela Ştefănescu RAA – drafts the conclusions of the meeting between Parliament representatives and NGOs representatives, on May 6, 2009 as well as the main lines of the meeting of RAA representatives and Commission of Human Rights of the Senate on the same date.
Sustainability demarches for programmes continuation after GF’s retreat must be initiated by having as many open dialogues with Parliament representatives as possible.
Silvia Asandi RAA – suggests organizing future training sessions of MPs, who are willing to learn about health programs, education programs and an eventual involvement in the national response to HIV/AIDS and TB. Thematic stand location will soon be changed to House of Free Press building in order to facilitate the dialogue between NGOs and journalists.
Maria Georgescu ARAS – Proposes taking meetings with local politicians, who frequently prove a higher rate of interest for activities in health zone. This action is of elementary importance in the process of decentralizing.
Dana Fărcăşanu CPSS- supports the idea, adding that such an implication on behalf of politicians could help programs in penitentiaries have a better track.
