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GFO Issue 107



Bernard Rivers

Article Type:

Article Number: 6

ABSTRACT Aidspan invites feedback from GFO readers about how decisions are made on CCMs and, more broadly, about the authority of CCMs.

The Global Fund’s CCM Guidelines state that CCMs should promote a “true partnership,” with all CCM members being treated as equal partners in decision-making. But is this “true partnership” principle a reality on most CCMs? We don’t know for sure because there has not been any extensive research on the issue.

A number of CCM case studies conducted in the last year or so by the Global Fund and by the International Treatment Preparedness Coalition (ITPC) provide some clues. The case studies looked at a number of issues concerning the structure and operations of CCMs, including governance and civil society participation.

The case studies found that on some CCMs, civil society was participating equally and had a significant impact on decision-making. However, on the majority of CCMs the participation of CCM members was not equal and decision-making tended to be tilted in favour of government.

In those cases where participation was deemed to be unequal, the reasons for the inequality varied by CCM, but included such factors as the following:

  • Within the CCM, government wields far more power than civil society organisations (CSOs), and the CCM as a whole tends to be deferential toward government, which is reflective of the culture of the country.
  • Information is hoarded by government and not shared with CSOs.
  • Governments and/or development partners show a lack of respect for CSOs; they do not believe that CSOs bring significant value or deserve to be treated as equal partners.
  • High-level government representation on the CCM is lacking, underscoring the fact that the CCM is not valued by government.
  • Civil society representatives on the CCM are significantly out-numbered by government representatives.
  • The civil society sector is weak, and many CSO representatives lack the capacity to function effectively on the CCM.

In addition, sometimes the CCM as a whole is not very influential. In one of the case studies, for instance, it was found that the CCM did not have the power to influence any decisions concerning Global Fund-related activities in the country. Rather, decisions were made by the PR.

All of this raises some questions about how decisions are made on CCMs and, more broadly, about the authority of CCMs. For example:

  1. What is the status of the CCM? Does it have the authority (as it should) to make decisions about the content of proposals submitted to the Global Fund, to nominate PRs, and to oversee grant implementation?
  2. Does the CCM speak for the country?
  3. How are decisions made on the CCM? Do all members of the CCM participate equally in decision-making? Do all members of the CCM have the opportunity to participate in discussions? Are their voices heard?
  4. How does the CCM make decisions when government wants to do something but the non-government sectors do not?

We’d like to hear your responses to these questions. You can address all of the questions, or just the ones that interest you. To make it as easy as possible for you to provide feedback, you can choose either of the following two methods:

  1. You can send your feedback via email directly to David Garmaise, Senior Analyst, Aidspan, at
  2. You can write to David Garmaise, indicate that you are interested in giving feedback, and provide a telephone number where you can be reached. David will call you and obtain your input over the phone.

Once we have heard from a sufficient number of people, we will summarise the response in a follow-up article in GFO and/or in a separate report. We will not reveal the identities or organisations of those we hear from.

GFO reported on the CCM case studies conducted by the Global Fund in Issues 95 and 101; and on the case studies conducted by ITPC in Issue 99. All three issues are available at

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