The 400 participants at the Global Fund's Partnership Forum in July 2006 in Durban, South Africa, made recommendations of two main kinds: strategic, and operational. The strategic recommendations were reported in GFO Issue 61. (See www.aidspan.org/gfo.) Now, in this issue, we summarize the operational recommendations.
Most of the following recommendations were developed during breakout sessions by working groups; they were then presented to the plenary and sometimes briefly discussed, but they were not formally adopted. The Fund's Board and Secretariat are free to follow the recommendations, but are not obliged to do so. The wording of the recommendations has been edited by GFO for clarity and for consistency of style. For space reasons, not all recommendations are included. (Note: The draft version of the official Partnership Forum report is accessible at www.theglobalfund.org/en/about/forum/2006. Comments can be submitted to the report's author until 29 September 2006.)
Country Coordinated Mechanisms (CCMs)
The working group on CCMs made the following recommendations designed to strengthen the effectiveness of CCMs:
- CCMs should establish secretariats (where such secretariats do not already exist) and strengthen those secretariats that are already functioning.
- CCMs should ensure that the CCM secretariats are independent of government (and other stakeholders).
- The Global Fund should require that CCMs have in place a constitution and by-laws, prepared with the participation of the various sectors represented on the CCM.
- CCMs should ensure that there is adequate representation on the CCM from the tuberculosis and malaria sectors, including from civil society organisations in these sectors.
- The Global Fund should encourage the rotation of the CCM Chair among the various sectors represented on the CCM.
- The Global Fund should communicate more clearly what the roles and responsibilities of CCM are with respect to monitoring and overseeing the implementation of projects funded by Global Fund grants.
- An independent evaluation should be carried out on civil society participation in CCMs.
In addition, Forum participants discussed the idea of consolidating CCMs and National AIDS Committees, and concluded that further analysis of the advantages and disadvantages of such an approach is required. While the idea has merit, it raises a number of issues, not the least of which is how the responses to tuberculosis and malaria would be accommodated.
Local Fund Agents (LFAs)
Many participants at the Partnership Forum expressed reservations about the effectiveness of LFAs. Specifically, participants said that while LFAs were experienced in accounting and other financial matters, they were usually not experts in evaluating programmes. Participants were also concerned about what they perceived to be poor communications between LFAs and other stakeholders in-country. The working group on LFAs made the following recommendations designed to improve the performance of LFAs:
- LFAs should be retained for financial auditing, but the Global Fund should re-examine the role of LFAs in auditing programme outcomes.
- The terms of reference of the LFA should spell out the formal relationship between the LFA and the CCM and PR.
- The Global Fund Secretariat should perform regular quality assurance reviews of LFAs, with the involvement of CCMs and PRs.
- The Global Fund Secretariat should clarify the communications requirements between the LFA and other stakeholders (particularly the CCM and the PR).
- The Global Fund Secretariat should establish an appeal mechanism for disputes involving the PR and the LFA.
- The Global Fund should establish a limit on the number of grants which an individual LFA is hired to oversee.
Principal Recipients (PRs)
Forum participants expressed concern about what they perceived to be a lack of clarity concerning the mandate of PRs, particularly as it relates to the mandate of CCMs. Participants also said that poor communications between PRs, CCMs and LFAs has led to mistrust and suspicion.
There was a strong consensus concerning the advantages of using multiple PRs to implement projects funded by Global Fund grants. Participants said that the use of multiple PRs enables countries to reach affected communities efficiently and effectively; that an environment of trust among stakeholders is essential to making the multiple PR model work; and that clear and consistent communications among PRs and SRs is essential.
The working group on PRs recommended that the Secretariat clarify communications requirements among the PRs, CCMs and LFAs, and communicate these requirements to all parties.
Civil Society Involvement
The working group on civil society involvement made the following recommendations designed to strengthen the involvement of civil society in proposal development and grant implementation:
- The Global Fund should conduct a formal and independent evaluation of civil society participation in the CCM's proposal development process.
- Civil society organisations should receive funding to strengthen their participation in the CCM's proposal development process.
- Civil society organisations should receive funding to improve their capacity to implement Global Fund grants.
- The Global Fund Secretariat should take steps to improve information sharing and communications between the Secretariat and civil society, and among civil society organisations in different countries.
Private Sector Involvement
Many participants at the Partnership Forum said that the Global Fund was not doing enough to leverage private sector involvement. Private sector participation can assist with management, governance, and processes such as the grant application process. The working group on private sector involvement advanced the following recommendations:
- The Global Fund should acknowledge the potential role of the private sector as an implementing partner bringing additional resources to grant implementation.
- The Global Fund should commit significant additional resources to efforts to raise funds from individuals and businesses.
- The Global Fund should examine opportunities for in-kind product and service contributions from the private sector, at both the Global Fund Secretariat and country levels, and should develop a clear policy on such contributions.
- The Global Fund Secretariat should develop a mechanism for responding to private sector requests for involvement with Global Fund activities at all levels.
Procurement and Supply Management
Almost half of the Global Fund's grant money is spent on commodities. Problems with procurement and supply management cause significant bottlenecks in grant implementation in many countries. The working group on procurement and supply management made the following recommendations designed to address the most common problems:
- The Global Fund Secretariat should, as a matter of urgency, investigate the root causes of procurement and supply management problems.
- The Global Fund Secretariat should improve guidance and mechanisms for drug quality assurance at the local level.
- The Global Fund Secretariat should arrange for the performance of procurement agents to be evaluated.
- The Global Fund should consider using international public procurements agents as a way to lower costs and reduce opportunities for conflict of interest.
The working group on technical assistance made the following recommendations designed to improve access to technical assistance and to make such assistance more effective:
- National action plans should be developed annually to define and prioritise technical assistance needs.
- The provision of technical assistance should be better coordinated and managed.
- Donor agencies should be providing greater resources for technical assistance.
- Donor agencies should cease the practice of requiring that technical assistance be contracted by the donor agencies themselves (where this is still happening).
- Civil society organisations should have greater access to technical assistance.
- Countries should rely less on the use of consultants from the North and, instead, should draw more on Southern experience.
The following additional recommendations were made by the various working groups at the Partnership Forum:
- Wherever possible, PRs should use multiple suppliers to ensure sustainability of delivery, to avoid shortages and to promote competition.
- For grants that are performing well, reporting should not be required more often than every six or 12 months.