TRP recommends MARP stream be continued in future rounds The Technical Review Panel (TRP) says that it is concerned about new applications for funding being submitted when lessons on implementation have yet to be drawn from the applicant's existing grants. This is one of the many observations made by the TRP in its report on Round 10 proposals. The TRP has raised this issue several times previously. In its report, the TRP said it is urgent that this issue be addressed before Round 11. The TRP “strongly recommended” that the Global Fund Board clearly define the rules for applying for new funds on a repeat basis, especially in situations where countries have an unsigned grant or are in the early stages of a recently signed grant. The TRP report covered many topics. We present a few highlights below. Readers should consult the full report to obtain more information. Consolidated proposals: The TRP said that the experience with consolidated proposals in Round 10 was, overall, “positive.” In general, applicants did a good job addressing the weaknesses of existing programmes, of explaining how these programmes would be modified, and of distinguishing between existing activities and (proposed) new activities. MARPs proposals: The TRP said that the quality of the proposed interventions for most-at-risk populations (MARPs) was greatly enhanced in Round 10, not only in MARPs proposals themselves, but also in other HIV proposals. The TRP attributes this to a greater focus on this topic brought about by the introduction of a separate reserve for MARPs funding. The TRP recommended that the MARPs stream be retained in future rounds, and possibly expanded.

Removal of a limited set of elements: In Round 10, compared to prior rounds, the TRP had increased authority to recommend a proposal for funding conditional upon the removal of a limited set of elements. The TRP exercised this authority, removing a total of about $96.5 million from the lifetime budgets of 14 proposals. (See “TRP Removed Parts of 14 Round 10 Proposals Recommended for Funding,” in GFO 138.) The TRP said that decisions concerning the removal of elements would be better made when the applicant is responding to requests for clarification from the TRP. The TRP said that removing specific elements was especially challenging in the case of consolidated proposals; the TRP recommended that the Global Fund Secretariat provide clearer guidance to both applicants and the TRP on the removal of specific elements from consolidated proposals for Round 11.

Human resources: Noting that significant funding is requested for human resources, the TRP said that the way compensation is currently addressed in Global Fund financing could lead to “mismanagement, ‘internal brain drain’ and, potentially, destabilization of the rest of the health care system.” The TRP recommended that, before Round 11, the Global Fund set strict rules for compensation. The TRP also recommended that, in their proposals, applicants provide a strategy on how they plan to try to retain their current health workers. In addition, the TRP recommended that all in-service training requests be based on a training needs assessment and include a plan for a training impact assessment. Finally, the TRP recommended that impact indicators be developed to measure the effect of training efforts. Financial gap analysis: The TRP said that “too often” applicants “fail to present a robust and accurate financial gap analysis.” The TRP recommended that, before Round 11, technical partners provide support to countries in developing clear, detailed and evidence-based financial gap analyses for the diseases and for the health sector. This could include supporting countries with costed national strategies and strategic plans, as well as forecasting pipelines from national and other sources. Other topics covered in the TRP’s report were the role of U.N. agencies, performance and evaluation frameworks, grant performance reports, cost-sharing, technical assistance and translations. The “Report of the Technical Review Panel and the Secretariat on Round 10 Proposals” is at www.theglobalfund.org/en/trp/reports.