Heavy-handedness will not deliver the best results
Article Number: 3
CSOs in Zambia complain to the Global Fund about the Country Team’s approach in grant making
The CSOs in Zambia have submitted a formal letter to the Global Fund Executive Director protesting about the Global Fund Country Team’s approach in grant-making. The strongly worded letter demands specific action from the Secretariat and raises valid points that call for a review of the grant making process. It is just one example of countries kicking back against perceived interference from external forces.
Recently, a group of civil society organisations (CSOs) collectively prepared and signed a protest letter about the Global Fund Country Team’s approach in Grant Making. It was submitted to the Global Fund’s Executive Director.
The letter to Peter Sands, dated 24 August, begins by acknowledging the Global Fund’s investment in the fight against HIV/AIDS/Malaria (HTM) over the past 20 years and the resulting significant progress towards achieving the 95-95-95 UNAIDS 2030 targets. It then states that further efforts are required, especially among key populations (KP), to prevent ongoing transmission of HIV in key and vulnerable populations (KVP). To reach these and increase effectiveness, investment in community-based models and Differentiated Service Delivery approaches will be critical to close gaps and achieve optimal health outcomes for people living with HIV.
The letter was prompted by the ongoing discussions with the Global Fund Country Team (GFCT) that followed the Technical Review Panel (TRP) approval of the Zambia funding requests for Grant Cycle 7 (GC7), for the years 2024-2026 amounting to a total allocation of $349,779,344. A Prioritized Above Allocation Amount (PAAR) of $215,265,511 was fully recommended (72% of the Allocation Amount). The civil society strengthening (CSS) component allocation was $5,457,757 (2% of the Allocation Amount, excluding disease specific and human rights and gender (HRG) investments) and Matching Funds of $5.4 million.
The CSOs state that the letter is their formal protest against the GFCT’s approach in attempting to impose its decisions over that of the country-led GC7 writing processes and positions.
The CSOs’ protests
The CSOs complain that the approach currently being used by the GFCT belittles and sidelines civil society contribution to the fight against HTM and its vital role in the implementation of the planned activities. They assert that the GFCT is disregarding the views of Zambia’s in-country partners which advocate for a strong multi-sectoral response to the fight against HTM. They go on to say that: (a) submissions from the GFCT have been characterized by a total lack of respect and regard for the in-country multi-sectoral and multi-partners’ strategic inputs to the GC7 application which is grounded in over 19 years of Global Fund implementation; (b) the authoritarian tone during the discussions and engagements falls short of the Global Fund partnership spirit; c) there are ongoing efforts by GFCT to cause divisions and disharmony between Government, civil society and other implementing partners, and (d) they believe that the GFCT’s approach is not in keeping with the founding principles of the Global Fund and its 2023-2028 Strategy.
The CSOs provide six reasons for what they consider to be the inappropriateness of the GFCT’s approach and they demand urgent and timely corrective action for each of them.
First, they explain that the GFCT continuously introduces parameters that were never raised by TRP and literally open up each and every proposed module for debate, despite the TRP stating that the modules in the proposal were technically sound; and with only a few TRP comments to be addressed during grant-making. The CSOs therefore ask that the GFCT sticks to addressing the issues raised by the TRP and desists from opening up each and every module for debate.
Second, they state that it is inappropriate for the GFCT to demand that budget lines be split for every GC7 intervention, despite the Country Coordinating Mechanism (CCM) clearly providing a country-led split. They therefore ask that the GFCT maintains the split of budget lines as recommended by the CCM, whose decision on the split had been informed by the Principal Recipients’ (PRs) assessment and the Office of the Inspector General’s reports.
Third, they consider that dual-track financing is threatened by a constant belittling of the multisectoral responses required to fight HTM. The CSOs claim that the GFCT appears to be aiming for a reduction of the role of CSOs in grant implementation, which is not informed by any objective evidence. The GFCT is said to have proposed budget allocations that deliberately undermine civil society’s contribution to Global Fund grant targets, ignoring the fundamental successes that have been achieved through a multi-sectoral response. The CSOs have therefore asked that the GFCT maintains the role of the CSOs in the grant implementation as outlined in the FR approved by the TRP (which was without any amendments).
Fourth, the CSOs report that the GFCT has repeatedly questioned the CCM’s decisions on the budget split, which decisions were submitted to the Global Fund after their careful review by a CCM-appointed technical team that had developed the FR. Furthermore, they claim that the GFCT seems to be re-opening discussions on country’s prioritized interventions which the TRP has approved. In doing this, the GFCT is undermining the CCM’s mandate of making country decisions on priorities for investment as well as the TRP’s position in reviewing applications for technical soundness and recommendation for funding. These actions are against the Global Fund mechanisms for setting country priorities for investment as well as the decisions of the TRP. The CSOs therefore ask that the GFCT respect the decisions on investment priorities arrived at through consultative country processes and focus only on the issues raised by the TRP as the country prepares implementation and disbursement-ready grant documents.
Fifth, the CSOs consider that the Country Team approach disregards past performance that is responsible for the gains the country has achieved. Zambia has implemented Global Fund-supported grants for over 19 years, with many successes and challenges, both of which are part of a mature programme. The Zambian successes have been due to a multi-sectorial response with all partners working in harmony under the leadership of the CCM (technical experts and representatives from the Ministry of Health, other Government ministries and agencies, bilateral and multilateral partners, and CSOs). They ask that the GFCT recognize the country’s past performance, whose successes have mostly been due to the multisectoral approach.
