Since I wrote my first article on the Global Fund Operational Policy Manual (GF OPM) an updated version (Issue 2.35) was published on 11 March 2022.  Guess what?  The only changes are to the introduction that I had written about.  Sorry to bore you by looking again at this section but I think it is interesting to see what updates have been made.

It begins by adopting my suggestion that the heading is ‘a note to external readers’ (no longer ‘external users’).  It also now provides readers with contacts for enquiries.  Good so far.  Then comes the bad news: “The Global Fund reserves the right to interpret the OPNs and Procedures set out in the Operational Policy Manual”.  I understand that policies and procedures may be adapted in the light of experience and changing circumstances and the manual then needs updating; but to state that there is a right to interpret the OPNs and Procedures introduces doubt.  Other must have the same right of interpretation but the purpose of the manual is to explain clearly to users the organisation’s policies and procedures and not leave aspects open to interpretation.

There is still no table of acronyms.

The introduction now has only one table which is explained (so long as the reader is fully acquainted with Global Fund terminology).  It then moves on to Section 1: Access to Global Fund Financing.  This too has been suitably reworded.

Let us now move on to where I left off in my previous article.

The next section deals with determining the funding request and review approach.  It explains that “Based on agreed differentiation triggers, the Grant Approvals Committee (GAC) will determine the most suitable type of funding request and corresponding review approach for each country component …”  It does not explain what the ‘differentiation triggers’ are or who ‘agreed’ them.

Five types of application and review approaches are then listed:

1. A request and review that is Tailored for Transition that applies to a country that is: receiving transition funding; or ii) is projected to move to high income; or iii) previously received transition funding and has become re-eligible and received an allocation; or iv) is using a transition workplan as the basis of its funding request; or v) is requested by the Global Fund to submit a tailored for transition funding request because of contextual considerations.  There are three other policy/guidance documents that are referenced for this type of application.
2. A request and review that is Tailored for a National Strategic Plan (NSP) when a country is invited by the Global Fund to apply using the NSP as the primary application source.
3. A request and review that is Tailored for Focused Portfolios when a country is categorized as Focused as per the Global Fund differentiation framework and is not selected to use the Tailored for NSP or Tailored for Transition approaches.
4. The Program Continuation approach when a country (based on criteria to be determined by the GAC) can access the allocation through a streamlined process for program continuation, which significantly reduces the level of effort by the applicant, the Secretariat and the TRP during the application and review stages.
5. A Full Request and Review aimed at a comprehensive overall review of a country’s investment approach and strategic priorities and applies to the following country components: (a) High Impact and Core country components that are not eligible for Program Continuation; and (b) High Impact and Core country components that are not invited to submit a tailored for National Health and Disease-Specific Strategic Plan (NSP) application.

More could be said about the Tailored for an NSP approach because the explanation for this approach states that “the invitation will be based on defined criteria” but the criteria vary, and the examples provided do not include quality.  In my experience, most countries claim to have an NSP, but they are often not relevant, either because they will be out of date by the time the grant actually applies, or they were prepared more than five years previously and need updating.  Moreover, some NSPs some present more of a desirable shopping list of aims and activities rather than a practical plan of action with measurable time-specified outputs and achievements.  Hence, this is why many performance frameworks are weak because they are hurriedly created merely to meet the funding request preparation and submission requirements.

Section II describes the processes that applicants must follow to develop and submit their funding requests.  It begins by stipulating that “an ongoing and inclusive country dialogue must form part of the grant lifecycle” and then outlines the types of support for the country dialogue.  What is noticeable here – and throughout the OPM – is the reference to ‘the Secretariat’.  A manual should be more precise about who – person (title) or group – is responsible for a function and what they can and cannot do, and not simply refer to everyone employed by the Global Fund.

It then goes on to explain the ‘program split’ – by which is meant the split of the country funding allocation between the disease programs – before eventually dealing with the development and submission of the funding request.  It is the applicant who confirms or proposes a revised program split and then proceeds to develop and submit the funding request following the guidance set out in the Global Fund Applicant Handbook 2020-2022.  Since this entire section is about the steps being taken by applicants it is surprising that there is no mention at all of the Applicant Handbook.

This is all the more surprising when we read the statement that “When developing the funding request, applicants should be mindful of the below elements:”.  Twelve elements are then listed and explained:

1. Alignment with national strategies.
2. Implementers.
3. Currency.
4. Compliance with the sustainability, transition and co-financing policy and related requirements:

1. Focus of application;
2. Co-financing;
3. Transition planning and preparedness; and
4. Strengthening sustainability.

5. Resilient and sustainable systems for health.
6. Challenging operational environments.
7. Streamlining grant operations and portfolios.
8. Leveraging joint investments.
9. Considering payments for results models.
10. Lessons learned, evaluations, results and key risks.
11. Progress on issues raised by the Technical Review Panel (TRP) and GAC in the previous allocation period.
12. Prioritized above allocation request (PAAR).

Since we are told that applicants must be mindful of these elements, it is interesting to compare these elements with the Applicant Handbook in which we find the order of the topics under the section ‘Components of the Funding Request Application’ to be:

1. Context.
2. Funding request and prioritization.
3. Operationalization and implementation arrangements.
4. Co-financing, sustainability and transition.
5. Essential data tables.
6. Prioritized above allocation request (PAAR).
7. Programmatic gap table.
8. Funding landscape table.
9. Performance framework.
10. Budget.
11. Country Coordinating Mechanism (CCM) endorsement of the funding request.
12. CCM statement of compliance.
13. National strategic plans.
14. Implementation arrangement map.
15. Co-financing documentation.
16. Sustainability and transition related documents.

It is baffling how different these lists are; note, for example, that the first list omits the budget and performance framework, two essential components that are often weak.  Surely there should be only one list: that which is to be used by applicants while, for each element, the OPM should provide guidance to Country Teams on what they need to be mindful of and what advice they can and cannot give to the CCMs and to whoever is preparing a funding request.  At present there is confusion because the OPM tells the reader what the applicant is supposed to be doing and how the Global Fund views each of the elements.  However, this is not how it is explained in the Applicant Handbook, and it is not always clear what the Country Team should do to help keep an applicant on course in the funding request development stage.

Note too that the first list also includes the following references which are not mentioned in the Applicant Handbook:

• Additional safeguard policy.
• Operational policy note on risk management.
• Guidelines on Implementers of Global Fund grants.
• Sustainability, transition and co-financing policy.
• Sustainability, transition and co-financing guidance note.
• Operational policy note on co-financing.
• Operational policy note on challenging operating environments.

More attention needs to be given to establishing a clearer synergy between the OPM and the Applicant Handbook with the former including clear instructions on the guidance to be provided to applicants and by whom.  It is no wonder that the preparation of funding requests is such a tortuous process for applicants and time-consuming for Country Teams and the TRP.

In the next article on the OPM we shall look at the funding request review process.