The Global Fund: Recent Developments

1
The Global Fund Recent Developments

• The Global Funds Regional Meeting for East Asia
  and the Pacific
• Bali, September 2007

2
Global Fund Process
3
Recent Developments
Health Systems Strengthening
Fixed Round dates
National Strategy funding
Rolling Continuation
Dual track financing
ME Strengthening Tool
Technical Support
Pooled Procurement
Procurement QA
Grant consolidation
Enhanced Financial Reporting
Grant closure
4
Recent Developments
Fixed Round dates
5
Fixed Round Dates

• Fixed Round dates come to address the lack of
  predictability in timing of rounds
• The 14th Board Meeting decided on fixed dates
  for the launch and approval of rounds with a
  minimum of one call per calendar year
• Round 8 will be launched on 1 March 2008 and will
  be approved at the 18th Board meeting (November
  2008)

6
Recent Developments
National Strategy funding
7
National Strategy Applications
With National Strategy Funding the Global Funds
Board is considering a new funding mechanism
based not on projects or programmes but on
national strategies. These strategies will need
to be certified through a rigorous technical
certification mechanism
8
National Strategy Applications
Purpose of the Board decision

• Enable streamlined applications to the Global
  Fund
• Improve Global Funds alignment with national
  strategies and with other donors
• Allow the country to plan for the long-term

9
National Strategy Applications
Issues under discussion

• Certification mechanism
• Content of application (ideally to include the
  certified national strategy and minimal
  additional information)
• Role of CCMs and NGOs
• Role of the Global Funds Technical Review Panel

10
Recent Developments
Rolling Continuation
11
Rolling Continuation Channel

• The Rolling Continuation Channel (RCC) provides
  for 6 years of additional funding to existing
  Global Fund grants which are performing highly

12
Rolling Continuation Channel
Two Primary Qualification Factors

• Demonstration of strong performance, with at
  least 50 of A ratings over the Qualification
  Period (month 25-42) and

• Evidence of potential for measurable impact on
  the burden of the relevant disease

13
Rolling Continuation Channel
Secondary Qualification Factors

• Demonstration of program sustainability

• Extent to which the expiring grant contributes to
  an inclusive and transparent national plan

• Exceptional situations (war, tsunami)

14
Rolling Continuation Channel
Rolling Continuation provides for

• Up to 6 years of funding
• Simpler Proposal form
• Prioritised funding
• Several application dates each year
• The ability to continue a programme with slightly
  modified scope and scale (no new programme)
• The TRP may recommend the approval of only part
  of a Rolling Continuation Proposal
• The Board expects that 25 to 30 of all expiring
  grants will qualify to apply

15
Recent Developments
Health Systems Strengthening
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Health Systems Strengthening (HSS)

• The Global Fund should invest in activities that
  reinforce health systems for improved
  achievements in reducing the burden of the three
  diseases
• Round 6 470 million dollars towards HSS type
  activities

17
Health Systems Strengthening (HSS 2/2)

• Current discussions on HSS touch upon
• HSS as a separate Proposal or part of disease
  components
• Definition of HSS activities
• Conditions for applications (e.g. HSS Plan)
• Ceilings (and floor) for HSS funding

18
Recent Developments
Dual track financing
19
Dual-Track Financing (DTF)
Board decision The Board recommends the
submission of proposals with both government and
non-government PRs. If a proposal does not
include both government and non-government PRs,
it should contain an explanation of the reason
for this.
20
Dual-Track Financing
Objectives

• Increased absorption capacity (taking full
  advantage of the implementation capacity of all
  domestic sectors, both governmental and
  non-governmental)
• Accelerated implementation and performance of
  grants
• Strengthening of weaker sectors

21
Dual-Track Financing

• Continued work by the Board Committees
• Secretariat to estimate budgetary implications of
  Dual-Track Financing, for Board consideration
• Proposal forms to include language that will
  encourage the use of dual track in Round 8
  proposal application forms
• Ideas for better inclusion of vulnerable groups
  (as determined by country context)
• Increasing capacity of TRP in the area of civil
  society

22
Dual-Track Financing

• Challenges to effectively leveraging civil
  society
• Multiple challenges facing the effective
  inclusion and strengthening of civil society in
  the Global Funds work at country level,
  including
• Lack of sufficient resources to build the
  capacity of local civil society organizations
• Dynamics at country level that limit meaningful
  participation by civil society in the design and
  implementation of programs
• Exclusion of critical voices and marginalized
  groups

23
Dual-Track Financing Situation

• Civil society is a PR in approximately 19 of
  Global Fund Grants
• Civil society is largely involved as sub
  recipients (30 of Global Fund grants)

