SUCCESSES AND FAILURES AMONG GRANTS REVIEWED FOR PHASE 2

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Download PDF During the past month, the Global Fund Secretariat has presented 26 grants to the board for consideration for Phase 2 renewal. For each of these grants, the Fund has provided the board with the results of an extensive and candid review of the grant’s performance thus far. The Secretarit’s review of each grant is contained in two overlapping…

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ABSTRACT Twenty-seven percent of the grants that have just been considered for Phase 2 renewal were rated as having performance that was "Inadequate, but potential demonstrated," or "Unacceptable."

During the past month, the Global Fund Secretariat has presented 26 grants to the board for consideration for Phase 2 renewal. For each of these grants, the Fund has provided the board with the results of an extensive and candid review of the grant’s performance thus far.

The Secretarit’s review of each grant is contained in two overlapping documents. First is the “Grant Performance Report,” which is made public at www.theglobalfund.org/en/funds_raised/performance. This contains considerable data about the grant (including comparisons between targets set and levels achieved for various indicators), together with certain Secretariat evaluations of the data.

Second is the “Grant Scorecard,” which is given to the board but is not made public. [Note: When board members show GFO copies of board materials such as these, GFO does not report on them until after the board has made its decisions.] The Grant Scorecard repeats some of the data in the Grant Performance Report, but provides considerably more discussions and evaluations of how the grant has performed.

Within the Grant Scorecard, the Secretariat aggregates its various assessments into an “Overall Grant Rating.” This can have the following values:

A: Grant performance has met or exceeded expectations

B1: Grant performance has not met expectations, but has been adequate

B2: Grant performance has been inadequate, but potential has been demonstrated

C: Grant performance has been unacceptable

Separately, the Secretariat assesses “Contextual Considerations,” which relate to factors beyond the control of those involved in grant implementation but that can have an impact on the chances of success.

Finally, after taking into account the “Overall Grant Rating” and the “Contextual Considerations,” the Secretariat makes one of the following recommendations:

“Go”: The grant should be approved for Phase 2 (Years 3-5)

“Conditional Go”: The grant should be approved for Phase 2, on condition that specified actions are taken by the PR and/or CCM within a specified time period.

“Revised Go”: The grant should be approved for Phase 2, subject to specified major changes being made from the original proposal.

“No Go”: The grant should not be approved for Phase 2.

The Board reviews these Go / No Go / etc. recommendations by email. (For “Revised Go” and “No Go” recommendations, the TRP is also asked for an opinion.) If, for any grant, the Board disagrees with the Secretarit’s recommendation, the Secretariat reviews the evidence and then submits a new recommendation (which might be the same as before) to the board. If they still don’t agree, the grant is discussed at a board meeting.

When there is no disagreement between Secretariat and Board, their agreed opinion (Go / No Go / etc.) becomes a final decision.

For the 26 grants that have been considered thus far, the outcomes were as follows:

Table 3: Decisions Regarding Phase 2 Renewals

 

Grant	Secretariat Rating	Secretariat Recommendation	Board Opinion	Result
Benin, Malaria – Rd 1	B1	“Conditional Go”	Agreed	Phase 2 approved
Burundi, HIV – Rd 1	B1	“Go”	Agreed	Phase 2 approved
China, Malaria – Rd 1	A	“Go”	Agreed	Phase 2 approved
China, TB – Rd 1	A	“Go”	Agreed	Phase 2 approved
Ghana, HIV – Rd 1	B1	“Conditional Go”	Agreed	Phase 2 approved
Ghana, TB – Rd 1	B1	“Conditional Go”	Agreed	Phase 2 approved
Haiti, HIV – Rd 1 (PR=an NGO)	A	“Go”	Agreed	Phase 2 approved
Haiti, HIV – Rd 1 (PR=UNDP)	B1	“Go”	Agreed	Phase 2 approved
Honduras, HIV – Rd 1	B2	Was “No Go”, but now being re-evaluated	Awaiting Secretariat re-evaluation	To be determined
Honduras, Malaria – Rd 1	B2	“Conditional Go”	Agreed	Phase 2 approved
Honduras, TB – Rd 1	B2	“Conditional Go”	Agreed	Phase 2 approved
India, TB – Rd 1	A	“Go”	Agreed	Phase 2 approved
LAO PDR, HIV – Rd 1	B2	“No Go”	Disagreed	Decision awaits Secretariat re-evaluation
LAO PDR, Malaria – Rd 1	B2	“Conditional Go”	Agreed	Phase 2 approved
Madagascar, HIV – Rd 2 (PR=CRS)	A	“Go”	Agreed	Phase 2 approved
Madagascar, HIV – Rd 2 (PR=PSI)	B1	“Go”	Agreed	Phase 2 approved
Madagascar, Malaria – Rd 1	B1	“Go”	Agreed	Phase 2 approved
Moldova, TB/HIV – Rd 1	A	“Go”	Agreed	Phase 2 approved
Mongolia, TB – Rd 1	A	“Go”	Agreed	Phase 2 approved
Morocco, HIV – Rd 1	A	“Go”	Agreed	Phase 2 approved
Panama, TB – Rd 1	A	“Go”	Agreed	Phase 2 approved
Rwanda, TB/HIV – Rd 1	A	“Go”	Agreed	Phase 2 approved
Senegal, HIV – Rd 1	C	“No Go”	Disagreed	Decision awaits Secretariat re-evaluation
Senegal, Malaria – Rd 1	C	“No Go”	Agreed	Phase 2 NOT approved
Tajikistan, HIV – Rd 1	A	“Go”	Agreed	Phase 2 approved
Zanzibar, Malaria – Rd 1	B1	“Go”	Agreed	Phase 2 approved

Summarizing the above, the Secretariat has rated the 26 grants as follows:

Table 4: Totals of Overall Grant Ratings for Phase 2 Renewals

Grant Performance	Number of grants	Percent
A:	Met or exceeded expectations	11	42%
B1:	Adequate	8	31%
B2:	Inadequate, but potential demonstrated	5	19%
C:	Unacceptable	2	8%
Total:	26	100%

In a new report, “The Global Fund at Three Years” (available at www.theglobalfund.org/en/about/replenishment), the Fund conducts a further analysis of the above “Phase-2-ready” grants. (The Fund’s analysis refers to 27 grants that have been assessed, rather than 26. One grant seems to have disappeared from the list after the Fund did this analysis and before recommendations were put to the Board.) The Fund’s findings include the following:

• Taken together, the 27 grants have reached just over 60% of their targets for people on antiretroviral treatment, nearly 80% of targets for malaria treatment, and more than 100% of targets for mosquito net distribution. All TB grants reached their targets for TB treatment under DOTS. The grants rated B2 or C account for most of the shortfall in targets that were not reached.

• B2 and C-rated grants reached only 27% of their agreed targets for “people reached,” 57% of their agreed targets for “people trained,” and only 24% of targets for “people on ARVs.”

• Non-governmental PRs have performed well in absorbing funds, with an average disbursement rate of 91% of expected disbursement, as compared to an average of 79% for governmental PRs. And non-governmental PRs had the strongest performance record, with two A, two B1, and no B2 or C-rated grants.

• Grants that performed poorly did so as a result of three forms of delay:

• Some delays resulted from a lack of capacity to execute the often sizeable programs, which frequently involve significant scale-up of new services with little in-country experience. The biggest problems related to procurement procedures.

• Some delays resulted from the Global Fund’s own procedures, or from lack of clarity regarding these procedures.

• Finally, some delays resulted from a variety of internal issues within the countries receiving the grants, ranging from repeated changes of political leadership or senior management to internal conflicts of various kinds.