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This article provides a summary of the main decisions made by the Global Fund Board at its 9–10 May 2018 meeting in Skopje, Macedonia.


The only really significant change to the Eligibility Policy adopted by the Board is that there are new metrics and thresholds used to determine TB disease burden. Income levels and disease burden are still the main determinants of whether a country and its components are eligible for funding. The Global Fund will continue to use gross national income per capita as the indicator of economic capacity.


The Board has acknowledged that there might be a circumstance where the Global Fund will want to provide support to a non-eligible country experiencing a health crisis (e.g. Venezuela). The Board tasked the Secretariat with preparing proposals for countries in this situation and said that the proposals will have to describe how the support would be funded. The Board is concerned about the potential impact on programs in eligible countries if the Fund supports non-eligible countries in crisis. The Secretariat appears frustrated with how this issue has been handled up to now.


The Global Fund Board has adopted a new CCM Policy, replacing the CCM Guidelines and Requirements for Country Coordinating Mechanisms. The Board also adopted a new Code of Ethical Conduct for CCM Members and approved $1.2 million over three years to fund implementation and enforcement of the code. Finally, the Board decided to add “CCMs” to the Fund’s list of strategic initiatives.


The intermediate level of ambition with a phased-in approach, which the Board has approved for the CCM Evolution initiative, will allow targeted technical and financial support to be provided to country coordinating mechanisms in 16 countries to implement activities aimed at increasing their maturity in oversight, key population engagement, linkages and CCM functioning. The Board approved $3.85 million to fund the initiative in 2018–2019.


The Global Fund is sticking with its decision not to proceed with grants to the Democratic People’s Republic of Korea, also known as North Korea. The Fund’s Board discussed the decision in executive session at its Board meeting on 9–10 May. The Board said that there will be a responsible phasing out of the current grants.


In approving the Risk Appetite Framework, the Global Fund Board has set risk appetite levels for nine key organizational risks, as well as target levels for these risks and indicative timeframes for achieving the targets. In the process, the Board decided that the risk appetite levels should be set at the current risk levels.


The new process for the selection of the Board chair and vice-chair calls for the use of a nominations committee to coordinate the process and for an executive search firm to provide support.The practice of rotating the positions of chair and vice-chair is maintained.


The Board has announced appointments to its three standing committees for two-year terms that started on 11 May 2018. The Ethics and Governance Committee has been directed to undertake a review of the process for selecting the leadership and members of the committees.