The Technical Review Panel (TRP) plays a central role in the Global Fund's funding process by providing independent technical assessments of proposals to ensure that grants are effectively focused on the most urgent health issues. Since its creation, the TRP's role and structure have evolved significantly. The Global Fund Board meeting held from May 7 to 9, 2025, marked a pivotal moment in this evolution, as the revised mandate of the TRP model was approved by the Board. In fact, A central theme emerging from the discussions was the interdependence of the TRP and country ownership, which is vital for the success of Global Fund-supported programs.

Let’s explore what this revision entails, but first, let’s take a moment to understand the context behind the desired evolution of the TRP model.

Context and rationale behind the evolution of the TRP model

Throughout the revision process, stakeholder feedback highlighted the interdependence of the TRP and country ownership, with many stressing that the TRP’s role is to empower and support countries, not replace their leadership. Several important insights emerged from the consultation:

1. Credibility and independence: Many stakeholders expressed concern about preserving the credibility and independence of the TRP review process, especially with the introduction of a more differentiated model. It was emphasized that the TRP must maintain its impartiality and technical rigor while also being responsive to the needs of countries. This balance ensures that the TRP can continue to offer valuable, independent advice while respecting the ownership of the countries it serves.
2. Country Ownership in transition contexts: Transitioning countries emphasized the importance of country ownership during the review process. These countries are moving toward greater self-sufficiency in managing their health programs, and they expressed the need for reviews that respect their leadership while ensuring continued oversight. Some stakeholders suggested that the TRP’s role should evolve to become more of a technical advisory function rather than a comprehensive assessment, supporting countries in navigating the challenges they face during the transition.
3. Capacity of the secretariat and technical partners: There was also feedback regarding the capacity of the Secretariat to provide the necessary technical oversight. As technical partners face diminishing resources, the Secretariat will play a more prominent role in supporting countries and ensuring that their requests are aligned with Global Fund priorities. Stakeholders stressed that this reinforces country ownership, as countries will be able to access support from trusted, local partners who understand their specific challenges.
4. Clarity and transparency: The importance of clarity and transparency in the revised review process was underscored. Stakeholders called for clear, transparent criteria for when a full review is required versus when a streamlined or tailored review would be sufficient. This is particularly important for ensuring that countries can make informed decisions and feel empowered to manage the review process based on their specific needs and priorities.

Figure 1: Objective of the proposed updates to the TRP Terms of Reference

Key aspects of the evolving TRP Model

The revised TRP model incorporates several significant changes that are designed to improve efficiency, flexibility, and oversight. These aspects are grounded in extensive discussions and consultations with stakeholders, who expressed the need for a more tailored, context-specific approach.

1. Differentiated review model: The new model introduces a differentiated approach to TRP reviews based on country and portfolio types. High-impact and core countries will continue to undergo a full TRP review. However, focused and transition countries will only be reviewed if certain pre-determined criteria are met. This aims to reduce the burden on smaller or lower-risk portfolios, while ensuring that technical oversight is still available when necessary. Stakeholders emphasized the need for a flexible framework that could quickly adapt to the unique challenges of focused or transition countries.
2. Program continuation: Previously, even well-performing programs that were continuing from the previous cycle were subject to a full TRP review. Under the new model, if a program meets certain criteria - such as positive portfolio performance and alignment with global targets - a full review may not be necessary. This is a response to feedback from countries and the Secretariat, who argued that the previous approach was redundant and overly burdensome for programs with proven track records.
3. Small and transition portfolios: The new model also introduces a more flexible approach for small portfolios and countries in transition, which represent a lower share of Global Fund allocations. These countries will no longer automatically undergo a full TRP review but will have the option to request reviews based on specific needs or concerns. Stakeholders representing countries in transition expressed concerns that these smaller portfolios could be overlooked in previous models and emphasized the importance of ensuring that technical oversight remains robust in such contexts.
4. Expertise and flexibility: The new model maintains the TRP’s commitment to a high level of expertise but emphasizes the importance of flexibility. This flexibility is essential for ensuring that the TRP can respond to emerging priorities, such as the introduction of new health technologies or urgent health crises. Stakeholders stressed that this flexibility is crucial for addressing fast-moving issues in global health while maintaining the TRP’s reputation for rigorous, independent review.

