MOSCOW, May 4 (Reuters) - The Global Fund to fight AIDS, Tuberculosis and Malaria may loan cash to developing countries when they grow too wealthy to qualify for grants, the fund's director, Michel Kazatchkine, said on Sunday.

Including loans in its remit would allow The Global Fund -- which has raised about $10.8 billion for donations since 2002 -- to extend help to governments and civic groups in heavily infected but increasingly wealthy countries.

"To us it's important that when the world's money for aid is being distributed it not only takes into account economic factors but also, for example, burden of disease," Kazatchkine told Reuters in an interview at an HIV/AIDS conference in Moscow.

The Global Fund, which was launched by Group of Eight industrialised nations and is financed largely by the U.S. and European governments, estimates that around 6 million people die every year from either AIDS, tuberculosis or malaria.

By the end of next year 10 countries from the Eastern Europe and Central Asia region -- including Turkey, Kazakhstan and Russia -- will no longer qualify for Global Fund grants as they will be considered upper income countries.

But some of these countries have only just built up the mechanisms to battle AIDS, tuberculosis or malaria and Kazatchkine cited Kazakhstan as an example of a country which may benefit from a loan and extended help from The Global Fund.

Former Soviet Kazakhstan in Central Asia has grown richer over the last decade from high energy and commodity prices but faces an accelerating number of people with the HIV virus.

"The challenge for Kazakhstan is how to manage in the future," Kazatchkine said.

"I wonder whether we couldn't consider, as an international community, whether Kazakhstan instead of not being eligible at all in the future could potentially be eligible but then commit to reimburse by 2015 or 2020 or whatever."

The Global fund has previously pledged over $67 million in grants to Kazakhstan to fight AIDS and tuberculosis.

It was Russia which set the precedent for potentially extending The Global Fund's work into loans, Kazatchkine said.

Huge wealth from energy and commodity exports have also enriched Russia and in 2006 it pledged to repay 80 percent of The Global Fund's $320 million grant.

"What I'm saying is that with the Russian example we may find ways of basically a free loan that would allow these countries to access resources now but also behave as a donor," Kazatchkine said.

Africa receives almost 60 percent of The Global Fund's cash -- whose main donors are taxpayers in the United States, Japan and Europe -- followed by East Asia with about 13 percent of the total raised.

The Global Fund has pledged nearly $1.2 billion to Eastern Europe and Central Asia through to 2010, about 55 percent into targeting HIV, and Kazatchkine said there has already been much progress -- especially in developing civic groups.

But as countries become richer and move away from grants, civil society groups worry without The Global Fund cash they will be marginalised by big government.

"These are societies the relationship between public sector and the non-governmental sectors haven't been established and do not run as smoothly as western societies," Kazatchkine said.

The annual rate of new infections in the Eastern Europe and Central Asia region has fallen in the last few years to about 150,000 last year from 210,000 in 2001.

Hamisi is the executive director of Burundi's National Association for the Deaf, which aims to facilitate communication for the hearing-impaired by teaching them sign language.

Burundi's HIV/AIDS policy has no special provision for HIV education for the disabled, so this section of the population remains largely unaware of even the basic facts about the virus. "On the TV we only see images, but with no interpreter there is no message," said Hamisi.

Few deaf people in Burundi have access to formal education and the few private schools for the hearing-impaired do not go beyond primary education. As a result, not only do they miss out on HIV/AIDS awareness programmes taught in schools, but many never learn to read, write or even sign.

Most communicate using made-up signs that are only comprehensible to their immediate family, but the National Association for the Deaf has recently begun to teach them formal sign language and is educating them about the dangers of HIV. "It is the only message on HIV/AIDS people like me can access," said Charles Njejimana, one of those who has benefited from this training.

The hearing-impaired are not the only disabled group left out of HIV/AIDS education. "For those with hearing or visual impairments, the messages are not adapted to their handicap; for others with physical handicaps, they cannot reach the places where they can get information such as public meetings, health centres, etc," Pierre Claver Seberege, chairman of the National Assembly of the Disabled, told IRIN/PlusNews.

At a meeting on HIV/AIDS and the disabled in April in the capital, Bujumbura, Immaculée Nahayo, the Minister for National Solidarity, who is also responsible for human rights issues, said Burundi had an estimated 15,000 HIV-positive disabled people.

Especially vulnerable

Handicap International, the non-governmental organisation that organised the meeting, supports 15 associations of disabled people in Burundi, training them as HIV/AIDS peer educators and teaching them skills such as tailoring and carpentry.

"This marginalisation is why disabled women are unlikely to get married, or have a tendency to accept any [sexual] proposal from men," Niyongabo told the meeting. "You will find many disabled women and girls pregnant because they consider that getting a child will [give them] value in the eyes of the community; this exposes them to multiple sexual partners and therefore to increased risk of HIV."

Women with disabilities are also easy prey for rapists, as many of them are not in a position to defend themselves from physical attack. Some Burundians also believe a myth that sex with a handicapped girl is associated with good luck. "Many traders seek sex with them to get their businesses prosperous," Niyongabo commented.

Delegates at the meeting called on the government to incorporate the disabled into the national policy for HIV prevention, treatment and care, and encourage their participation at all levels of HIV decision-making.

"All people involved in the sector should design specific messages to take into account the different forms of disability: specific messages for those with hearing or visual impairment, or even the mentally disabled," said Seberege, of the National Assembly of the Disabled.

The disabled were also challenged to be more outspoken about their needs and to take the lead in issues pertaining to their health.