Sixth, the CSOs assert that the GFCT is at the forefront of causing divisions between the Government, civil society and implementers by making unfounded statements that the civil society’s contribution to the fight is negligible, and hence not deserving of increased funding. This approach, which undermines the spirit of partnership and is tantamount to divide and rule, is a disappointment to Zambian civil society. The CSOs ask that the GFCT desist from causing divisions between the implementing partners and the PRs.
The CSOs conclude by asking if the Global Fund‘s founding principles have changed and whether the principles of country ownership, dual track financing and working through the CCM decisions are no longer valid. They seek the Global Fund senior management’s intervention to ensure that the long-term partnerships, both in-country and outside, are maintained and built on, rather than destroyed by the GFCT. They say that their constituency is being alienated for the reasons given above, and there is a need to address this matter urgently.
These developments come against the background of Zambia’s CSO efforts during the GC7 FR application development process where CSOs and KP-led organizations sought to have a third PR in place specifically to serve CSOs/KVP intervention implementation to maximise their contribution in the GC7 grant implementation, a position that was supported by some key partners (CCM eligibility requirement 2). The CCM reached a consensus after a protracted debate to select a stronger SR for CSOs/KVPs to improve grant implementation.
Not a new story: previous reporting on country ownership
Wow! The CSOs in Zambia are clearly unhappy and have raised some serious complaints. Before we consider what is likely to – or should – happen, it should be noted that this is not a new issue or one confined to Zambia.
Ten years ago in a GFO article on the evolution of country ownership at the Global Fund, we began by saying that ‘country ownership’ has been one of the core principles of the Global Fund since it was created in 2002. The Fund’s Framework Document says: “The Global Fund will base its work on programs that reflect national ownership and respect country-led formulation and implementation processes.” The Global Fund’s Who We Are brochure says: “The Global Fund model is an innovative approach, based on the principle of country ownership.” Our article then goes on to discuss what ‘country ownership’ means and quotes the 2011 High-Level Panel review which said that “The Panel has heard the mantra of ‘country ownership’ invoked to explain and justify almost every aspect of the Global Fund’s business model and decision the institution makes. Yet while ‘country ownership’ is a founding principle highlighted in the Framework Document, there does not appear to be a shared perception – inside or outside the Global Fund – about what the term means in practice.” It appears that there is still no shared perception.
A year later, in another GFO article on country ownership, the point was made that the “disconnect between the assumptions of the principle of country ownership and the realities of the political spaces in many countries heavily affected by the epidemics, is at the root of many of the tensions that can compromise the Global Fund model, and can seriously interfere in the process of grants applications and approvals. An airing of the differences this disconnect produces is needed.” Perhaps it is time for another airing of the differences.
The importance of civil society involvement in the fight against HIV/AIDS was discussed extensively at the 20th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) held in Kigali, Rwanda in December 2019. This was further emphasised on World AIDS Day (1 December 2019) when the theme was ‘Communities make the difference’. And, also in that year, we reported on role of recipient CSOs in the Sixth Replenishment campaign.
The Global Fund Strategy 2023-2028 places communities and beneficiaries at the centre of the response and this means that increased civil society and community participation must be encouraged to strengthen programme outcomes and sustainability. Moreover, after the onset of the Ebola and COVID-19 pandemics, we witnessed in many countries how CSOs played a vital role in the responses. It is therefore surprising to learn that the Zambia GFCT seems to prefer less CSO involvement.
Finally, in a GFO article in 2020, we highlighted the importance of the Global Fund Secretariat helping set directions in order to ensure that countries use grants in the best possible ways but without being over-prescriptive.
History has shown that the involvement of CSOs is an absolute necessity in the fight against the three diseases and other pandemics. It is also aligned to the Global Fund Strategy goal of maximizing the engagement and leadership of most affected communities to leave no one behind. It is therefore incumbent on the Global Fund Secretariat to ensure that GFCTs maintain a cordial engagement and partnership with CSOs. To achieve the Strategy objective of leaving no one behind may require some trade-offs regarding some Global Fund core principles (e.g., Value for Money). In the case of CSOs it may not be only about achieving the targets in the funding request’s Performance Framework (which may be a major concern of the GFCT), but rather an initial focus on CSO capacity building for a better chance at longer term sustainability of responses and transitioning to greater national support for health.
Given the situation that has arisen, there appear to be two important steps to be taken by the Secretariat.
From the protest letter it is evident that the CSOs in Zambia have been alienated by the GFCT. So, to demonstrate the responsiveness of the Global Fund and to restore the confidence of the CSOs, the first step must be to try to improve communications with the GFCT. We understand that recently the GFCT reached out to Zambian civil society in this regard.
The second step, which should apply to all countries, might be for the Global Fund to re-examine its grant-making process. The CSOs in Zambia have raised a valid point: they have gone through a FR development process, which has involved interaction with the GFCT and various reviews culminating in the submission to the TRP. While grant-making should address any points raised by the TRP, there can be no valid reason for re-examining every aspect of the funding request without evidence to show why this needs to be done. In fact, no other aspects should require further debate unless: (a) the GFCT had already registered specific concerns prior to the TRP review and those concerns have yet to be addressed; and/or (b) the GFCT has formally registered with the Secretariat issues that it considers the TRP to have overlooked.
Since writing this article, the GFCT has been in discussion with the Zambian civil society platform regarding the issues raised. We wait with interest to see what happens next.