On 2-3 May 2017, the Regional Center for Technical Assistance (CRAT in its Spanish acronym), which is the host of the Regional Communication and Coordination Platform in Latin America and the Caribbean under the Global Fund’s Community, Rights and Gender (CRG) Initiative, organized a two-day “closing” meeting in Bogota, Colombia.
One of the highlights of the meeting was the presentation of the results from three studies on technical assistance (TA) for grant implementation financed by the Global Fund and provided to CSOs in three countries.
The meeting was billed as a closing meeting because CRAT’s term as host of the Regional Platform ended on 31 May 2017. The Global Fund has issued a call for proposals for the next period. CRAT has submitted a proposal.
The objectives of the meeting were: (a) to provide information on recent changes in Global Fund policies and processes; (b) to report to civil society organizations (CSOs) on CRAT’s collaboration with CRG; and (c) to obtain feedback on the current needs of CSOs and communities in the context of the implementation of the Global Fund’s Sustainability, Transition and Co-Financing (STC) Policy.
CRAT coordinator Anuar Luna said that the meeting helped change the atmosphere among CSOs from discomfort towards the STC policy to acceptance of a reality and a need to move forward to achieve sustainability.
“We observed an evolution from the first regional platform meeting in Lima in 2016, when we started to work on transition and sustainability, to this meeting in Bogotá in 2017,” Luna said. “The level of discussion improved from complaints to action.”
Luna was referring to the fact that while the Lima meeting was characterized by complaints about the STC policy, by the end of the meeting in Bogota, participants were focusing on the positive steps they can take to promote sustainability and ensure that transition away from Global Fund financing is smooth.
A presentation on the STC policy by Global Fund staff during the Bogota meeting led to a very lively discussion on whether eligibility criteria to access funds that is based on per capita income is applicable to a region with the highest inequalities in the world. It was agreed, however, that the time has passed for complaints about the eligibility policy because the policy is not up for discussion at this time. The allocations for 2017-2019 have already been made, with decisions concerning eligibility having been based on the current eligibility policy.
The three countries involved in the studies on TA were Bolivia, Dominican Republic and El Salvador. The objective of the studies was to improve knowledge concerning access, effectiveness and innovation in the provision of the TA.
Below, we provide information on the results from the individual studies. Following this, we provide a summary of findings that were common to all three studies.
In Bolivia, the study found that for HIV and TB, the only CSOs that received TA were SRs; and in all cases the TA was provided by the PRs (i.e. HIVOS and UNDP). For other CSOs, access to TA was difficult. One of the reasons for this is that the national strategic plans and government regulations do not specifically provide for the provision of TA to CSOs.
For malaria, it was different: Some CSOs that were not SRs received TA.
With respect to effectiveness, 70% of the CSOs surveyed expressed satisfaction and said that the objectives of the TA were met. TA was considered effective in terms of improving the skills of people delivering the services; improving the quality of the interventions; and strengthening the core functions of the CSOs themselves.
Only a few TA initiatives were deemed to be innovative. They included an initiative on community surveillance of malaria; and one on program monitoring.
One important finding of the survey was the sentiment expressed by TA recipients to the effect that the decisions concerning what TA is provided should be based on a needs assessment conducted by the CSOs themselves.
TA for CSOs in El Salvador focused on three areas: outreach for prevention; administration and management strengthening; and knowledge management. Similar to the experiences in Bolivia, the TA in El Salvador revealed that the lack of a regulatory framework for the provision of TA hindered access by communities. Only bigger NGOs acting as SRs accessed TA. The study concluded that given that TA is a necessary asset for organizations, not being able to ensure access to TA constitutes a barrier to sustainability.
As was the case with Bolivia, the TA provided to CSOs in El Salvador was seen as being effective. The greatest satisfaction was expressed for TA that provided support to build local networks for the implementation of HIV programs, and TA on advocating for the approval of human rights-based regulatory frameworks for sex work and gender identity. However, some organizations pointed to a lack of follow-up as a major drawback of the TA provided.
TA seen as being innovative included initiatives on sustaining CSOs and community organizations; on advocacy for the regulation of sex work and gender identity; and on project management.
The study in the Dominican Republic found that CSOs had more resources for TA in 2013 than they did in 2016. However, 2016 was the first year that TA was made available to organizations working on TB, which constituted a major achievement. Most TA initiatives examined in the study included a gender perspective, especially regarding issues of sexual diversity, sex work and gender identity. CSOs and communities expressed concerns that their participation in the identification of TA needs has not been meaningful.
Initiatives that were seen as effective were the ones focused on strengthening M&E and quality assurance systems in CSOs, as well as TA provided in the framework of the program implemented by the Latin American and Caribbean Network of Sex Workers (REDTRASEX), which was the only TA that included a systematic follow-up. Initiatives identified as innovative were an online course for sex workers, and training related to the establishment of a Human Rights Observatory for Vulnerable Groups. The objectives of the training for the Observatory included building the capacity of the organization to identify human rights violations, and helping to develop the tools for filing complaints.
There were several findings that were common to all three studies. They were as follows:
- There is a lack of official regulation of TA, which raises questions about who can access the TA. Accessing TA was more difficult for organizations not serving as sub-recipients (SRs).
- There is no system in place to ensure that the results of the TA are widely disseminated.
- There was a consensus that the TA was effective.
- CSOs and community groups are not well prepared to start the transition phase.
- Few TA projects were seen as being innovative.
There are different factors affecting who can receive TA. One factor is the official regulations of the country. Another factor is how each training is organized. The Global Fund advises that, whenever possible, training should be provided to all CSOs participating in the response to the disease, not just SRs. Global Fund TA is provided through PRs. The PRs do not always make the extra effort to include CSOs that are not SRs. This was one of the reasons the Secretariat initiated the studies – i.e. to find out if the trainings were reaching non-SRs. With PRs in newer grants, the Secretariat has been very insistent that the PRs present capacity building plans that include CSOs that are not SRs.
The meeting included a presentation of the Regional Platform’s initiative on “dialogues for transition to sustainability,” and its implementation in Belize, Panama and Paraguay (see GFO article for more details). Participants agreed that this initiative is needed in all countries facing transition because civil society and community groups need to agree on a common position and define a common strategy before the process starts. Requests for implementation of this initiative in other countries, including Bolivia, Dominican Republic and Peru, were expressed.
A panel of speakers presented and discussed initial findings and lessons learned on social contracting in six countries in LAC. Different models of social contracting were presented, giving participants ideas to think about when planning for sustainability. This session included a report on an evaluation of an initiative in one country to integrate community services within the services provided by the public health system.
The meeting gave a space to representatives from Venezuela to update participants on the situation in the country and on the discussion that was about to take place at a Global Fund Board meeting in Kigali, Rwanda concerning whether to provide assistance to Venezuela (see GFO article). The participants showed a high degree of solidarity with their Venezuelan colleagues and a joint communique was signed and sent to the Board.
All documents presented during the Bogota meeting can be found on the regional platform website http://plataformalac.org/. The documents are in Spanish, with summaries in English.