TANZANIA – A PARTNERSHIP MODEL FOR THE GLOBAL FUND AND PEPFAR

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Download PDF The successful partnership between the Global Fund and PEPFAR in Tanzania offers a good model that the two funding agencies can replicate in other countries, according to a former president of Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria. Natasha Bilimoria makes this observation in a paper published in the July 2012 issue of the journal Health Affairs….

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ABSTRACT A paper published in the journal Health Affairs states that the successful partnership between the Global Fund and PEPFAR in Tanzania offers a good model that the two funding agencies can replicate in other countries.

The successful partnership between the Global Fund and PEPFAR in Tanzania offers a good model that the two funding agencies can replicate in other countries, according to a former president of Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria. Natasha Bilimoria makes this observation in a paper published in the July 2012 issue of the journal Health Affairs.

Friends of the Global Fight is an advocacy organisation dedicated to sustaining and expanding US support for the Global Fund. According to Ms Bilimoria, PEPFAR and the Global Fund together provide almost 90% of the financing for HIV programming in Tanzania, with PEPFAR having contributed nearly $1.19 billion and the Global Fund more than $943 million.

The author identified four ways in which PEPFAR and the Global Fund have built a successful partnership in Tanzania: sharing information; working together on proposal development, grant negotiations and grant oversight; coordinating projects on the ground; and collaborating on the provision of medicines. This article explains the nature of the partnership in these four areas, as explained by Ms Bilimoria.

Sharing information

PEPFAR and the Global Fund recognise that they must share information to maximise the impact of their respective programmes. Weekly teleconferences between the Global Fund’s fund portfolio manager and the PEPFAR country team in Tanzania help identify areas of potential collaboration between the two programmes. One outcome of these teleconferences was a decision to jointly construct warehouses for medicines (see below).

Good communications between the two agencies has helped to ensure an adequate and uninterrupted supply of drugs. Because the Global Fund makes disbursements to countries only after the countries have clearly demonstrated results, late reporting can delay disbursements. However, PEPFAR in-country staff keep the Global Fund apprised of possible interruptions in the delivery of medicines caused by delayed disbursements. In cases where delays in disbursements are unavoidable, PEPFAR has provided bridge funding for purchasing medicines.

Proposal development, grant negotiations and grant oversight

PEPFAR is represented on the Tanzanian CCM. In that role, PEPFAR participates in the development of proposals. In addition, PEPFAR representatives have visited the Global Fund Secretariat to assist in the negotiation process after proposals from Tanzania have been approved. Further, PEPFAR’s on-the-ground experience in Tanzania helps the CCM monitor grant implementation.

Projects on the ground

The Global Fund and PEPFAR are collaborating on several projects in Tanzania, focusing on ensuring drug quality, reducing stockouts and helping to cut the risk of drug theft.

One project involves the installation of a new health management information system to computerise the country’s medical storage, procurement and distribution systems. When the new systems are in place, districts will be able to order drugs online from the government, making it possible to track the movement of drugs closely, ensure an accurate and consistent supply of drugs, and deter theft. This project is managed and funded by PEPFAR, while the Global Fund has committed to supplying the necessary medicines.

Another project involves the construction of eight state-of-the-art drug storage facilities. When completed, the new facilities will add 24,000 square meters to Tanzania’s drug storage capacity. The Global Fund is providing funding for the construction of the facilities, and PEPFAR is acting as the in-country project manager.

Provision of medicines

PEPFAR collaborates with the Global Fund on antiretroviral treatment in a number of countries, including Tanzania. In this collaboration, the Global Fund funds first-line treatment while PEPFAR provides second-line treatment. The plan is that by the end of 2013, PEPFAR will focus its efforts in Tanzania on providing support for activities such as monitoring and evaluation, voluntary counselling and testing services, capacity building and technical assistance; and Global Fund-supported programmes will provide commodities such as medicines, tests and insecticide-treated nets for the prevention of malaria.

Conclusion

In her paper, Ms Bilimoria said that as the relationship between PEPFAR and the Global Fund in Tanzania and elsewhere deepens, the lessons learnt should be applied in all countries where the two agencies work. “Because of U.S. leadership and support, the Global Fund and PEPFAR are the two leading supporters of HIV/AIDS programs worldwide,” said Ms Bilimoria. “Over the past decade we’ve learned many important lessons, but a key outcome is that both types of aid – PEPFAR’s bilateral model and the Global Fund’s multilateral model – are necessary to win the battle against HIV/AIDS. Together, they create a force that is greater than the sum of its parts.”

The paper by Natasha Bilimoria, entitled “Lessons Learned From a Decade of Partnership Between PEPFAR and The Global Fund: A Case Study From Tanzania,” is available here. Readers may need to subscribe to the journal to obtain the full article.