As mentioned in Article 2, the Global Fund and the Global AIDS Vaccine Alliance (GAVI) will develop a joint proposal form for cross-cutting health systems strengthening (HSS) activities in time for use in Round 11. In November 2009, GFO reported on earlier steps in this initiative; see the item on "Common Platform" in Issue 111 (available at www.aidspan.org/gfo). This article provides updated details.
The health systems funding platform initiative now has two tracks, with one track containing two options, as illustrated in the table below.
Table: Health Systems Funding Platform Initiative
Track 1: Harmonisation based on existing investments
Track 2: Developing a new platform
Option 1: Joint GAVI and Global Fund HSS proposal
Option 2: Funding for HSS based on national health plans
Work is underway on Track 1. Three funding agencies - GAVI, the World Bank and the Global Fund - and the World Health Organization (WHO) will undertake assessments and streamline processes in 3-5 countries where the funding agencies already support HSS activities. The purpose is to harmonise programming among the funding agencies in four areas: reprogramming of current HSS support to achieve greater complementarity; development of a common HSS performance framework; development of common approaches to programme oversight; and coordination of HSS technical support and capacity building mechanisms.
Track 2, which the Board approved at its meeting last week in Geneva, involves testing and further developing two concepts that the Global Fund has been considering for some time: joint proposals, and funding based on national health plans.
Under this option, the Global Fund and GAVI will prepare a joint proposal form. Countries could then use this form to (a) apply through the CCM to the Global Fund; (b) apply to GAVI; or (c) apply jointly to the Global Fund and GAVI. Under this last scenario, applicants would be required to indicate how much funding they are requesting from each agency.
Joint applications will be reviewed and recommended for funding by a joint committee made up of members of the Global Fund's TRP and GAVI's Independent Review Committee (IRC). Grant negotiations would be done according to each agency's existing grant negotiation cycles and practices.
Note that even after this option becomes available, which will likely be at the time of Round 11, the Global Fund plans to keep its existing HSS channels open.
Funding based on national health plans
This option involves a pilot project that will be launched in 2011 in 4-5 low-income countries by the Global Fund, GAVI and the World Bank. This is how the pilot project is expected to work:
- The national health plans of participating countries will be jointly assessed by a committee that includes TRP and IRC members. CCMs will participate in the development of the national health plan and take part in the assessment.
- Following the assessment, and the finalisation of the national health plan, the participating country will submit a formal funding request, with the national health plan as the key document. For this purpose, a short joint proposal form will be developed. Proposals can be submitted to the Global Fund, GAVI, the World Bank and other partners, indicating the financing gap, areas where funding is required, and the amount requested from each partner.
- Requests for Global Fund funding can be submitted by the CCM or by a health sector coordinating committee that meets the Global Fund's six minimum requirements for CCMs. Each proposal would be assessed by the agency that receives it. For the Global Fund and GAVI, this could include a joint TRP/IRC review.
There are several issues that are not yet resolved - such as the scope of Global Fund support for HSS, and what the implications are for the workload of LFAs. The Global Fund will continue to refine its plans for the pilot project.