When, on 15 June, The Global Fund Board adopted a new key performance indicator (KPI) framework (see GFO article in this issue), it also approved 12 strategic KPIs. The strategic KPIs form the top tier of a three-tiered framework. This article contains a description of the strategic KPIs. Note that although the indicators were approved, the targets have yet to be developed. They are scheduled to be adopted at the Board’s last in-person meeting in 2016.
The 12 KPIs have been divided into five categories:
- KPIs tracking the Fund’s mission-level strategic targets;
- KPIs tracking Strategic Objective 1: Maximize impact against HIV, TB, and malaria;
- KPIs tracking Strategic Objective 2: Build resilient and sustainable systems for health
- KPIs tracking Strategic Objective 3: Promote and protect human rights and gender equality; and
- KPIs tracking Strategic Objective 4: Mobilize increased resources.
Mission-level strategic targets
KPI 1 - Performance against impact targets
This indicator will gauge performance according to the number of lives saved, and reductions in new infections. The targets for this KPI will be aligned with modelling developed with partners, and the replenishment result. The Board has been told that data for this KPI is reported with a one-year lag as a result of partner schedules and “is sensitive to changes to the modelling methodology and changes to historical data.”
KPI 2 - Performance against service delivery targets
This indicator tracks progress of the Fund towards meeting 17 disease-specific targets, including number of people on antiretroviral therapy, the number of notified cases of TB, and the number of long-lasting insecticide-treated nets distributed to at-risk populations. The Board has been warned that data quality could be a challenge for this KPI. To address this, it is proposed that data collected for some indicators is focused on a subset of countries, and that data systems in these countries be strengthened.
(KPIs 1 and 2 will be complemented by further data reported through the two lower levels of the framework. These will provide details of how national programs have invested money from the Fund, data on health systems strengthening, and results attributable to investments by domestic, Global Fund and other major sources of finance.)
Maximize impact against HIV, TB, and malaria
KPI 3 - Alignment of investment and need
This indicator is designed to track how well investment decisions match country need, in terms of disease burden, and the country’s economic capacity. It will monitor how effective the Fund is at investing in countries with most need, rather than in countries best able to absorb the financing.
KPI 4 - Investment efficiency
In conjunction with KPI 3, this indicator monitors whether funding decisions maximize the Fund’s impact. It will be measured as the change in cost per life saved or infection averted.
KPI 5 - Service coverage for key populations
This KPI focuses on people affected by low coverage of prevention services and high rates of infection. It will track how well the Fund is reaching these populations with appropriate treatment and prevention services.
Build resilient and sustainable systems for health
KPI 6 - Strengthen systems for health
This indicator will measure the progress made in strengthening priority areas of countries’ health systems. It will aggregate data from a number of linked implementation KPIs.
KPI 7 - Fund utilization
This indicator looks at whether the full allocation of funds is being used to deliver services that increase program impact. It measures whether health systems are strong enough to achieve this, by monitoring the extent to which countries can use their allocation and whether programs can spend the budgeted funds.
Promote and protect human rights and gender equality
KPI 8 - Gender and age equality
This indicator will focus on the HIV incidence in women aged 15 to 24 years. It will record how well programmes targeting women and girls lead to a reduction in new infections in selected countries.
KPI 9 - Human rights
This indicator will monitor progress towards establishing programs that reduce human rights barriers to services. It will focus on 15-20 priority countries. In middle-income countries, it will examine the scale-up of programs that reduce human rights barriers for key populations. In countries likely to transition out of Global Fund support, it will measure how well governments support and take over programs that reduce these barriers.
Mobilize increased resources
KPI 10 - Resource mobilization
This KPI remains largely intact from the 2014-2016 KPI Framework. It will measure how much success the Fund is having in getting pledges from public and private sources. It will measure actual pledges as a percentage of the replenishment target, and as a percentage of forecast contributions.
KPI 11 - Domestic investments
The Global Fund is of the view that domestic investment is needed to speed up the end of HIV, TB, and malaria epidemics and to foster sustainable programs. This KPI will track the percentage of these commitments that are actually fulfilled by governments.
KPI 12 - Availability of affordable health technologies
This KPI assesses how effective the Global Fund has been at increasing the affordability and availability of key medicines and technologies. To measure availability, it will work out how many products in a defined set are available from at least three quality-assured manufacturers. For affordability, it will measure the annual savings made through the pooled procurement mechanism.
Information for this article was taken from the “2017-2022 Strategic Key Performance Indicator Framework,” Board Document GF-B35-ER05. This document is not available on the Global Fund website.