CCM Members Meting

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					                               CCM Members Meting
 For GFATM Round-10 Proposal Endorsement & To Discuss Various Other Matters
                                Related to TGF Grants
                 Held at MoH, Islamabad, Time: 08:30 am to 11:30 am,
                               Dated 17th August 2010
List of Participants

   1.    Mr. khusnood akhtar Lashari        Chairperson CCM / Federal Sectary Health
   2.    Dr. Qasir Javaid                   Vice Chair CCM
   3.    Dr .Noor Ahmed Baloch              National Manger TB Control Program
   4.    M. Aslam Khan                      Director , Malaria Control Program
   5.    Dr. Sajid Ahmed                    National Manger NACP
   6.    Mr. Aurangzeb Rehman               Joint Education Advisor
   7.    Dr Muhammad Qais Khan              Chief Health , Planning Commission
   8.    Dr. Guido Sabatinelli              WHO Country Representative
   9.    Mr. Oussama Tawil                  Country Coordinator UNAIDS
   10.   Ms. Zoi Andrew                     Deputy Program Manger DFID
   11.   Dr .Sardar Talat Mahmud            Senior Health Advisor
   12.   Mr. Sohail Ahmad                   Senior Program Officer JICA Pakistan
   13.   Mr. Hector Nihal                   Persident AIDS Awerness Society (AAS)
   14.   Mr. Francis Rufi Sardar            Director – RASTI ( Pakistan)
   15.   Shukria Gull                       PLWHA Member
   16.   Abdullah Khan Sumbal               Special Secretary Health , Punjab
   17.   Mr. Syed Hashim Raza Zaidi         Provincial Secretary Health, Sindh
   18.   Dr. Syed Sohail Altaf              Provincial Sectary Health , KPK
   19.   Mr. Khalid Ahmed                   Additional Sectary Health, Balochistan
   20.   Dr. Shahina Qayyum                 Research Coordinator OJHA
   21.   Mr. Hassan Nawaz Tarar             Additional Secretary (E.A.D)
   22. Ms. Rehana Hashmi                    Project Director (GRAP)
   23. Mr. Bashir Jan Mohammad              President, Kharadar General Hospital
   24. Mr. Zubair Ahmed Malik               Former Vice President, FPCCI
   25. Professor Dr. M. Hafeez Ullah        Vice Chancellor, Khyber Medical University
   26. Dr. Altaf H. Tariq                   Key affected Community Member (HMAP)

   Members Who Did not attend the Meeting:
   27. Professor M. Ismail               Secretary/ KPK, AIDS Consortium
   28. Mr. Alam Zeb Khan                 Chairman, Sahar
   29. Muhammad Aqeel                    Program Officer, Thakt Bhai

List of Observers
            1.    Humaira Majid abassi      CCM Gender Focus Group Representative
            2.    Dr. Ali Ather             SPO, Mercy Corps. TB Round-6 grant
            3.    Dr. Qadeer Ahsen          Country Director, Health Net TPO
            4.    TM Baig                   R. Manager, Health Net TPO
            5.    Dr. Abdul Khaliq Ghauri   NTP
            6.    Raza Zaidi                Health Adviser, DFID
            7.    Dr Amanullah              Director Health, Save the Children
            8.    Dr. Ayesha Khan           HSS PU- MoH , HSA
            9.    Dr. Rehan Hafiz           HSA
            10.   Aamir Hussain             LFA, Team Leader
            11.   Saif Abbas                UNOPS- LFA

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            12.   Riaz Muhammad                DEA ( R) M/o Education
            13.   Dr. Suresh Kumar             Additional Sectary Health , Sindh
            14.   Dr. M. Saleem                UNAIDS
            15.   Dr . Shahnaz Kazi            World Bank , Islamabad
            16.   Dr. Farah Sabeh              NPO, WHO

Facilitators :
                  Zarina Kasuar                Executive Secretary-CCM
                  Adeel Sarwar                 Project Officer - CCM

Agenda Item -1:

The CCM meeting started on time as per the agenda duly approved by CCM members. The
Secretary Health and the Chair CCM opened the meeting forum. The chair CCM thanked and
welcomed all the members for making it convenient to attend the CCM meeting.

Agenda Item -2:
CCM Endorsement for Round-10 PRs & SRs for HSS and Malaria Control Proposal Components:
All the CCM members were briefed about the PRs selection process for GFATM Round-10 Malaria
and HSS proposal.

