Peter Sands delivered his first report as Executive Director to the Global Fund Board, on the first day of the 40th Board meeting held on 14–15 November in Geneva, to an appreciative and warmly supportive set of responses from Board delegations.
Sands struck a business-like yet warm tone, embodying his broader commitment to “efficiency and effectiveness” in delivering a concise version of his 30-page Report to the Board, which had been circulated among Board members almost two weeks in advance of the meeting along with other Board papers.
Sands began his address by saying that in his eight months at the Fund so far, what has made the most powerful impression on him have been the opportunities he’s had to be in the field, “meeting people who have been affected by the three diseases and those who are in the front line working to help them.”
In mentioning a few specific examples – a mother “beaming with joy” because her youngest child was protected from malaria, a woman with MDR-TB describing being thrown out of her job, her home, and her family, and a health-care worker being regularly beaten up by her boyfriend – Sands evoked not just the direct disease-related challenges but the complexities of the broader, inter-related challenges of grant programming and implementation.
Any Executive Director’s first address to the Board must give an overview of the Global Fund’s past, present and future, must finesse the breadth and complexity of activities in the organization’s scope, and must express the new leader’s point of view on the range of issues facing the Fund. In doing so, Sands hit a range of required notes, whipping through his summary version of the report in less than 30 minutes, and mentioning only a few of the main points within each section of the written report: (1) the ‘state of the fight’, (2) ‘scaling up and stepping up’, (3) ‘transforming for efficiency and effectiveness’, and (4) ‘2019 and the path forward’.
Some of his points in the first three sections were:
- If [we] don’t “turn off the tap” of new HIV infections (two million per year), address the TB case identification and treatment gap (four million out of ten million cases per year), and “get on top of the transmission dynamics” for malaria, the Fund will not achieve its ambitions;
- Underpinning addressing these “gaps” is a focus on building resilient and sustainable systems for health (RSSH); Sands pointed out that 28% - or $1 billion – of the Fund’s current grant funding goes towards RSSH, and acknowledged that there are “lots of debates around how we can do this more effectively”;
- On challenging operating environments (COE), sustainability, transition and co-financing (STC) and Country Coordinating Mechanism (CCM) evolution, “none of these are finished pieces but all are significant steps in our taking a more effective and coherent approach to our work”
- The Global Fund’s office move to the Global Health Campus is already enhancing cooperation with partners, and the Fund has taken a galvanizing role in global health leadership in working “particularly closely” with WHO and Gavi in crafting the SDG 3 Global Action Plan.
2019 and beyond
Under the fourth section, Sands outlined the Fund’s five main priorities for 2019. First, a successful Sixth Replenishment (“we have to put our delivery in the context of the [Global] Action Plan particularly for SDG 3”). Second, driving impact in the current grant cycle, including addressing issues and challenges in the implementation of the STC policy. Third, preparing for the next cycle of grants, including making decisions in May 2019 on allocation methodology, and balancing prescriptiveness with CCM flexibility. Fourth, “a tight focus on efficiency and effectiveness,” with “new leaders who can lift our game” (here Sands mentioned Francois le Pape as Chief Financial Officer, Francoise Vanni as Head of External Relations, Philippe Francois as head of Sourcing and Supply Chain, and Michael Johnson as Chief Information Officer).
Under his last priority for 2019, Sands emphasized a focus on investing in people – “a key asset of the Secretariat” – by undertaking four complementary activities: a rewards and benefits review, piloting and rolling out strategic workforce planning, reinforcing the Fund’s performance management approach, and developing a systematic approach to talent acquisition and development.
Reflections and Conclusions
The most distinctive part of both Sands’ presentation to the Board and the written version came in the fifth section of his report, in which he expressed his own observations.
In the written report, Sands described “the fundamental tension between the scale of our ambitions and the extent of our resources”; the “disconnects between the debates that dominate global conferences, and the practical realities of in-country implementation,” and the “huge scope for innovation” across a range of activities and actions from decision-making to mobile-phone technologies.
In his spoken, summary version delivered to the Board, Sands built on these points, saying that he thought the Global Fund was “at a ‘crunch point’.” The Fund should “step up and embrace the challenge of SDG3”, he said, “step up and do what it takes the end the three epidemics – because that can be done,” and can “step up to become more innovative, more collaborative, a bit more willing to take risks with who we partner with, and innovate”.
Before thanking all constituencies for their “energy, determination and passion for the mission," Sands said, “The Global Fund was a mold-breaking departure. It was an extremely practical, powerful statement of global solidarity translated into something very real and with huge impact. We need to make sure we keep that level of ambition and boldness in how we approach things.”
Board Document GF-B40-04 (Report of the Executive Director) should be available within two weeks at www.theglobalfund.org/en/board/meetings/40.
Editor’s note: This article is dated 15 November, which is when this article was uploaded into our automated system. The article was not published until 16 November, the day following the Board meeting. This respects our agreement with the Global Fund concerning when we publish articles that are based on the content of the Board papers.
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