The definition and understanding by applicants to the Global Fund of the concept of value for money is not the same across all countries, according to the Technical Review Panel (TRP). On the Round 10 proposal form, applicants were asked to explain how their proposal constituted good value for money. In its report on the Round 10 proposals, the TRP commented at length on this topic.

The TRP explained how it attempted to assess value for money when it reviewed the Round 10 proposals. Trying to "un-pack" the concept of value for money in a practical way to ensure a consistent approach, the TRP said that it assessed value for money in the context of "how well suited the proposed goods and services are to making a difference in the fight against the three diseases and effect positive change in the health systems." In particular, the TRP considered:

• Given the current situation and local context, as presented in the proposal, did the proposed activities correspond to what needed to be done, and did they reflect appropriate priorities?
• If the activities corresponded to what needed to be done, would they be undertaken in an effective way? (When considering effectiveness, the TRP looked at "how" interventions were to be undertaken - i.e., whether the activities were likely to achieve the desired outcomes and impacts, whether they were coherent and needs-based, and whether they would be sustainable over time.)
• Would the proposed interventions be done efficiently (i.e., were the costs of what was being proposed appropriate)?
• Would the funding being requested truly be additional to existing funding?

The TRP recommended that, for Round 11, the value for money concept be addressed by asking applicants to justify, for each service delivery area, the technical appropriateness of the approaches being proposed, and to provide the evidence upon which the approaches are based. As well, the TRP said, applicants should be required to demonstrate that the most effective interventions are being proposed at the lowest cost. However, the TRP also said that there may be situations where a higher cost could be justified by the applicant based on appropriateness, effectiveness or sustainability.

The "Report of the Technical Review Panel and the Secretariat on Round 10 Proposals" is at www.theglobalfund.org/en/trp/reports.