Setting up an ESTHER project ?
If you wish to set up a care
programme for people living with HIV/AIDS in a developing country that will
integrate:
- Country´s national
AIDS strategy,
- Hospital twinning
between France and the developing country,
- A comprehensive approach and
continuum of care.
The ESTHER network can help you
design and coordinate the programme in terms of both expert methods and funding
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WHO
MAY INITIATE AN ESTHER PROJECT?
- The
host country government.
- A
French hospital with the agreement of its opposite number in the developing
country which wishes to develop a partnership for the care of people living
with HIV/AIDS or to strengthen existing clinical or administrative
cooperation.
- A
Health center, or district health structure
in the developing country.
- A
French or local non-profit association.
Applications
should be sent to the
Secrétariat
général du GIP ESTHER at
36
rue de Charenton, 75012 PARIS.
They
may be sent directly or via :
- The
French Embassy (SCAC) in the country concerned,
- the
French Ministry of Health or International Cooperation an Development.
HOW
ARE APPLICATIONS EXAMINED?
All
applications must comply with GIP ESTHER recommendations concerning access to
care for people living with HIV/AIDS (see :
www.esther.fr/ressources:groupes
de travail)
and
ESTHER financial procedures and charter. The applications are analysed by the
GIP ESTHER team on the following criteria:
1) The
developing country´s involvement in the fight against HIV/AIDS, and the
resources available to implement a strategy.
Priority
for ESTHER action goes to countries that have already structured their
approach to the fight against AIDS, in order to guarantee programme
feasibility.
Points examined : existence of a national AIDS programme/committee, national programme
of care for PLWHA, decentralisation, existence of national solidarity
mechanisms, compliance with WHO recommendations, anti-discrimination policy,
active screening policy, application to Global Fund.
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2) Quantitative
data :
ESTHER
priority goes to countries which prevalence is highly increasing. Exceptions
may be taken into account for countries involved in a proactive prevention
policy.
Points examined: Population (millions), prevalence, incidence, HDI rank,
per capita GDP.
3) Involvement
of civil society in the care of people living with HIV/AIDS.
Priority
for ESTHER actions goes to projects that favour the emergence or development
of non-prifit associations likely to support patients´ psychosocial care.
Points examined: Associations likely to take part in care in various types of
health structures. Decentralisation of care is a major factor in planning
projects.
4) Earlier
partnerships analysis :
Priority
for ESTHER action goes to projects based on earlier relationships between
French and local hospitals, in order to strengthen existing links, while not
discouraging further twinning.
Cooperation
with other French or international partner should be clearly identified
(World Bank, NGO, French National Agency on AIDS Research, etc...) so that the
ESTHER project can be designed to complement existing ones.
Points examined: Applications from France (hospitals, associations), links with France (partnership, twinning)
international funding, health sector.
After
this preliminary analysis, an investigating mission sent out, comprising
French and local partners and advised by GIP ESTHER in coordination with the
French Embassy, to examine the feasibility of the project and make
recommendations for the major features of care to be adopted.
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STAGES IN SETTING UP AN APPROUVED COUNTRY PROJECT
1) Ministerial agreements. Before any project begins, it must be included in a
agreement signed by the Ministers of Health of France and the Host country.
2) Consultation with all potential hospital and community
partners. This dialogue among all actors is
an essential stage, and ESTHER supports the liaison committees that are set up
for that purpose.
3) Definition by both sides of the project under
heading and activity for the first year, and forecasts for the following two
years. a The project is defined according
to a model intended to make it easier to monitor and assess.
4) GIP ESTHER monitors the process and defines the
budget.
5) The project and recommendations are submitted to
the project examination committee (CEP) for its opinion. Three opinions are
possible:
- The project is approved without modification,
- The project is approved, subject to a few changes,
- The project is postponed.
The GIP ESTHER Director forwards the opinion of the
project examination committee to the GIP ESTHER chair, who decides whether or
not to approve projects and to commit ESTHER resources.
6) Hospital and financial agreements are signed by GIP
ESTHER and the project operators.
In the financial procedure
1) Financing is
divided and allocated in advance between actors and operators in France and in the host country.
2) Financial agreements are signed for one year, to
allow small-scale adoption in the second year.
3) Grants are disbursed in two blocks: 60% and 40%
Financial rules
All expenditure procedures must comply with French
public accounting rules.
1) The
authorising officer must be distinguished from the paying agent to avoid risks and ensure that the latter has
regular, immediate control over the former.
2) Expenditure must be subject to double control by
countersignature of cheques to
ensure permanent control of the proper use of funds.
3) Use of the subsidy must be clearly limited, and procedures available to deal with misuse.
4) Detailed financial accounts and invoices for expenditure must be produced before
an agreement is made for the second year.