24
Dual-Track Financing Performance of civil
society PRs

• 83 of civil society principal recipients were
  rated as exceeding expected results
• 2 of civil societys principal recipients were
  rated as having unacceptable performance

25
Dual-Track Financing Principles guiding the
Board decision
Principles

• Performance based funding
• Consistency with National Strategies
• Consistency with alignment and harmonisation
  agenda
• Implementation should minimise transaction-costs
  to CCMs, PRs, and the Global Fund

26
Recent Developments
ME Strengthening Tool
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ME Systems Strengthening tool

• Introduced as part of the ME and Data quality
  framework to assess and strengthen ME capacity
• The assessments will also be used to guide
  strategic investment decisions during the grants
  life-cycle (Grant signature, Phase 2, RCC)

28
ME Systems Strengthening tool
29
ME Systems Strengthening tool

• The tool has been implemented for one of the
  disease components in 32 countries, including 7
  in East Asia and the Pacific
• HIV China, East Timor, Philippines, Vietnam
• Malaria Cambodia, China, Indonesia,
  Philippines, Vietnam
• TB China, Philippines, Thailand
• All disease components are required to implement
  the tool by end of 2007

30
ME Systems Strengthening tool
Implementation

• PRs need to use the tool to initiate discussion
  on ME system among different stakeholders
• The tool can be adapted to the countrys context
  and needs
• The stakeholders workshop needs to be carefully
  prepared
• Ideally, the workshop should be facilitated by a
  disease-specific specialist

31
ME Systems Strengthening tool
Partnership

• Mobilize Support from technical partners to the
  ME assessment process
• Action Plan as ONE harmonized plan
• In order to ensure sustainability and building of
  national ME systems, the implementation of this
  Action Plan requires support
• Technical expertise
• Additional financial resources for strengthening
  measures beyond Global Fund grant capacity

31
32
ME Systems Strengthening tool

• In order to reduce the burden of frequent and
  overlapping ME assessments
• Multi-agency Technical Working Group on
  Harmonization of ME assessments for HIV (Global
  Fund, World Bank, UNAIDS, Measure EVALUATION and
  MACRO Intl.)
• Process underway to refine the tool and come up
  with one overall ME assessment tool

33
Recent Developments
Grant consolidation
34
Grant Consolidation Summary

• Board-mandated pilot study in 2007
• Combine multiple single-disease grants into one
• Streamline grant management for PRs and
  Secretariat
• Increase alignment with national plans
• Cambodia, Ghana, Pacific, Perú, Viet Nam

35
Grant Consolidation Objectives

• To assess added value and feasibility of grant
  consolidation
• To identify specific policy and architectural
  changes needed
• To develop strategy and policy recommendations
• To draw operational, policy and architectural
  lessons to facilitate broader roll-out
• To identify the criteria for and situations that
  favor grant consolidation

36
Grant Consolidation Process

• Combining grants into a single grant agreement
• Aggregating performance targets
• Aggregation and adjusting budgets
• Optimal time in the lifecycle of grants?
• Proposal preparation stage (via the rounds-based
  channel or the RCC)
• Grant negotiation of approved proposal
• During implementation

37
Grant Consolidation Lessons Learnt To Date

• Considerable planning precedes going live on
  grant consolidation
• Consolidation of existing grants is possible but
  involves high time input by PR, SRs, and
  Secretariat
• Consolidation at proposal preparation stage has
  lower transaction costs but requires advance
  planning
• Policy adjustments will be necessary to
  facilitate broader roll-out of grant
  consolidation
• Preliminary recommendations go to November 2007
  Board Meeting
• Round 8 likely to be Consolidation Round

38
Grant Consolidation Status Update 4 countries
39
Recent Developments
Technical Support
40
Update on Technical Support

• Technical Support needs surge at various points
  of the Grant Life Cycle
• Proposal development together with technical
  agencies followed by support in TRP
  Clarifications and Negotiations
• Implementation Phase typical bottleneck areas
  are governance procurement ME financial
  management management of SRs annual planning
  and budgeting specifically
• Preparing for Phase 2 and for RCC
• Clearing Conditions Precedent

41
Developments in Technical Support

• The Global Fund does not provide technical
  support to implementation, but can facilitate the
  access to such support from our partner
  organisations
• The secretariat can provide limited support
• to diagnosing the problem (regional contractors)
• Country Coordinating Mechanism workshops

42
Partners Providing TS

• Various mechanisms for accessing TS exist and
  funding for this area is increasing
• Through UN technical agencies STB, RBM, WHO/HIV,
  UNICEF, UNAIDS/WB
• Through bilateral mechanisms USG/PEPFAR Global TS
  mechanism, GTZ Backup Initiative
• More details in TS session tomorrow afternoon!

