Countries in the West and Central Africa region face major challenges in developing concept notes for their next Global Fund grant applications, in the context of the rapid spread of the COVID-19 virus.
Figure 1: Mapping COVID-19 in Africa; image from 17 March 2020
Source: WHO website
While the African continent initially appeared to be relatively spared by the coronavirus, the surge of cases in recent days raises fears of rapid expansion in the coming weeks. The three Maghreb countries (Morocco with 44 cases, Tunisia with 24 cases, Algeria with 60 cases), which are among the most affected so far, are trying to limit the spread and have already closed their air borders, particularly to travellers coming from Europe. Following the discovery of new cases in the Democratic Republic of Congo, in Ethiopia, South Africa, Senegal, and more recently in Côte d'Ivoire, Rwanda, Kenya, and Benin, African countries are taking strong preventive measures: quarantines, bans on meetings, religious holidays, closure of places of worship, schools and universities, cancellation of visas, quarantine of citizens from countries affected by COVID-19 and closure of air borders in some cases.
As a result, many consultants to Global Fund grants were unable to travel to the African countries where they were due to work, because of their nationality or place of residence, especially experts from Europe (France, Germany and Italy).
Since the beginning of the week, the main technical assistance providers involved in supporting Ministries of Health in the preparation of funding requests have suspended their activities, whether Expertise France, a major provider of technical assistance (TA) in the region, or UNAIDS, Roll Back Malaria, and WHO. The TA providers and consultancy firms are now repatriating the consultants still present in the field and asking them to continue their remote support.
This remote coordination will undoubtedly change the nature of the country dialogue process, which is also made impossible by the fact that many countries are not allowed to organise meetings and workshops. Inclusive and in-depth discussions will therefore be almost impossible and meaningful collaboration between consultants and programmes, CCMs and national stakeholders involved in the fight against pandemics is proving very difficult.
Moreover, the ministries in these countries are now very focused on the containment of COVID-19, and it will be hard to mobilize the Ministry of Health staff needed to prevent epidemics in general, including for the three diseases, in the country-dialogue process, at a time when preventing the spread of the coronavirus is the priority of the ministries of health.
Status of funding requests
With respect to Global Fund funding requests for the March window (Window 1 of three in 2020, for the Global Fund’s 2020-2022 allocations), requests are almost complete (the deadline for submission in this window is 23 March), and countries are entering the home stretch: integration of comments and suggestions from Global Fund country teams, validation by national authorities of strategic choices, discussions around co-financing (amount and activities covered). The hasty return of the consultants to their countries of origin has deprived the recipient countries of their support at this critical phase, since most of the decisions taken at this stage are key under close scrutiny by the TRP: co-financing and implementation modalities (choice of Principal Recipients, among others).
But the situation is even more delicate for countries whose funding requests must be submitted by the May window (Window 2, with a submission deadline of 25 May), as almost all the consultants (except national experts) who were supposed to support the countries in the preparation of their funding requests have been sent back home.
Apart from the March 4 ‘New Guidance in Response to COVID-19’ update published on the Global Fund website, we have not seen any real discussion coming out of the Global Fund on what comes next for countries’ funding requests, in light of the coronavirus’s disruption of countries’ ‘normal’ functioning. Even if the decision has already been made to organise a virtual Technical Review Panel (TRP) review of funding requests for Window 1 (the TRP session for Window 1 was originally scheduled for April 29 to May 11), it is most likely that the process of writing funding requests will from now on be very chaotic, and is unlikely to be able to respect any of the Global Fund’s principles of transparent, inclusive and comprehensive country dialogue given the difficulties raised by countries’ restrictions on meetings and people’s movements.
It is clear that the Secretariat is concerned about a delay in the submission of concept notes in Window 2 (as any delay means that there will not be enough time to properly conduct the whole funding request process until the grant agreements are signed before the end of December). While the Global Fund is keen to avoid disruption of services or extremely time-consuming extensions, there is a real risk that funding applications will not meet the necessary quality criteria and will be the result of a very limited consultation process.
The capacity of recipient countries to submit high-quality applications that are approved by the TRP is now the key concern of this discussion. This capacity is all the more necessary as the amounts allocated to the recipient countries in the 2020-2022 allocations are much higher than in the current period, and require a real discussion - especially on resilient and sustainable health systems and the most efficient strategies to eliminate the three diseases.
The African constituencies on the Global Fund Board, aware of what is at stake for their region, have taken the lead, and have developed a statement that is expected to be released today. The statement underscores the unique context in which the fight against coronavirus is taking place, highlighting the efforts made by ministries of health on this continent with still fragile health systems to contain the virus. Finally, the statement requests that the Secretariat propose flexibility measures to allow countries to submit their requests under favorable conditions: By postponing Window 1 (with the March 23 submission deadline) by a few weeks (up to a month), by postponing submissions for Window 2 to the submission deadline date originally scheduled for Window 3 (from May 25 to August 30), and by discussing now the possible extensions of grants from the current funding period to the first quarter of 2021, in order to give countries time to complete the grant negotiation process.
The topic will certainly be addressed at the Global Fund's next Strategy Committee session, which is scheduled to take place virtually on Thursday 19 and Friday 20 March.
The Global Fund Observer and the Observateur du Fonds Mondial will continue to report on this critical issue in upcoming editions. Please send any comments or questions in this regard to email@example.com with “Global Fund and COVID-19” in the subject line.