CCM Endorsement - PRs Selection for Malaria Control Proposal :

In response to CCM advertisement of inviting submission from government and non government
sector the interest to be the potential Principal Recipient (PR) for GFATM Round-10 Malaria and
HSS proposal component, CCM received 10 EOIs for PRs for malaria whereas nine EOIs were
received for HSS proposal. CCM in its meeting held on June 02, 2010 constituted a committee to
review and short list potential PRs for Round-10 CCM proposal. The CCM PRs short listing
committee comprised of UNAIDS, USAID, DFID, WHO and CCM member representing private
sector on CCM.

The committee members met on July 15, 2010 and conducted review of EOIs for Malaria and HSS.
The CCM sub committee recommended two PRs for Malaria proposal, The Directorate of Malaria
Control as the PR from Government Sector and Save the Children from Non Government sector
PR.. CCM Secretariat prepared the draft minutes of meeting and after taking the committee
members endorsement, finalized the minutes. Considering the time factor, CCM members
electronic endorsement for the potential PRs recommended by the CCM sub Committee was taken
and identified PRs were intimated for taking up the proposal development process including the
selection of SRs. CCM Secretariat also intimated the organizations who could not qualify as PRs.
The potential PRs for malaria were present in the CCM meeting and were asked not to raise their
hands while CCM endorsement of PRs is solicited. CCM members by majority endorsed the PRs
for Round-10 Malaria Control, Directorate of Malaria Control as the PR from government sector
whereas Save the Children as the PR from non government sector.

PRs Selection for HSS Proposal :

On the same date i.e July 15, 2010 during the EOIs review meeting, no PR could be identified
since no organization could obtain score of 70/100 points. Thus the CCM Sub committee
recommended that considering the HSS interventions complex approach, not many organizations
would qualify therefore, the CCM sub committee recommended that the qualifying score for HSS
to be 65/100 which is only a recommendation from the CCM Subcommittee to short list PRs where

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as it is subjected to CCM approval. The CCM members approved the overall strategy i.e. the EOI to
be re-advertised for extending the date of EOIs submission.

On July 30, 2010 HSS PRs EOI was re-advertised and in response CCM received nine EOIs. The
CCM sub committee to short list PRs meeting was called on Aug.6, 2010 in which seven
organizations could not qualify the minimum eligibility criteria the provision of registration as a
legal entity and minimum financial turnover of 50 millions.

Only three organizations met the minimum criteria and were reviewed in line with the PRs short
listing criteria. Two organizations obtained score 65/100. The CCM Sub committee members
recommended Health Net TPO as the non government sector PR where as HSA as the government
sector PR. CCM members electronic endorsement was taken and the PRs were intimated

Responding to the concern of two CCM members that lowering down of the minimum qualifying
score of 65/100 for HSS is of not discrimination approach for Malaria PRs and it does not intimate
for any legal steps. The members were briefed that the CCM members are the apex body for
approving and or not approving matters related to the Global Fund grants. In this case, as per CCM
by laws, CCM Sub committee recommended to CCM the lowering the minimum qualification score
from 70/100 to 65/100 points subjected to CCM endorsement. The full CCM was reached and
CCM endorsed the sub committee’s recommendation and after wards the CCM approved decision
has been implemented. The CCM members endorsed the PRs for HSS and the Malaria Control
Proposal. It may kindly be noted that the potential PRs were present in the meeting but they were
asked not to vote while CCM endorsed the PRs.

CCM Endorsement for the SRs Selection for GFATM Round-10 Malaria & HSS Proposal:

CCM in its meeting held on June 2, 2010 constituted a sub committee to review the submission for
SRs for Malaria and HSS Round-10 proposal. The committee comprised of members from civil
society, Key Affected Community (Ex) representative, UNAIDS, DFID and USAID. The
committee members and the Round-10 PRs for malaria met on July 30, 2010 and reviewed the
submission received for integration in to Round-10 malaria proposal. The committee members
reviewed the EOIs in line with the Round-10 objectives and the short listing criteria. Accordingly
scores were allocated and the organizations, NRSP, ACD, PLYC, ASD and Merlin were identified
as SRs for Malaria proposal for which an CCM electronic endorsement was taken and after wards,
PRs DoMC invited SRs for discussion and finalization of the proposal implementation strategy for
Round-10. CCM members endorsed the SRs. Regarding the SRs for HSS proposal, both the
potential PRs for HSS (HSA and Health Net TPO) were invited to CCM Secretariat for reviewing
SRs EOIs. EOIs were reviewed and scored in line with the short listing criteria. The relevant
experience in HSS implementation could not be potentially identified except the Health System
Policy Unit was only be selected by the PRs as SR. CCM endorsed the selected SRs for Round-10