Figure 2 : Proposal to adapt the TRP through a differentiated review model

Stakeholder feedback: engaging the broader community

Throughout the revision process, stakeholder feedback highlighted the interdependence of the TRP and country ownership, with many stressing that the TRP’s role is to empower and support countries, not replace their leadership. Several important insights emerged from the consultation:

1. Credibility and Independence: Many stakeholders expressed concern about preserving the credibility and independence of the TRP review process, especially with the introduction of a more differentiated model. It was emphasized that the TRP must maintain its impartiality and technical rigor while also being responsive to the needs of countries. This balance ensures that the TRP can continue to offer valuable, independent advice while respecting the ownership of the countries it serves.
2. Country Ownership in Transition Contexts: Transitioning countries, in particular, emphasized the importance of country ownership during the review process. These countries are moving toward greater self-sufficiency in managing their health programs, and they expressed the need for reviews that respect their leadership while ensuring continued oversight. Some stakeholders suggested that the TRP’s role should evolve to become more of a technical advisory function rather than a comprehensive assessment, supporting countries in navigating the challenges they face during the transition.
3. Capacity of the Secretariat and Technical Partners: There was also feedback regarding the capacity of the Secretariat to provide the necessary technical oversight. As technical partners face diminishing resources, the Secretariat will play a more prominent role in supporting countries and ensuring that their requests are aligned with Global Fund priorities. Stakeholders stressed that this reinforces country ownership, as countries will be able to access support from trusted, local partners who understand their specific challenges.
4. Clarity and Transparency: The importance of clarity and transparency in the revised review process was underscored. Stakeholders called for clear, transparent criteria for when a full review is required versus when a streamlined or tailored review would be sufficient. This is particularly important for ensuring that countries can make informed decisions and feel empowered to manage the review process based on their specific needs and priorities.

Comparative presentation: Previous approach vs. Revised approach

Analytical summary: logic behind the changes and their implications

According to the document proposed by the Strategy Committee and approved by the Board, the suggested changes to the TRP model reflect a strategic shift towards efficiency, responsiveness, country ownership and flexibility, while maintaining rigorous independent review.

The differentiation of review processes based on portfolio type is driven by a recognition that not all countries or programs require the same level of scrutiny. High-impact countries, with established systems, will benefit from streamlined processes, while focused or transition countries will have the opportunity for tailored reviews as needed.

The revised model also aims to address stakeholders' concerns regarding the independence of the TRP and its expertise.

By ensuring that reviews are conducted based on transparent criteria and by reinforcing the Secretariat’s role in providing technical oversight, the Global Fund aims to balance flexibility with accountability.

Conclusion: key takeaways

The evolution of the TRP model could be a key step in the Global Fund's ongoing efforts to improve the efficiency and country ownership. Key takeaways from the revision process include:

• A differentiated review approach that balances the need for rigorous oversight with the realities of diverse country contexts.
• Program continuation reviews will be streamlined, acknowledging the proven success of well-established programs and promoting local leadership.
• Small and transition portfolios will receive tailored reviews, reflecting the unique challenges faced by these countries while reinforcing their ownership of health programs.
• The revision places a strong emphasis on the interdependence between the TRP and country ownership, ensuring that countries have the technical support they need to sustain and improve their health systems over the long term.
  

It is to be hoped that this evolution will truly reflect the Global Fund's commitment to ensuring that its resources are used as effectively as possible, focusing on areas where they can have the most significant impact, while ensuring that countries retain ownership and responsibility for their health programs. Ultimately, it will be in the field where we will see whether these changes achieve the desired outcomes.