FUNDING IN THE AMOUNT OF $224 MILLION APPROVED IN NOVEMBER

Author:

David Garmaise

Article Type:

Article Number: 8

For the first time, external funding has been used to fund an initiative on the UQD register

ABSTRACT In the latest wave of funding, 22 grants from 14 countries and one regional organization were approved. This marked the first time that external funding has been used to fund an initiative on the UQD register.

In November 2015, the Global Fund Board approved $224 million in funding for 22 grants emanating from concept notes submitted by 14 countries and one regional organization. The Board was acting on recommendations from the Grant Approvals Committee and the Technical Review Panel.

Included in the $224 million was $16 million in incentive funding. In addition, the Fund placed interventions worth $40 million in the registry of unfunded quality demand. See the table for details.

Most of the funding approvals for individual component were for relatively small amounts. Benin, with three components spanning four grants, received $70 million, far more than any other country. Belarus was second with $26 million. See the table for details.

Table: Funding for country grants approved by the Global Fund, November 2015 ($ million)

Country (component)	Grant name		Principal recipient	Approved Funding			Of which, incentive funding	Added to UQD register
				Existing	New	Total
Armenia (HIV)	ARM-H-MOH		Ministry of Health	0.7 m	3.2 m	3.9 m	NIL	5.0 m
	ARM-H-MEA		Mission East	NIL	1.7 m	1.7 m
Azerbaijan (HIV)	AZE-H-MOH		Ministry of Health	3.6 m	6.3 m	9.9 m	NIL	NIL
Belarus (HIV)	BLR-H-RSPCMT		Rep. Scientific Practical Center of Medical Technology	1.7 m	12.0 m	13.7 m	NIL	0.2 m
Belarus (TB)	BLR-T-RSPCMT			0.4 m	11.9 m	12.3 m	NIL	NIL
Benin (HIV)	BEN-H-BENPLNS		Ministry of Health	23.0 m	NIL	23.0 m	NIL	NIL
	BEN-H-PlanBen		Plan Benin	2.4 m	5.3 m	7.7 m
Benin (Malaria)	BEN-M-PNLP		Ministry of Health	8.5 m	25.3 m	33.5 m	9.0 m	NIL
Benin (TB)	BEN-T-PNTUB		Ministry of Health	1.5 m	4.9 m	6.4 m	0.4 m	NIL
Côte d’Ivoire (Malaria)	CIV-M-SCI		Save the Children	9.5 m	4.4 m	13.9 m	NIL	20.9 m
Dominican Rep. (TB)	DOM-T-MSPAS		Ministry of Health	0.6 m	7.8 m	8.4 m	NIL	NIL
El Salvador (TB)	SLV-T-MOH		Ministry of Health	0.2 m	9.8 m	10.0 m	NIL	NIL
Gabon (TB)	GAM-T-NLTP		Ministry of Health	NIL	3.9 m	3.9 m	NIL	NIL
Gambia (TB)	GMB-T-NLTP		Min. of Health and Social Welfare	1.3 m	6.7 m	8.0 m	0.4 m	NIL
Regional (HIV)	QRA-H-HIVOS		ICW Latina	NIL	4.3 m	4.3 m	NIL	NIL
Jamaica (HIV)	JAM-H-MOH		Ministry of Health	0.3 m	14.9 m	15.2 m	NIL	NIL
Paraguay (TB)	PRY-T-AVA		Alter Vida	0.4 m	5.6 m	6.0 m	NIL	NIL
Tajikistan (TB)	TJK-T-HOPE		Project HOPE	4.7 m	8.6 m	13.3 m	NIL	NIL
	TJK-T-RCTC		Republican Center of TB Control	NIL	4.7 m	4.7 m
Timor-Leste (TB)	TLS-708-G04-T		Ministry of Health	0.6 m	4.2 m	4.8 m	0.9 m	NIL
Timor-Leste (HIV)	TLS-H-MOH		Ministry of Health	3.9 m	0.4 m	4.3 m	NIL	NIL
Vietnam (Malaria)	VNM-M-NIMPE	National Institute of Malariology, Parasitology & Entomology		2.8 m	12.5 m	15.3 m	4.8 m	13.5 m
TOTALS				66.1 m	158.1 m	224.2 m	15.5 m	39.6 m

The grants to Benin, Côte d’Ivoire and Gabon were in euros which we converted to dollars at the rate of 1.0720. Discrepancies in totals due to rounding.

