One of the reports prepared for the Replenishment Meeting in Stockholm next week, discussed above, is "The Global Fund at Three Years" (available at www.theglobalfund.org/en/about/replenishment). This contains some interesting items of information, including the following:
Monitoring the Fund
In assessing its own performance, the Fund will monitor activities and impacts at four levels. Using the Fund's terms and GFO's explanations, these are:
(a) Operational performance - What the Secretariat is doing
(b) Grant performance - What grant recipients and sub-recipients are doing
(c) System effects - What impact the above two have on health systems (and related systems) in-country
(d) Impact - What impact all the above have on levels of disease
As part of measuring and reporting on (a) above, the Fund will, starting this month, post at its web site, with monthly updates, an Executive Dashboard. This will measure five things:
- Resource mobilization (Primarily: Resources contributed as compared to pledges and internal targets for resource mobilization)
- Proposal management (Primarily: Grants signed as a share of the total number of approved grants)
- Grant negotiation (Primarily: The median proposal handling time, from call for proposals to grant signing)
- Disbursement and grant management (Primarily: Actual disbursements compared to disbursement targets)
- Business services (Primarily: Operating and Secretariat costs as a percentage of total expenditure)
LFA study and reform
Late last year, the Fund commissioned a thorough external review of (a) the whole concept of using outsourced oversight; (b) the effectiveness and value-for-money of existing LFA contracts and working arrangements; and (c) the effectiveness, benefits and weaknesses of individual LFAs. From this review came a number of recommendations, which the Fund says it is now implementing through updated work procedures and revised terms for future contracts. Details have not been provided of the actual findings or recommendations.
"In a number of countries, the CCM model is an idea somewhat ahead of its time and has not worked as well as hoped. Some of the problems facing CCMs are due to practical limitations: travel costs, language barriers, lack of organization among constituencies and scarce resources for administration have all hindered the smooth functioning of some CCMs. In others, the government has not been willing to fully include nongovernmental groups in decision-making processes and oversight functions, and this has reduced genuine multi-sectoral participation. ... However, while CCMs in many countries are in need of reform, not even their critics are in favor of scrapping what is a cornerstone of the Global Fund structure and process."
The Fund has developed a simple CCM checklist (available in Appendix 2 of "The Global Fund at Three Years") which "will serve as a tool for yearly self-assessments of CCM composition and functioning, and as a basis for regular sample audits." The Fund has initiated a study that will develop a set of baseline data for all CCMs by June 2005.
A success story
"In the Western Cape, South Africa, pilot programs run by NGOs were already in place treating hundreds of people for HIV/AIDS. Global Fund financing enabled these pilots to be rapidly scaled up, with local governments building on the successful NGO model to treat over 5,000 people - meeting their five-year treatment target in only one year. Global Fund financing was only one piece of the success amongst the concerted efforts of multiple players, but once all the elements were in place, treatment scale-up was very rapid. The Principal Recipient was amazed at the speed of the results and is now focused on scaling up prevention efforts as well as maintaining ongoing treatments."