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Global Fund Receives Praise for Applying Aid Effectiveness Principles
GFO Issue 149

Global Fund Receives Praise for Applying Aid Effectiveness Principles


David McCoy

Article Type:

Article Number: 5

ABSTRACT An independent evaluation of the International Health Partnership (IHP+), of which the Global Fund is a member, finds that the Fund performs "reasonably well" in applying the principles of the Paris Declaration on Aid Effectiveness.

Independent evaluation of the IHP+ undertaken

Aidspan would like to hear from countries that took part in the evaluation

According to an independent evaluation of the International Health Partnership (IHP+), of which the Global Fund is a member, the Fund performs “reasonably well” in applying the Principles of the Paris Declaration on Aid Effectiveness. For example, the Global Fund scores positively in terms of the predictability of its disbursements and its use and strengthening of country systems for procurement and public financial management.

The International Health Partnership was launched in September 2007 “to better harmonize donor funding commitments, and improve the way international agencies, donors and recipient countries work together to develop and implement national health plans.” Shortly after its launch, it was re-branded as the International Health Partnership “plus related initiatives” (IHP+) to include a number of other health systems strengthening efforts.

Essentially, IHP+ represents the application of the principles of the Paris Declaration on Aid Effectiveness to the health sector. In no other sector was the need to improve aid coordination and harmonisation so great. For example, at the time of the launch, the U.K.’s Department for International Development noted the existence of over 40 bilateral donors and 90 global health initiatives. It also noted that in Zambia, only 10% of donor support was going to the government to support comprehensive health systems, while 90% was going to disease-specific programmes; and in Cambodia, 22 different donors were providing support for health through 109 separate projects.

Twenty-four recipient countries (see box) and an equal number of donors and development partners, including the Global Fund, have signed up to an “IHP+ Global Compact” which commits all of them to a set of principles and mutual accountability standards.

List of recipient countries that have signed the IHP+ Global Compact

Note: Those countries identified with an asterisk took part in the evaluation of the IHP+.

Benin, *Burkina Faso, *Burundi, Cambodia, Cameroon, *Democratic Republic of Congo, *Djibouti, *Ethiopia, Kenya, Madagascar, *Mali, Mauritania, *Mozambique, *Nepal, *Niger, *Nigeria, Pakistan, Rwanda, Senegal, Sierra Leone, Togo, Uganda, Vietnam and Zambia.

Note: In May 2011, three other countries formally joined the IHP+: Chad, El Salvador and Sudan.

Two years ago, an independent and international research consortium, IHP+ Results, was established to conduct an evaluation of the IHP+. Recently, the consortium published its first public report. The evaluation covered the 10 recipient countries (see box) and 15 donors and development partners who were willing to take part in the evaluation.

A set of standard performance measures was developed to track progress. These measures include 10 indicators and targets for recipient country governments, and 12 indicators and targets for donors and development partners. The measures of performance have been used to produce individual scorecards for governments and donors which are publicly available.

It should be noted that there are a number of limitations to the evaluation methodology. First, the evaluation refers to performance in 2009, so the results are somewhat out of date. Second, much of the data used to assess performance was self-reported by the development partners and was not independently verified. Third, performance was often scored according to “progress made” rather than against a common and pre-determined standard of good performance. Thus, if you were previously doing well against a standard performance measure and this standard of performance was maintained but not increased, you may get penalised for not having made “progress.”


Aidspan comment

Despite these limitations, this report represents a significant milestone in efforts to improve the transparency of development assistance for health and the accountability of donors and international agencies. The Global Fund’s overall scorecard can be found here; and its scorecard in each of the ten recipient countries can be found here.

(The Global Fund also performs its own evaluation of its adherence to the Paris Declaration through an annual “questionnaire survey” filled in by principal recipients and validated by local fund agents. The latest results, which can be seen in Annex 10 of the Global Fund’s latest performance report, cover performance in 97 countries for the year 2009. The results have been placed into a scorecard of 13 indicators, nine of which the Global Fund has met or is “on track” to meet. The four indicators for which the GF is “lagging behind” are: “aid recorded in national budgets”; “aid recorded as scheduled”; “joint mission with other donors”; and “joint analytic reports with other donors.”)

In overall terms, while there has been some progress in ensuring more effective donor harmonisation and alignment with country policies and plans, there is still much fragmentation, inequity and inefficiency within health systems across the world; and there are still opportunities to maximise the impact of vertical disease-focused programmes on comprehensive and sustainable health systems strengthening efforts.

The Global Fund is one of the more important development partners operating in the health sector; and its moves in the direction of NSAs, grant consolidation, harmonised reporting systems and health systems strengthening are very much in line with the principles of the IHP+. But more detailed assessments of how Global Fund grants interact with other development partners and with national plans for health systems development and health improvement are needed.

We encourage GFO readers from the countries that took part in the IHP+ evaluation – i.e., Burkina Faso, Burundi, Djibouti, Democratic Republic of the Congo, Ethiopia, Mali, Mozambique, Nepal, Niger and Nigeria – to review IHP Results’ assessment of the Fund’s performance in these countries. Aidspan would like to know if you think this is a fair reflection the Fund’s performance (email us at:

A list of the IHP+ donors and development partners is available on the IHP+ website. The Global Fund’s latest performance report, entitled “Making a Difference: Global Fund Results Report 2011,” undated, is available here.

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