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НОВЫЙ ВЫПУСК GFO
The sustainability outlook “looks weak,” the Technical Review Panel said when it reviewed Nigeria’s malaria funding request. “Nigeria continues to request Global Fund funding support for large quantities of basic yet fundamental malaria prevention and control commodities, with little prospect of transitioning to national financing in the medium term,” the TRP stated. “This is a question of political will.” This article discusses the sustainability issue and provides information about the two malaria grants approved by the Board.
Nigeria submitted a TB/HIV funding request in May 2017 which was returned for iteration. Because the revised request has taken (and will take) considerable time to develop, and because the existing TB and HIV grants were scheduled to end on 31 December 2017, the Board has approved 18-month costed extensions for four existing grants. The extensions are to be funded from Nigeria’s 2017-2019 allocation. Meanwhile, the Grant Approvals Committee has reported “widespread frustration” with the slow progress towards impact of Nigeria’s TB grants.
The Global Fund Board has approved another batch of grants, the fourth from the 2017–2019 allocations. The value of the grants was $1.38 billion, bringing the cumulative amount awarded to date to $7.64 billion. The Board approved 26 grants emanating from 18 funding requests submitted by 12 countries. Interventions worth $447.9 million were added to the Unfunded Quality Demand Register.
“The work on defining risk appetite is in its early stage and until [it is] sufficiently advanced, there is limited guidance on the required level of assurance.” So says the Office of the Inspector General in a new audit of in-country assurance. In addition, the OIG said, assurance activities are insufficiently aligned to the highest risk areas in the grant portfolio, particularly supply chain management and programmatic risks. The OIG also noted that programmatic and health product risks have supplanted financial risk in the rankings.
Mozambique’s new TB/HIV grants will have a strong focus on retention and adherence for people who were recently initiated on antiretroviral treatment. According to the Technical Review Panel, civil society, including representatives of key populations, were fully engaged in the development of the funding request. Among the concerns raised by the TRP was that the interventions to improve treatment outcomes for multiple-drug-resistant TB were not clearly articulated. In addition, the TRP sent two matching funds requests back for iteration.
In the summer of 2017, certain amendments were adopted to the law regulating the response measures for HIV and other socially communicable diseases in the Republic of Belarus. The amendments allow for the establishment of a social contracting mechanism to make government funding accessible for NGOs working on HIV prevention among key affected populations. The amendments come into effect in January 2018. Currently, a package of documents which will regulate the functioning of the mechanism is being prepared by relevant ministries. However, there are still a lot of questions about how this mechanism is going to work in practice. This article describes how the social contracting mechanism in Belarus came into being.
The Board has adopted a set of “principles” governing the selection of local fund agents. The principles include some policy decisions. The main change from current practice is that local fund agent tenders will be for six years instead of four. The Board has delegated to the Audit and Finance Committee the authority to modify the principles; and has delegated to the Secretariat the authority to establish the procedures for procurement of LFA services.
The Technical Review Panel says the proposed programs in Zambia’s TB/HIV funding request will reduce gender- and age-related disparities and close the gaps in service delivery for key populations. The TRP had some concerns, but they were well addressed during grant-making.
Despite facing substantial economic challenges, Zambia has successfully scaled up interventions across all three diseases, concluded an audit of Global Fund conducted by the Office of the Inspector General. However, issues concerning the capacity of health workers and the capacity of diagnostic systems have negatively impacted service delivery, the OIG found, and there have been delays in implementing program activities. Finally, Zambia’s health systems operating with obsolete infrastructures struggle to cope with the rapid increase of volumes caused by program scale-up.
HIV, TB/HIV and malaria grants to Burkina Faso were among the third batch of grants approved by the Global Fund Board in December. This article provides a summary of the comments on the funding requests from Grant Approvals Committee and the Technical Review Panel.
The Technical Evaluation Reference Group, an independent advisory body accountable to the Global Fund Board through its Strategy Committee, is looking for new members to replace those who are outgoing.