43
Recent Developments
Quality Assurance in Procurement
44
Quality Assurance Background

• Global Fund Procurement Principle
• To procure quality assured products at the
  lowest price, in accordance with national and
  international law, and in a competitive and
  transparent process
• Quality Assurance
• Set of management activities required to ensure
  that the medicines (or other health products)
  that reach patients are safe, effective and
  acceptable to the patient.
• Responsibilities for PSM activities
• PRs are responsible for ensuring adherence to
  Global Fund QA/QC requirements.

45
The Global Fund QA Policy

• Multi-Source Pharmaceutical Products

Must comply with quality standards and
requirements of Drug Regulatory Authority in
the recipient country.

• Single and Limited-Source Pharmaceutical
  Products

Must procure single or limited source
pharmaceutical product that complies with
criteria approved by the Global Fund Board.
46
The Global Fund QA Policy (2)

• Option A Products pre-qualified by WHO (UN
  procurement quality and sourcing project)
• Option B Products authorized for consumption in
  their country by a Stringent Regulatory Authority
• If the PR determines that there is one or no
  equivalent product meeting standard A or B or if
  a product is unavailable, then PR may procure
  products under Option C

47
Obligations

• PR
• Promptly notify the Global Fund in writing if
  they plan to procure any products pursuant to
  Option C1 or C2
• Shall obtain documentation of the application
  and/or GMP compliance
• Shall permit access to storage sites and removal
  of samples
• GF
• Has contracted an independent 3rd party to
  conduct random quality analysis of products
  procured under Option C (Note PR still retains
  responsibity for random sampling and analysis of
  products procured under Options A/B and
  multi-source products).

48
Non-Compliance

• Non-Compliance with the QA Policy
• Potential risk for patients to get unsafe
  products as the Global
• Fund will not be able to conduct random testing
  of such products.
• Corrective measures will be applied to ensure the
  safety of products procured with Global Fund
  support
• Non-Compliance Level 1 No Notification
• 1st Instance Request and Verify compliance
• Issue warning letter to Principal Recipient
• 2nd Instance same as above and direct payment to
  Procurement Agent or Supplier
• Non-Compliance Level 2 No Notification
  Non-Compliant Procurement
• 1st Instance Request and Verify compliance
• Reimbursement Amount to be deducted from Grant
• Direct payment to Procurement Agent or Supplier

49
Recent Developments
Voluntary Pooled Procurement
50
Voluntary Pooled ProcurementBoard decision

• GF to implement voluntary pooled procurement
• Rapidly strengthen existing Price Reporting
  Mechanism (PRM)
• Establish a voluntary pooled-purchasing service
  with the following characteristics
• Covering a set of target products (phased
  approach initially a small number of target
  product categories to be determined)
• Operated by one or more procurement agent(s)
• Available to PRs on a voluntary basis, with some
  exceptions
• Direct payment to suppliers (via procurement
  agent) from Trustee account, with agent to enter
  relevant/required data in PRM
• Make available, via contracted providers,
  procurement capacity-building services and
  supply-chain-management assistance on an optional
  basis for all PRs participating in the
  pooled-purchasing mechanism

51
Voluntary Pooled Procurement Benefits
Expected benefits of Voluntary Pooled Procurement

• Increasing speed and reliability of the
  procurement process
• Decreasing lead times for delivery of products to
  countries
• Reducing stock outs
• Reducing price volatility
• Negotiating better prices than available to
  recipients individually
• Reducing transaction costs for recipients
• Ensuring medium-term supply availability and
  reliability
• Guaranteeing procurement of quality-assured
  products

52
Voluntary Pooled Procurement Implementation

• Key steps in the implementation of Voluntary
  Pooled Procurement Service Strengthen the PRM
• Short term improvements (Dead-line September
  2007)
• Longer term enhancement of existing system /
  development or a new system (Dead-line December
  2008)
• Select external agent for periodic audit process
  (Dead-line March 2008)
• Establish a voluntary pooled-purchasing service
• Detailed implementation planning including
  Conducting further analysis in order to determine
  suitable initial target product categories
  (Dead-line December 2007)
• Select and contract appropriate Procurement
  Agent(s) (Dead-line June 2008)
• Selection and negotiation with manufacturers
  (Dead-line December 2008)
• Fully operational procurement model (Dead-line
  January 2009)
• Contract with providers of capacity-building
  services and supply-chain-management assistance
• Detailed implementation planning including
  determination of needs/requirements (Dead-line
  December 2007)
• Select and contract appropriate Service Providers
  (Dead-line June 2008)
• Fully operational as of July 2008

