A High Level Panel led by former President Mogae of Botswana and former US Secretary of Health and Human Services Michael Leavitt has recommended in its report, released yesterday, that the Global Fund make some major changes in its structure and working methods. The Panel was established six months ago by the Board of the Global Fund after widespread media publicity about corruption among some grant implementers.
The Panel was given a broad remit to look into the Global Fund's problems and what should be done about them. Much is riding on the report; several donors have delayed making, or implementing, their funding commitments for 2011 and later until they see how the Panel reports and how the Fund responds.
"The panel's report provides a great opportunity to sharpen the focus of the Global Fund and make it fit for the future," said Simon Bland, Chair of the Global Fund's Board. "We commissioned the panel to give us an honest, hard look at the institution from the outside, and that is exactly what we have got." Bland added that the Fund is "totally committed" to making necessary changes.
Among the changes recommended by the Panel are:
(a) Board to specify maximum available funding for each type of country. Before proposals are submitted, the Board should each year determine, based on a "risk-stratification matrix," how much funding it wishes to allocate to each country grouping (based on factors like risk, capacity, burden and funding available from other sources) and/or each programme category and/or each type of intervention. This determination by the board would lead, in effect, to a maximum possible value for each proposal from each country; but that maximum could vary widely from one country to another. (For further details, see Article 5, Recommendations 2 and 4, below.)
(b) Two-stage grant application process. The Global Fund should introduce a two-stage grant application process. Each applicant CCM would first submit a relatively brief concept paper, which the Technical Review Panel (TRP), drawing upon the Secretariat and outside experts as necessary, might then recommend to the Secretariat for "approval in principle," subject to a TRP-specified budget ceiling. When this approval in principle had been received, the relevant PR could, if necessary, then receive relatively modest amounts of "project preparation funds" to help with the building of basic accountability, fiduciary and operations systems. Once such funding (if any) had been put to good use, CCMs whose concept paper had been approved in principle could prepare a fully-fledged grant proposal. Unlike the present situation regarding proposals, this stage would involve active cooperation between the CCM and the Secretariat, with the two parties working together to create a proposal that was in line with the Board-approved concept paper and with sound public-health practice and that had the greatest possible chance of approval. The TRP, in consultation with the Secretariat, would then recommend to the Board whether the proposal should be approved, and what the ceilings should be for various budget items. The Board would make the final approval. (See Article 5, Recommendation 4, below.)
(c) OIG to focus on recent years: The Office of the Inspector General (OIG) should primarily focus, in its audits and investigations, on Round Six (2007) and later - though it must not ignore "significant" wrongful acts that occurred prior to then. (See Article 5, Recommendation 1, below.)
(d) OIG publication of reports: The OIG should continue to publish its reports on its audits; it should be selective in what it makes public from its investigations; and, in line with international best practice, it should not publish its audits of internal business practices within the Secretariat. (See Article 5, Recommendation 1, below.)
(e) Procurement: The Fund should insist on pooled procurement, and on the outsourcing of drug storage and delivery, except where the Fund certifies that one or more local institutions are available to perform these tasks according to appropriate standards. (See Article 5, Recommendation 2, below.)
(f) The Board: The Board should focus on high-level issues. It should replace its existing committees with an Audit Committee, an Investment Committee, and a Finance Committee. The Audit Committee should oversee the work of the OIG; a majority of the committee's members should not be board members or members of board constituencies; and one of these independent members should serve as the committee's chair. (See Article 5, Recommendation 3, below.)
(g) Staffing: The overall ratio of Country Program staff (Fund Portfolio Managers (FPMs) and others) to other staff within the Secretariat should increase. The most-experienced FPMs should work on the most difficult and most risky countries. FPMs should be empowered to make far more decisions than at present. The Fund should continue not to have offices in implementing countries, but FPMs should spend a higher proportion of their time visiting the countries whose grants they oversee. (See Article 5, Recommendation 5, below.)
(h) EMT: The Secretariat's Executive Management Team (EMT), which reports direct to the Executive Director, should be reinforced, should be given clear terms of reference, and should be the body that makes major decisions on grant-making. (See Article 5, Recommendation 5, below.)
(i) Results: The Global Fund should "get serious about results." It should focus on outcomes, not inputs. To assist with M&E, it should mandate and underwrite simple (such as mobile phone-based) data-tracking and -management systems in the field. (See Article 5, Recommendation 6, below.)
The Global Fund's Board will hold a special meeting on 26 September to consider the findings of the Panel and to prepare an action plan. Then at its regular meeting in November, the Board will consider larger changes to the Fund's governance structure, strategy and work processes.
The Panel's seven members come from Botswana, USA, Egypt, Colombia, Germany, Australia and France. The Panel has a support team of ten, none of whom work for the Global Fund. In the course of its work, the Panel reviewed very large numbers of documents (particularly regarding a "representative sample" of 40 countries that it examined in depth), conducted hundreds of interviews, and travelled to 13 countries.
The High Level Panel's 149-page report, "Turning the Page from Emergency to Sustainability," is available at www.theglobalfund.org/en/highlevelpanel.