In addition to the $224 million, the Board approved $31.3 million for Zimbabwe’s HIV component, made up of $25.3 million in incentive funding, and $6.2 million specifically to support the provision of pediatric ARVs and related initiatives. As an early NFM applicant, Zimbabwe did not have an opportunity to compete for incentive funding. Thus, the country coordinating mechanism was allowed to submit a request for funds specifically from the incentive funding envelope.

The pediatric initiatives are being funded by the Children’s Investment Fund Foundation. The initiatives the CIFF will support were on the register of unfunded quality demand. This represents the first time that an initiative from the UQD register has been funded with money from a source external to the Global Fund.

Because of perceived risks, the funding award to Jamaica was accompanied by a special condition in the grant confirmation form requiring the submission of a detailed annual report on compliance with essential health product absorption commitments, including antiretroviral expenditures and management.

The Board also approved exceptions to existing policies to make it easier to manage grants in challenging operating environments in Iraq, Palestine, Syria and Yemen (see GFO article.)

Regional grant

The strategic focus of the regional grant to be administered by ICW (International Community of Women Living with HIV/AIDS) Latina is “to position women living with HIV in 11 Latin American countries as a key population in the effort to contain and reverse HIV, and empower them as actors who are trained to defend their human rights in their communities.”

Included in the program’s strategies are (a) advocacy at the regional and national level, including the development of an online tool to track regulatory and policy frameworks related to the rights of women living with HIV; and (b) capacity building of women living with HIV. The latter will entail development of a methodological toolkit that focuses on gender-based violence, human rights, and exercise of citizenship; and transformational leadership workshops for the ICW Latina network.

Funding for key populations and harm reduction in HIV awards

Services for key populations were contained in eight HIV components. Specifically, services for men who have sex with men were included in four components; for persons who inject drugs in four; for sex workers in three; for people in prisons in three; and for transgender people in two.

Armenia plans to provide methadone substitution both inside and outside of prisons. In Azerbaijan, needle exchange programs will be scaled up. In Belarus, opioid substitution therapy and needle exchange are among the services to be provided.

Among the strategies included in the HIV grants to Benin are (a) programs addressing gender violence and removing legal barriers through policy and legal advocacy; and (b) providing psychological, legal, and microcredit economic support to people living with HIV, orphans and vulnerable children, and key populations.

One of the strategies identified in the report is innovative approaches to reaching young women and girls.

Funding for malaria: highlights

The Board approved minor additional funding for two malaria components that had already been awarded funding under the NFM: Bangladesh and Côte d’Ivoire. For one Bangladesh grant, BGD-M-BRAC, the approved grant budget was raised from $9.7 million to $9.8 million. For a second grant from that country, BGD-M-NMCP, the approved budget went from $15.7 million to $15.9 million. The GAC said that the additional amounts are within the allocations, and represent the reinvestment of undisbursed and unused cash funds from Round 10 grants that were not included in the total budget when the Board approved funding for the Bangladesh malaria grants in June 2015. According to the GAC, the CCM has requested that the additional amounts be invested in initiatives on the UQD register.

For Côte d’Ivoire, the approved budget for grant CIV-M-MOH was increased from $83.5 billion to $88.4 billion. GFO is planning to provide additional details on the increase in a separate article.

The GAC report noted that in Benin, spot checks of a sample of 140 vendors in markets and streets revealed that up to 50% are selling counterfeit or substandard artemisinin combination therapies. Given that a high proportion of the population obtains services from the private sector, Benin will use efficiencies identified in the budget for the malaria grant during grant-making to support current efforts to address this problem involving Benin’s drug regulatory agency, and partners such as USAID and the (U.S.) President’s Malaria Initiative.

With respect to malaria grant for Vietnam, the Global Fund will phase out contributions to salary incentives by the end of 2015, and will support only a travel allowances for village health workers, which is considered critical for active case finding efforts.

Funding for TB: highlights

With respect to the TB funding for Gabon, a key strategy for providing services to key populations involves the use of community agents to provide patient support, including patient follow-up, psycho-social services and peer training for other community agents.

Some of the funding awarded to the Gambia TB component will be used for programs to retain and build the capacities of health workers and technicians.

Sustainability

The GAC report briefly described steps that were taken in nine of the 22 country grants to strengthen the sustainability of programs currently supported by the Global Fund (see GFO article).

Information for this article comes from the November 2016 report of the Secretariat’s Grant Approvals Committee to the Board (GF-B33-ER18). This document is not available on the Fund’s website.