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LESSONS LEARNT FROM WINDOW 1 SHOW COUNTRIES STILL GRAPPLE WITH TRANSLATING HIV PROGRAM AMBITIONS INTO GLOBAL FUND FUNDING REQUESTS
GFO Issue 429
2023-06-03

LESSONS LEARNT FROM WINDOW 1 SHOW COUNTRIES STILL GRAPPLE WITH TRANSLATING HIV PROGRAM AMBITIONS INTO GLOBAL FUND FUNDING REQUESTS

Author:

Aidspan

Article Type:
Analysis

Article Number: 0

More guidance than ever is provided; but the number of Annexes and complexity has also increased

The Technical Support Mechanism, UNAIDS’s technical assistance provider to countries’ HIV responses, reviewed 15 draft funding requests submitted under Window 1 of the Global Fund’s Grant Cycle 7. It is disappointing to note that, despite all the technical guidance provided by the Global Fund and its partners, countries still struggle in designing their funding requests. This review has produced several valuable lessons for countries submitting under Windows 2 and 3 later this year.

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Background

One of the ways in which the Joint United Nations Programme on HIV and AIDS (UNAIDS) provides technical support to countries’ HIV responses is through its Technical Support Mechanism (UNAIDS-TSM). This supports UNAIDS Country Offices and their clients, the countries and beneficiaries themselves, in developing and delivering national HIV programs.

As well as support in many aspects of HIV programming, a significant part is through assistance in funding request development. Countries preparing their Global Fund Grant Cycle 7 (GC7) funding applications can request consultants to lead or draft various components of the funding request and, through the UNAIDS-TSM Virtual Support Desk (VSD) mechanism, UNAIDS-TSM can provide backstopping and technical support, including peer review of deliverables.

Virtual Support Desk

The VSD has three primary functions:

  1. Virtual review of national strategic plans (NSPs), draft Global Fund applications and other supporting material.
  2.  Virtual support to UNAIDS TSM in-country technical missions, including backstopping and mentoring local consultants, and providing international TA.
  3. Strategic learning and skill-building.

Under item 1 above, the VSD can coordinate the peer review of draft NSPs, other HIV program ‘building blocks’ (Stigma Indexes, Gender Assessments, HIV programme reviews, etc.) and Global Fund funding request applications for GC7. This is done through leveraging the technical expertise of Joint Programme partners such as the United Nations Population Fund, World Health Organization, etc. The VSD can support funding request preparation and launch phases, as well as the implementation phase; and it can provide thematic expertise (i.e., in HIV prevention, human rights and gender, community-led responses, costing, etc.) as appropriate.

For the review of deliverables, it can harness and consolidate the feedback of multiple peer reviewers including technical experts from the UN Joint Programme.

Secondly, the VSD provides virtual support to UNAIDS TSM in-country technical missions, Identifying the best thematic consultants and coaching local ones. This is done in a number of ways: assignment ‘kick off’ emails and calls to launch both administrative and technical elements of TA; mentoring, backstopping and trouble-shooting if needed during an assignment; and peer review of some or all products on request at any stage of the application process.

The third element of the VSD’s work, strategic learning and skill-building, includes Identifying lessons learnt and best practices for replication and sharing; establishing a Community of Practice to provide a resource centre of helpful materials and documentation brought together in one place; and holding webinars and clinics on specific topics, e.g., prioritisation, differentiated service delivery (DSD), community-led responses and monitoring, Global Fund costing and budget tables, etc.

However, probably the most significant aspect of VSD work in 2023 is the opportunity to afford countries to have multiple iterations of their draft funding requests and accompanying annexes reviewed by a broad range of technical and thematic experts.

Key lessons learnt from Window 1 peer reviews

The VSD reviewed 15 draft funding requests, all but one country eventually submitted under Window 1 and one postponed to Window 2. Some countries submitted more than one draft to be reviewed, enabling the VSD to assess whether and to what extent its earlier comments had been taken into account and how the draft had improved between iterations.

General Comments and Red Flags
Last-minute requests for peer review imply countries are not well prepared and have started the FR process late
  • At the Mock TRP (Nairobi, March 2023), six draft FRs were reviewed. Prior to the Window 1 deadline with eight working days left, ten FR drafts from a potential 15 countries were received within the space of three working days and with less than two weeks to a week prior to submission. The VSD provided nine peer reviews (of the ten, one arrived one working day before submission with a request to review  it!) in the five working days before submission of the final draft to Global Fund. This is not sustainable for Window 2, which has more countries.
  • For Windows 2 and 3, the VSD should push countries for more sane deadlines beyond which it cannot promise peer reviews.
  • As a result of running out of time, some countries submitted incomplete packages  to the GF with missing annexes and even missing some CCM member signatures for endorsement.
Failure to follow the GF instructions/template
All but two countries did not send in their Performance Frameworks, Gap Tables, Funding Landscapes, Budget, Prioritised Above Allocation Request (PAAR), and/or RSSH Annex: this makes it nearly impossible to comment on consistency across the FR components.

