Partnership Forum Generates Recommendations on Global Fund Strategic Issues

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Download PDF Over 400 people from 118 countries attended the Global Fund’s second Partnership Forum on 1-3 July 2006 in Durban, South Africa. Some of the most significant recommendations to emerge called for the possible use of programme-based rather than Round-based funding; making technical assistance more efficient; re-thinking the role of Local Fund Agents (LFAs); and fixing procurement and supply…

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ABSTRACT Over 400 people from 118 countries attended the Global Fund's second Partnership Forum this week in Durban, South Africa. Some of the most significant recommendations to emerge called for the possible use of programme-based rather than Round-based funding; making technical assistance more efficient; re-thinking the role of Local Fund Agents; and fixing procurement and supply management bottlenecks.

Over 400 people from 118 countries attended the Global Fund’s second Partnership Forum on 1-3 July 2006 in Durban, South Africa. Some of the most significant recommendations to emerge called for the possible use of programme-based rather than Round-based funding; making technical assistance more efficient; re-thinking the role of Local Fund Agents (LFAs); and fixing procurement and supply management bottlenecks.

The Partnership Forum meets every two years, gathering together a broad range of stakeholders to discuss the Fund’s performance and effectiveness and to make strategic and operational recommendations. The first Partnership Forum was held two years ago in Bangkok, Thailand.

In general, participants believed that the Durban Partnership Forum was better organised, more broad-based in its participation, and more focused in its discussions than the Bangkok Partnership Forum. Nevertheless, some concerns were expressed about the lack of time to discuss issues in depth, the quality of the facilitation in one or two of the break-out sessions, and the process for agreeing on recommendations.

Civil Society was the largest stakeholder group in attendance, constituting 36% of total participants. Others present came from Government (18%), Global Fund Board and Donors (11%), Private Sector (8%), CCMs (7%), UN agencies (6%), and Others (13%). Some of the Government and Civil Society participants represented Principal Recipients (PRs). The only major stakeholder not in attendance was LFAs.

The agenda included skills-building sessions, plenary presentations and discussions, and group work in breakout sessions. In the sessions on operational issues, participants discussed procurement and supply management; LFAs; CCMs; PRs; private sector involvement; civil society involvement; technical assistance; and multi-country projects.

With respect to strategic issues, participants discussed Global Fund strategic positioning; Global Fund size; optimizing grant performance; funding the right things; moving beyond Phase 2; health systems strengthening; leveraging civil society and the private sector; influencing market dynamics; alignment and harmonization; resource mobilization; Global Fund architecture; and measuring impact and ensuring accountability.

The following is a list of some of the key recommendations on strategic issues that emerged from the Partnership Forum. The wording that is (with permission) shown here is based on the text that was being prepared for the Fund’s website as GFO went to press. For space reasons we have omitted some of the recommendations, and we have made a few minor stylistic edits. A more definitive listing will shortly be provided by the Fund at www.theglobalfund.org/en/about/forum/2006, and a final version will appear some weeks later in the formal report of the Forum. Most of the recommendations were developed during breakout sessions by working groups; they were then presented to the plenary and sometimes briefly discussed, but they were not formally adopted. The Fund’s Board and Secretariat are free to follow the recommendations, but are not obliged to do so.

Alignment and Harmonization

• The Board should consider shifting from Rounds-based funding to programme-based funding.
• The Board should set fixed annual Round dates for countries not eligible for programmatic funding.
• The Board should allow the Secretariat the strategic flexibility required to enable comprehensive grant consolidation.
• In line with the commitments set out in the UN Political Declaration (June 2006), the Board should revise the eligibility criteria for financing of grants to include middle-income countries.

Optimising Grant Performance

• The Board should explore the development of more efficient forms of information-sharing among the Secretariat, PRs, CCMs and LFAs.
• The Board should commission an in-depth analysis of the supply and demand situation of technical assistance.
• The Board should require that technical assistance be provided in a more streamlined manner, covering each stage of proposal preparation and programme implementation.
• The GF should make more of an effort to recommend a variety of sources of technical assistance, including from civil society and the private sector, and not just from UN agencies.

Global Fund Architecture

• The Board should review the architecture and terms of reference of LFAs.
• The GF should promote the use of multiple PRs.
• The GF should ensure that the TRP includes members with expertise on gender, human rights and health system strengthening.

Measuring Impact and Ensuring Accountability

• The GF should measure its impact not only on disease burden, but also on strengthening health and other systems.
• The GF should, as much as possible, permit countries to report using indicators and systems that are already used at the country level.
• The measurement of indicators should not provide an excessive burden on staff time. For stable grants, grant reporting should not be required more often than every six or twelve months.
• The Board, together with UNAIDS and GF recipients at country level, should convene all donors with a view to agreeing to a single reporting methodology and consolidated country report.

Resource Mobilisation

• The Board should consider moving the GF from a low level to a high level of engagement around innovative financing. The Board should ensure appropriate flexibility in order to accommodate the differences between innovative financing mechanisms and the GF model.
• The Board should explore modifying its resource mobilization response and using more of a “business model.” This would include addressing issues such as the skill set of the Executive Director, Secretariat staff and the Board. A key principle of the resource mobilization response needs to be long term predictable financing and multi-year applicability.

Beyond Phase 2

• The Board should ensure that high performing grants which have been completed should qualify for extensions instead of being part of new Rounds (as long as the activities remain the same as in the initial grant).
• The Board should explore the need for longer term grants – e.g., 8-10 years – while maintaining the role of the TRP and other performance-based funding requirements.
• The Board should consider some form of exit or sustainability strategy in the grants process. Features of such a strategy could include:
  • Phased exit strategy: Incremental (step by step) in line with governments’ financial planning.
  • Differentiation: Different approaches for different diseases, contexts and countries.
  • Inclusion of government commitment and support to civil society in the strategy.

Health Systems

• The Board should have a strong, clearly articulated mandate for ongoing investments into a broad range of health system strengthening interventions.
• The Board should establish longer funding cycles for health systems strengthening.
• The Board should prioritize funding health systems strengthening for integrated primary health care delivery within universal access goals.
• The Board should consider expanding the scope of funding to include sexual reproductive health and basic primary health care.

Civil Society and the Private Sector

• The Board should commission an external evaluation of civil society participation, especially the participation of affected communities, at all levels of the GF.
• The Board should commission an external evaluation of private sector participation at all levels of the GF.

Market Dynamics

• The Board should develop a comprehensive market dynamics approach (including a procurement strategy) that aims to get the largest number of products to the greatest number of people in the shortest possible time at the lowest possible cost, while maintaining a level of assured quality.
• The Board should urgently commission participatory research into the entire procurement process (from producer to patient) in order to identify the root causes of procurement and supply management problems and to inform the strategic consideration of the GF’s market dynamics approach (including a procurement strategy).