Agenda Item – 3:

Presentation - CCM Endorsement of GFATM Round-10 Malaria Proposal :

Both PRs for Round-10 collaboratively worked to develop the proposal in consultation with SRs
and presented the proposal to CCM. Malaria Round-10 proposal focusing the following objectives:

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    1. To enhance the access of population at risk to quality assured early diagnosis and
       prompt treatment services.

    2. To scale up coverage of multiple preventions (especially LLINs and IRS) to the level of
       universal coverage in target population in high risk districts

    3. To strengthen existing program management capacity to co-ordinate, plan,
       implement and monitor effective curative & preventative interventions nationwide

    4. To improve public sector health facility utilization for early diagnosis, effective
       treatment and preventive measures through enhanced community awareness and

The presenter shared with the CCM members that the proposal is focusing the universal coverage of
malaria control interventions and in addition to continuity of these services in GFATM Round-7 19
districts, addition 19 highly endemic districts have been included and total in 38 districts Round-10
proposal will be focusing to implement the proposed malaria control strategies. PRs covered the
complete proposal development strategy, its implementation plan, budget and the proposal
development process and shared it with CCM members. All the CCM members highly appreciated
the proposal and CCM endorsed it. For details please refer to the detailed soft and hard copy of
presentation attached with the minutes.

PRs shared the details related to their SRs:

Merlin, ASD, PLYC, ACD and NRSP are the SR for Round-10 proposal. He also mentioned that
most of their R-10 SRs are also the SRs in GFATM Round-7 Malaria grant implementation.

Agenda Item – 4:
CCM members discussed in detail and endorsed the Malaria proposal for submission to the Global
Fund in Round-10.

Agenda Item – 5:

Presentation and CCM Endorsement for HSS Proposal Round-10:

HSS proposal development consultant Dr. Rehan Hafiz presented HSS Proposal to CCM forum.
He presented the objectives focused in Round-10 for addressing the emerging gaps in Health
System Strengthening. In this regard two areas have been identified and duly approved by CCM for
Round-10 HSS proposal. Followings are the objectives and their respective SDAs.

Objective 1:
To develop an integrated and comprehensive supply, logistics and management system that
includes HIV, TB, Malaria, PHC & FP programs in 10 districts in Pakistan (KPK and

–   comprehensive system that tracks , forecasts and manages drugs, commodities, supplies
–   Provincial level warehousing and District level storage and transport
–   Trained staff capacity for SLM
–   Integration and linkage with DHIS

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1.1 comprehensive system that tracks and manages drugs, commodities, supplies:
    review/streamline outdated inventory, to integrate and develop compatibility between vertical
    and other program SLM systems.

1.2 Provincial level warehousing and district level storage and distribution: modifications based on
    needs assessments, enhanced        efficiency and utilization of services.

1.3 Trainings/Capacity-Building recruiting, appropriate skill based staff placement, ongoing
    trainings etc

1.4 Establish Linkages – DHIS, other existing information systems. To be housed and linked to the
    provincial M&E units.

Objective 2: To develop a Strategic Plan For Human Resource for Health

- Development of a Health Resource                 Strategic Plan
- Formation of HRH databases and                  observatories
- Training and Capacity Building
- Operational Research

2.1     Develop a HR Strategic Plan: detailed nationwide mapping of public-private        health
        care workers, ensure   distributional balance etc.

2.2     Formation of HRH observatories in 10 districts to improve HRH management capacity
        at the district level.
2.3     Leadership Trainings of district managers from the selected districts based on standardized
        global techniques aimed at enhancing leadership capacity
2.4     Operational/Action Research to pilot initiatives for Strengthening HR management
        actions and capacities

Principal Recipients of HSS Round-10 proposal are :
       Public sector: Health Services Academy
       Private Sector: Health Net TPO

Sub- Recipients of HSS Round-10 proposal are :
Health System Strengthening & Policy Unit

CCM members appreciated the coherence and strategic approach in the proposal. Regarding the
financial approach, CCM members invited that HSS team to share with CCM member the detailed
budget plan electronically and the team promised to e mail to all CCM members the detailed
financial layout by Aug. 18, 2010.

