GRANT IMPLEMENTATION HAS BECOME MORE COMPLEX, SAYS MAJOR TECHNICAL SUPPORT PROVIDER
David GarmaiseArticle Type:
Article Number: 4
ABSTRACT Grant Management Solutions say that the growth of the Global Fund's grant portfolio over the past decade, the transition to single-stream-of-funding grants, and issues raised by the work of the Office of the Inspector General have contributed to a growing complexity in Global Fund grants. This article reports on the work GMS has done with grant implementers and CCMs.
Grant Management Solutions says requests for support from CCMs have never been higher
GMS has provided assistance to CCMs and PRs in 73 countries
Issues confronting Global Fund grant implementers are becoming more complex. The growth of the grant portfolio over the past decade, the transition to single-stream-of-funding grants, and issues raised by the work of the Office of the Inspector General (OIG) have contributed to this complexity, as have the global economic crisis and political events in some countries.
These are some of the statements contained in the 2011 annual report of Grant Management Solutions (GMS), covering the fiscal year ending 30 September 2011. GMS is a major provider of technical support for Global Fund grant implementation, governance and related processes and structures.
In its 2011 annual report, GMS said that the governance and oversight challenges facing country coordinating mechanisms (CCMs) have become acute, and that this calls for “a more energetic commitment to, and capacity for, country ownership, transparency and accountability.” GMS said that the requests from CCMs for technical support have never been higher.
The primary mission of GMS is to provide urgent, short-term technical support to CCMs, principal recipients (PRs) and sub-recipients (SRs). GMS is funded by the U.S. President’s Emergency Plan for AIDS (PEPFAR) and the U.S. Agency for International Development (USAID).
GMS provides support in four technical areas: (1) CCM governance and oversight; (2) grant and financial management by PRs; (3) pharmaceutical and supply management; and (4) reporting, and monitoring and evaluation. The GMS project is nearing the end of its five-year cycle, which started in 2007. However, a similar multi-year project is expected to be launched early this year.
When the U.S. Congress approved funding for the Global Fund, it decreed that up to 5% of this funding could be used to provide Global Fund-related technical support. The GMS project is funded through this appropriation. (This appropriation also provides some funding for the UNAIDS Technical Support Facilities, Roll Back Malaria, the Stop TB Partnership – TB Team, and the Green Light Committee.). The budget for GMS’ current five-year project is $61 million.
GMS support is available to all countries that receive Global Fund grants, except those on the U.S. Department of State’s list of state sponsors of terrorism. GMS provides short-term support through teams of 2-4 national, regional and international consultants. For each project, GMS can assign national consultants for up to 50 days. GMS can send regional and international consultants to a country for up to 90 days. These ceilings require GMS to focus its interventions on the most urgent priorities and to hand over medium-term support to other technical support agencies and consultants whenever possible. CCMs and PRs seeking support submit requests to the Office of the U.S. Global AIDS Coordinator.
In its fourth year, CCM governance and oversight accounted for more than 40% of the GMS projects. Governance assignments focused primarily on helping CCMs strengthen their structures and procedures. Oversight assignments focused mainly on building the capacity of CCMs to be proactive, using timely information on performance, including grant dashboards. (Dashboard templates are available here.) Other assignments in GMS’ fourth year involved preparation for signature and start-up for new grants; preparation for Phase 2 review; grant consolidation; and alleviating bottlenecks to grant implementation.
The volume of the work done by GMS is staggering. By the end of its fourth year, on 30 September 2011, GMS had started or completed 227 assignments in 73 countries, affecting 333 grants with approved funding of $4.75 billion (which is more than a quarter of all funding approved by the Global Fund). In its fourth year alone, the GMS project fielded 60 teams to respond to new requests, involving 245 consultants.
The following table, which lists the countries that received support from GMS in the period 2007-2011, is taken from the GMS 2011 annual report.
