11 Mar 2010

The Global Fund Board has approved two of the nine Round 9 proposals whose original rejection had been appealed by the applicants. The newly approved proposals are an HIV proposal from Pakistan that will cost $11.9 million and a TB proposal from Ukraine that will cost $34.6 million (costs are for the first two years). The approvals are subject to a number of requests for clarification being successfully responded to in a timely manner.

To be eligible for appeal, a proposal has to be have been turned down for funding in two consecutive rounds. Twenty-six proposals met this criterion in Round 9, but appeals were filed for only nine of these. The unsuccessful appeals were from Brazil (HIV), Burkina Faso (HIV), Cameroon (HIV),

Columbia (TB), Djibouti (TB), Kenya (malaria) and Nepal (HIV).

The appeals were reviewed by an Independent Appeal Panel (IAP), comprised of two members of the Technical Review Panel (TRP) together with three experts, one from each of Roll Back Malaria, the Stop TB Partnership and UNAIDS. The experts served in their personal capacities. The two TRP members had not been primary or secondary reviewers of the proposals under appeal.

With respect to the successful appeal from Ukraine, the IAP found that the TRP had made a number of errors concerning most of the weaknesses it identified on the TRP Review Form. On balance, the IAP concluded, the proposal had only one major weakness and a few minor ones, which did not justify the TRP's Category 3 classification. The IAP recommended that the proposal be re-classified as approved, under Category 2.

With respect to the successful appeal from Pakistan, the IAP found that the TRP had made a number of errors when it identified the major weaknesses of the proposal which, when taken together, "constitute a significant and obvious error by the TRP." The IAP recommended that the Pakistan proposal be re-classified as approved, under Category 2. (The recommendation applies only to the disease part of the proposal. The original rejected proposal included a health systems strengthening [HSS] component, but Pakistan did not appeal that part.)

NSA appeals

The IAP also reviewed appeals from the two applicants whose National Strategy Applications (NSAs), first learning wave, were not recommended for funding by the TRP. (Five of the seven NSA applications were approved for funding in November 2009.) The appeals were for HIV proposals from Kenya (cross-cutting HSS part only) and Malawi. The IAP rejected both appeals.

Concerning the Kenya proposal, the IAP said that the TRP had correctly identified several fundamental weaknesses, and that while some of the weaknesses could have been dealt with through clarifications, nevertheless the IAP "did not identify a significant or obvious error on the part of the TRP ... that would be sufficient to overturn the TRP's funding recommendation."

The IAP was more emphatic with respect to the Malawi proposal. It said that the TRP had correctly identified several major weaknesses and that the IAP "strongly endorsed" the TRP's findings and the TRP's classification of the proposal as Category 3.

Lessons learned

The IAP said that there were some instances where the language used on the TRP Review Forms was not sufficiently clear. As well, the IAP encouraged the TRP to use more consistent definitions for "major" and "minor" weaknesses.

The IAP recommended that countries be given clear guidance, for both rounds-based and NSA applications, that if they would like an argument or element to be considered by the TRP in their original application, they must include it on the application form itself or in the mandatory attachments. The IAP said that any additional annexes provided by the applicant do not constitute the core part of the application, and are only for elaboration or clarification of specific topics already adequately discussed in the application. The IAP recommended that applicants strictly limit the number of additional annexes to those necessary to support information provided in the body of the proposal; and it said that applicants should assume that annexes not specifically summarised and referenced in the proposals will not be reviewed by the TRP.

The IAP said that applicants should be reminded that Global Fund rules prohibit the introduction in an appeal of new information or new justification for what was contained in the proposal. The IAP said that there were a number of instances where political letters of support were included as attachments to the Appeal Form; the IAP considered that these letters were both new information and inappropriate.

Specifically with respect to NSAs, the IAP recommended that applicants pay particular attention to two key issues:

  1. The NSA is a two-step process, with a strategy review identifying critical issues of the national disease strategy prior to the preparation of the NSA itself. Each critical issue found during the strategy review must be addressed in the NSA along with a concrete set of actions likely to overcome the problem.
  2. The NSA is a request for support to implement portions of the national disease strategy. Accordingly, the application must describe the implementation arrangements in more detail, not merely repeat the strategy. This includes providing information on the actions to be taken, on who will implement them and how, and on the resources required for implementation.

The information for this article was taken from the "Report of the Independent Appeal Panel for Round 9 Proposals and the First Learning Wave of National Strategy Applications," which should be available shortly on the Global Fund website at www.theglobalfund.org/en/trp/appeals.

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