Agenda Item – 6:

Discussion and Endorsement by CCM Members:
CCM members discussed and endorsed the HSS proposal for submission to the Global Fund in

Agenda Item – 7:
Discussion / Endorsement of the regional Proposal on APN HIV/AIDS :
Ms. Shukrai Gul CCM back up member representing PLHIV presented the context of the regional
proposal to be submitted to the Global Fund to be submitted in Round-10.
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Ms. Shukria Gull presented about the capacity issues within the PLHIV net works at regional and
national level. She stated that despite of the fact that Networks of PLHIV have strong role in AIDS
response, however does not have enough resources in technical and financial capacity CCM
members agreed with the proposal contents and endorsed on the behalf of CCM Pakistan. She
commented that although there is significant progress in countries, there are still gaps in PLHIV
accessing services (eg. ARVs are provided, however treatment education for PLHIV remain a
challenge, etc). These gaps can be filled in by the networks of PLHIV. The regional proposal to
address the following areas:
         Lack of supportive environment for PLHIV in accessing services (eg. Policy barriers,
             lack of treatment understandings, etc).
         Lack of strategic information and knowledge on PLHIV’s needs, in terms of increasing
             quality of health and life.
         Strengthen the technical capacity of PLHIV networks to be involved and contribute
             meaningfully to the national AIDS response
         Build leadership skills for PLHIV networks in order to be involved meaningfully in the
             AIDS response
         Provide direct services for PLHIV to fill in the service gaps, with strong consideration
             on not duplicating the existing services provided
         Support policy advocacy conducted by networks of PLHIV
         Document evidence related to PLHIV needs and progress in fulfilling the needs
         It is more economical to address the issues in multi country approach as the cost of
             providing assistance, grant management and services will be lower.
         A multi-country approach would facilitate south-to-south capacity building between
             country networks more effectively. The country networks will be able to learn from
             experience and will be able to adopt practical steps in addressing their issues.
         Through multi-country approach, new sources of information will be able to be
             identified and shared through out these countries and also other countries in the region.

CCM endorsed the proposal. One of the CCM member shared his concern that since the care and
support component is well addressed in the government budgetary allocations and as well in
GFATM Round-9 HIV/AIDS proposal. Such regional proposal to consider these resources while
building proposal for the Global Fund.

CCM Endorsement of Sub Recipient (SR) for APN Regional HIV/AIDS Proposal in Round-
PLHIV networks among itself carried out a consultative process and identified one SR for
communicating to APN to be included in the regional HIV/AIDS proposal – Strengthening PLHIV
New Works in the region. The Association for People Living with HIV and AIDS was
recommended by the PLHIV network. CCM approved the identified SR by the PLHIV newtwork in
Pakistan for Regional APN proposal.

CCM Endorsement of Regional MENAHRA proposal on Harm Reduction and Oral
Substitution Therapy (OST):
WHO presented the proposal back ground that the subject proposal was submitted in Round-9 and
was placed in category -3. the Mehahra regional proposal is to be re submitted in round-10 after
addressing TRP comments. He also mentioned that CCM Pakistan had endorsed this proposal in
Round-9. All the CCM members endorsed the proposal . One of the CCM member shared his
concern that in future, a national level body to be constituted so that which should be forum for
coordination and information while such regional proposal are constituted and submitted.

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Elections results by the Key Affected Community For CCM Discussion, Approval/Endorsement:
The Executive Secretary briefed the forum that the two years term of the representative of Key
Affected Community had ended on June 20, 2010. The Key Affected Community member was
informed about his completion of two years term. In line with the CCM by laws, the CCM member
could continue its membership for an other two years term provided his constituency approves it.
The out going CCM member representing the Key Affected Communities requested CCM to allow
his to lead the process for getting his constituency approval for his next two years term continuity.
CCM approved his request and Dr. Altaf H. Tariq coordinated a consultative process by inviting
meeting of organizations working for the Key Affected Communities in Pakistan.
His constituency member organizations appreciated his inputs to CCM on the behalf of the Key
Affected Communities and voted and endorsed to continue representation on CCM for another two
years term. The Key Affected Constituency organizations who could not attend the meeting shared
their endorsement electronically while copying to CCM e amil as well. All the original
correspondence related to the election process has been submitted to CCM Secretariat for record.
Dr. Altaf H. Tariq who was present in the meeting was requested to leave the meeting hall while his
membership endorsement was discussed. Once the members voted and approved him as the CCM
member to represent the Key Affected Communities, he was invited to rejoin the meeting. CCM
members endorsed his membership for next two years. Two of the CCM members raised their
concern that in future, such elect ions to be advertised in the newspapers. The other member
commented that in future instead of organizations to represent the Key Affected Communities,
direct representation by the Key Affected Communities to be considered. He was informed that at
present, it is mandatory for the organization representing the Key Affected Communities to bring
along in CCM activities member from the Key Affected Communities so that the community could
be well versed with the CCM meetings and they get an opportunity be able to communicate their
concerns directly with CCM members as well. CCM endorsed the membership that Dr. Altaf H.
Tariq to continue his next two year term as duly approved by his constituency.