Table: Countries receiving GMS support 2007-2011
(number of assignments in parentheses, if more than one)
|Latin America & Caribbean
|Eastern Europe, Central Asia & Middle East||Anglophone Africa
|Francophone, Lusophone Africa||Asia, Southwest Asia|
COPRECOS (2 countries)
Burkina Faso (3)
Kyrgyz Rep. (2)
Sierra Leone (5)
South Sudan (2)
West Africa Corridor
Central African Republic (9)
Cote d’Ivoire (3)
Democratic Republic of
Sao Tome y Principe
Lao PDR (3)
Papua New Guinea
Timor Leste (2)
When providing technical support, GMS teams frequently make several visits to a country. Usually, the first visit starts off with a diagnostic assessment of the problem(s). Often, on the basis of the findings from the assessment, GMS has to make adjustments to the technical support that was planned.
Examples of support provided
One example of technical support provided by GMS in 2010-2011 involved the Guatemala CCM, which sought assistance to improve its understanding of the Global Fund’s grant architecture, processes and procedures; to clarify the Fund’s expectations concerning the roles and responsibilities of CCMs; and to ensure compliance with the Global Fund’s updated CCM eligibility criteria. The CCM also requested support to review its existing conflict-of-interest policy, to develop an effective oversight system, and to improve communication within the CCM. Following an initial diagnostic assessment, the CCM and the GMS team worked together to develop a new version of the CCM’s bylaws, including a new approach for selection of CCM members; a conflict-of-interest policy; an operations manual; a work plan and budget; an oversight plan; a dashboard for Guatemala’s Round 6 TB grant; and a management dashboard for the CCM. In September 2011, the CCM revised its membership using the new selection guidelines.
In 2010, GMS provided assistance to the CCM in Mauritania to enable the CCM to respond to the findings of the OIG concerning the implementation of Global Fund grants and the functioning of the CCM (GFO wrote about the OIG findings here). GMS also worked with the CCM to develop a plan for reimbursing the losses identified by the OIG.
Some assignments are more challenging than others. In the third year of its project, in collaboration with several other organisations, GMS began providing support to the Democratic Republic of Congo (DRC) on preparations for signing the DRC’s ambitious Round 9 tuberculosis and health systems strengthening (HSS) grants, involving two PRs, the Ministry of Health (MOH) and CARITAS DRC. According to the 2011 annual report, this proposal was so complex – virtually three projects in one document – that the Global Fund granted two exceptional extensions before the grants were finally signed in May 2011. (GMS collaborated with four other agencies on this assignment.)
One factor that contributed to the delay was that the MOH’s project management unit, which was already administering grants from the World Bank and the GAVI Alliance, had to be strengthened to enable it to take on the Global Fund PR role. Since the funding rules of the three donors are quite different, budgeting the shared management functions was complicated.
In addition, the HSS component required extensive supplementary planning to develop a unified personnel remuneration policy for the MOH, agreeable to all donors and to the Government of the DRC, to be used for performance-based payment and to target the geographic areas for Phase 1 of the grant. According to the 2011 annual report, this was undoubtedly the most complex pre-signature assignment that GMS has ever worked on, “in large part because crucial policy decisions had not been made during the design of the proposal.”
GMS operates in a very participatory fashion, working with CCMs and PRs to identify problems and explore options for solutions (as opposed to GMS telling PRs and CCMs what GMS thinks they should do.) In addition to its work at country level, in collaboration with the Global Fund’s CCM Unit, GMS has conducted a series of training sessions on the use of grant dashboards for CCM oversight. GMS has also conducted numerous train-the-trainer sessions on civil society strengthening.
In May 2011, GMS initiated a formal process to document, polish, publish and share best practices, tools, and models developed by GMS consultants and staff. This initiative will be completed in 2012.
Because it is nearing the end of its current five-year project, GMS is no longer accepting technical assistance requests for this project. However, in a note on its website, GMS explains that a new project is expected to begin early this year and that applicants may submit a request for assistance under that project. There is a section of the website that explains how to initiate a technical support request.
GMS operates as a partnership among five companies: Management Sciences for Health (MSH), Abt Associates, Futures Group, Inc., International Program Assistance, and MIDEGO, Inc. The GMS offices are in Arlington, Virginia. GMS maintains an ever-expanding consultant roster that currently includes nearly 420 technical experts and local consulting groups. See the GMS website for more information. The 2011 annual report can be downloaded directly on the GMS website here. The report contains numerous examples of the technical support provided by GMS. Also available are annual reports for each of the first three years of the GMS project.