 
Failure to submit all related documents/annexes
Many countries did not complete their narrative form in compliance with the instructions, resulting in misalignment and garbled language, inconsistencies and rambling text. Following the instructions is key to a relevant, succinct FR.

 
Poorly written and organized drafts
  • Follow the narrative guidance, including regarding numbers of pages.
  • On formatting: a badly formatted, messy draft with margin errors, bad spelling, poor structure, etc. does not inspire confidence in the technical content!
Weak rationale and consistency
  • A good rationale, and consistency in prioritising the right interventions in line with the NSPs and guiding documents is very important, and key to what the Global Fund is looking for.
  • Failure to provide evidence of current performance: for example, why targets had not been met or exceeded as justification for scaling up, scaling down or revisiting.
Interventions misaligned with budget
  • Systematically number activities in the FR in line with the Budget: e.g. some countries had long lists of activities, many of which probably wouldn’t have their own budget line.
  • Some countries narrative was not reflected in adequate budget allocations, especially for prevention and key population activities.
Use of jargon and meaningless phrases
  • Some FRs were very ‘wordy’. It is relatively easier to write badly written text, and regurgitate the verbiage from GF guidance documents, than make text concise and focused. As one reviewer said: “My fingers itched to edit the two FRs that I read. I could have cut them both by half and not cut any substance, I think.” Less is more!
  • In places, many drafts had a lot of bullet lists of ‘key words’ of Global Fund language and phrases (saying what countries thought the Global Fund would like to hear?), but without a lot of thought/analysis behind the words.
Repetitions in resilient and sustainable systes for health (RSSH) sections, whereas RSSH is cross-cutting
  • Most countries struggled with this key Annex.
  • Many FRs still addressed RSSH on an individual disease-by-disease basis, resulting in a siloed approach with many repetitions between disease components, when one RSSH intervention to address all components would have been appropriate, e.g. procurement supply management (PSM), human resources for health (HRH) such as community health workers (CHWs).
  • CHWs cut across many public health issues and are not connected to any one disease in particular. Countries should use the CHW programmatic gap table to assist with this.
  • There should be ONE consolidated RSSH Annex across all three diseases. The Country Coordinating Mechanism should make the final prioritisation.
  • However, it should be noted that at the Bangkok workshop the Global Fund admitted that there was some inconsistency in the RSSH instructions which perhaps explained this confusion.
One the five funding modalities/approaches, the “Tailored for NSP” approach caused the most problems
  • Three countries submitted draft FRs Tailored for NSPs for peer review but without the accompanying NSP.
  • Timing/readiness of the revised NSP (or addendum) was an issue that affected the quality of the FR submission.
  • Countries are meant to be using their NSPs to guide the applications for GC7.  But apart from one country with a brand new NSP, the duration (timeframe) of the revised NSPs for three others reviewed all fall short of the duration of the proposed grants.
  • Consequences of this misalignment of the NSP for the grants were not made clear in the FRs, but in any case, they are poorly aligned (in content and timing), especially for two of the four countries reviewed.
  • Conclusion:  for three out of four FRs this model of application was not relevant for these countries. This is because (i) NSPs were under revision or being developed almost at same time; and (ii) the versions of NSPs used for developing FRs were incomplete – while the Global Fund says this is acceptable, this is a subjective assessment of what constitutes completeness. It meant that the specifics of several parts of the FRs were not well developed (or were non-existent).

 

Conclusion

The foregoing is just an example of some of the main lessons learnt from Window 1 draft FRs. A more detailed paper has been prepared on these experiences and it is to be hoped that Window 2 and 3 countries may reap the benefits of some of these earlier lessons. Most countries were unaware of the Technical Review Panel’s example of a Full Review HIV/TB Funding request, the fictitious country Jasmania; this provides a very clear example of what a Full Review Funding Request should look like and is barely 50 pages in length (excluding those 20 annexes, of course!).

It remains to be seen if the lessons learnt are taken into account by the remaining countries…but we shall let you know after Window 2 closes at the end of May!

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Michelange Muberuka
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