CCM Endorsement for the Gender Group Formation :
CCM in response to the Global Fund priority approach in addressing Gender and the Sexual
identities in Pakistan reverted to take its initiative of formulating Gender Focused Group for its
inputs in the Global Fund grants proposal development and its implementation. The CCM members
were informed that a meeting of Gender focused organizations was convened on June 8, 2010 at
CCM Secretariat. The meeting was facilitated by UNAIDS. The participating organizations after
consultation among themselves, nominated APWA to represent the gender group on CCM.
UNAIDS recommended that UNIFAM, UNAIDS and APWA to meet again for spelling out
strategy to widen the gender group and to enhance their inputs for addressing the gender so that
access to the health facilities could be ensured for all i..e women, man, boys, girls and the sexual
identities etc. CCM endorsed the Gender Group Formulating Strategy but advised that such group
formation also to be openly announce i..e news paper etc. and the Ministry of Women Development
(MoWD) to be invited in the Gender Group meetings.

CCM Endorsement fo rTB GFATM Round- 6 and Round-9 Consolidation Proposal :
In response to the Global Fund guidelines of merging grants of Round-6 & Round-9 for TB. The
National Manager NTP, Dr. Noor A. Baloch presented to CCM the consolidation proposal of NTP
for CCM endorsement. He shared with the CCM members the methodology and facilitation in form
of Technical Assistance provided by the Global Fund through the Grants Management Solutions
(GMS) for addressing the TB grants consolidation. He termed the consolidation as very useful
strategy since it will reduce burden of extra reporting, it allowed to address the emerging needs
with out incurring additional cost. It also had reduced the grant targets from 40-20 and now PRs
will be submitting progress reports per quarter for both grants. CCM members endorsed the grant
consolidation proposal for onward submission to the Global Fund.

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Discussion on Civil Society Members Role ;
The in effective participation of the three Civil society CCM member in CCM meeting was
discussed. CCM members recommended that the three CCM members to be sent a final letter to
highlight their continuous absence and its observation and the required actions in line with the
CCM by laws. Regarding the communication / coordination ethics, a CCM sub committee
constituted during CCM meeting held on June 2, 2010 to out line the CCM members
communication within members related to any CCM matters. CCM to discuss and finalize for
future so that any member violating the rules could be held accountable.

Decisions & Approvals by CCM :

      CCM endorsed GFATM Round-10 PRs and SRs for HSS and Malaria control proposal
      CCM endorsed Malaria Round-10 proposal for submission to the Global Fund.
      CCM endorsed HSS Round-10 proposal for submission to the Global Fund.
      CCM endorsed the regional APN proposal addressing the strengthening of PLHIV
      CCM endorsed the regional MENHARA proposal address Harm Reduction and OST
       focusing the IDUS in the region.
      CCM endorsed the SRs recommended by the PLHIV Network for Implementing APN
       regional proposal once approved by the Global Fund in Round-10.
      CCM endorsed the election process conducted for continued representation of the Key
       Affected Communities representation on CCM. Dr. Altaf H. Tariq to continue for the next
       two years term.
      CCM endorsed the strategy of Gender Group Formation and its way forward for its
       enhanced involvement in the Global Fund proposal development and its implementation.
      On the behalf of CCM, a letter to be written to the CCM members representing Civil
       Society for finally intimating the CCM by laws and their in adequate response towards their
       participation in the CCM activities and meetings.
      CCM approved that CCM sub committee to meet and outline the CCM communication
       ethics and guidelines on holding CCM members accountable in case CCM members violate
       the CCM by laws.

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