53
Recent Developments
Enhanced Financial Reporting
54
Enhanced Financial Reporting

• What is It?
• A request for Standardized and Enhanced Financial
  Information from Grant Recipients
• An Excel Template to be completed with Budget,
  Expenditure and Variance Analysis
• Information required by Cost Category, Service
  Delivery Area (SDA) and Implementing Entity
  (PR/SR)
• To be completed once per year on the Grant Cycle
  and at Phase 2.
• Successfully Pilot Tested
• Currently Under Review by Global Fund Policy and
  Strategy Committee

55
Enhanced Financial Reporting

• Why request this information?
• Improving Transparency and Accountability
• Improving Application of Performance Based
  Funding
• Satisfying Board and Donor Requests
• Improving Risk Management
• Cost Effectiveness Analysis

56
Enhanced Financial Reporting

• What are the next steps?
• Due for Review by Policy and Strategy Committee
  in September
• Notification of Template and Guidance
  Documentation in October/November
• First Batch of Grants (Grant Cycle ending in
  January 2008) due to Report by April 2008.
• Frequently Asked Questions and Dedicated Email
  Address will be available for any Queries.

57
Recent Developments
Grant closure
58
Grant Closure Overview

• Grant Closure reports, audits, and other
  procedures performed by the Principal Recipient
• ... With Country Coordinating Mechanism oversight
  and Local Fund Agent verification...
• ... For Global Fund approval.

58
59
Grant Closure Overview

• Planning starts in Year 4
• PR includes close-out costs in Year 5 budget
• Close Out Plan and Budget submitted 6 months
  before the grant ends
• Programmatic activities are not allowed once the
  grant is closed
• Continuity of Services request is only possible
  in very specific conditions

59
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Grant Closure Documentation

• Close Out Plan
• Describes close-out activities and timeline
• Lists all grant assets and liabilities, and
  proposed asset distribution
• Data collection and reporting (financial/programma
  tic) plans
• Close Out Budget
• Termination Agreement Signed by the Principal
  Recipient and Global Fund once Close Out Plan is
  fully implemented and verified by the Local Fund
  Agent.

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61

• Re-tendering of the Local Fund Agent Contracts
• MyGlobalFund

Two other recent developments
62
LFA Call for Proposals

• Re-tendering of Local
• Fund Agent Contracts

63
LFA Re-tendering

• Since GF doesnt have country-level presence
  outside Geneva, independent advice is contracted
  from
• Local Fund Agents (LFAs)
• Key LFA tasks include
• to assess that PRs have minimum capacity to
  ensure financial and programmatic accountability
  for grant before signing of PGAs
• to provide independent verification of the PRs
  verifying program progress and financial
  accountability during grant period.

64
LFA Re-tendering

• The current LFA Contracts expire 15 Nov 2007
• Steps in Competition Process Timeline
• Step 1
• a) Pre-Solicitation Notice 24 April 2007
• b) Request for Proposals (RFP) 25 July 2007
• c) Proposal deadlines 21 Sept 2007
• d) Award of new LFA IQC Contracts Nov Dec
  2007
• Step 2
• Post-award competition for work orders
• to select in-country LFAs Dec 2007 March
  2008

65
LFA Re-tendering

• 1) To increase diversity among applicants, the
  RFPs encourage applications from a wide
  range of organizations
• -small/large firms, non-profit organizations,
  educational institutions, consortia
• 2) The RFPs invite proposals for the individual
  countries within the region and place no maximum
  or minimum limit on the number of countries for
  which proposals may be submitted.
• 3) The RFPs, incorporate
• a revised Statement of Work/Terms of Reference,
• performance evaluation measures and
• option for penalties for poor performance.

66
LFA Re-tendering

• www.TheGlobalFund.org

67
LFA Re-tendering
68
LFA Call for Proposals

• MyGlobalFund

69

• Introducing
• MyGlobalFund
• A virtual meeting place to discuss and
• communicate on your work with colleagues in
• other countries.
• A communication tool to
• share best practices
• communicate on your results and the challenges
  you are faced with
• meet other experts

70

• MyGlobalFund
• Key Features
• Participate in discussion in the Forums
• Promote your work, share your best practices,
  learn from other peoples experience through the
  Blogs
• Get to know other experts people involved in
  the same field of work through the Members
  section

71

• MyGlobalFund
• Blogs
• Your webpage to communicate on
• Results
• Milestones achieved
• Simple human-interest stories showing how the
  national programs are changing peoples lives
• Description of innovative approach
• Announcements
• Challenges (procurement capacity building)
• Links to new content on your website

72

• Next steps
• Currently in Beta version
• A trial period to test MyGlobalFund and make
  final adjustments
• CCM eForum discussions
• October 2007
• Official launch
• November 2007, Global Fund Board meeting

73

• Thank You