Quote: "This question is a difficult nut to crack, because vast majority of Nigerians know nothing about Global Fund not to talk of how appointment into CCM is done.Few people who  know something about Global Fund , do so  through net or people working with international organizations that have link with the Fund.There is general belief in Nigeria that the Global Fund works directly with the Federal Government and international organizations.Moreover,majority of international organizations do not have their branches nation wide. Even government officials at state level know nothing about the Fund ,how much more ordinary worker or common people in the streets."

Dear Dr Hilary,

Thank you for your contribution. This raises some additional questions. There has been an approved maximum of US$ 745,266,095 in Nigeria so far, so what do you think are some of the reasons why the vast majority of people in your country do not know about the Global Fund? How do you think this could be changed? Do you see the exchange of information on MyGlobalFund.org as a way to inform peers on the Global Fund and the way it works?

I would also like to leave members with a few links to resources that the Global Fund has produced to answer some of the questions on what it is and what it does. More information is also available on www.theglobalfund.org.

• The Global Fund: Who We Are, What We Do 
  
• Partners in Impact - Results Report 2007 (pdf 3MB)
  
• Annual Report 2007 
  
• A Report on the Country Coordinating Mechanism Model: Lessons Learned in the Field Health Financing and Governance  (pdf 696kb)
  
• Global Fund Policies and Guidelines (including CCM-related guidelines)

For more resources, please visit the GlobalFund's Media Center.

Consultation with other sectors & CCM participation 

1.      Small NGOs are not listened to. NGOs, particularly in rural areas, lack information on the different processes for proposal development. 

2.      Community based organizations that represent sexual workers, transgender, people living with HIV are not called upon to take part of the development of the proposals, or define indicators, and thus the needs of different sectors are not consulted. 

3.      Proposals are often developed very late on and there is no time for consultations or translation.

4.        Often the best technical skills for proposal development are found in the private sector or with consultants, who are not consulted. In Argentina, for example, there are a lot of technocrats with minimum experience in the practice of health work, prevention and prophylaxis. 

5.      The extent of transparency is very much linked to the diversity in composition of the CCM. 

6.      Yes. Many CCMs are working to engage all sectors and have an impartial panel to review proposals for inclusion into the main proposal. 

7.      The Global Fund should strengthen PLWHA communities and the education of its leaders. 

8.      The NGOs should be more active when seeking to participate in all stages of programming and implementation. However, many requests made to the CCM by civil society are left unanswered.  

9.      The Global Fund and the CCMs should give greater consideration and support to projects presented by people living with the disease when they are grouped together and organized within an association. 

Complexities 

10. Bureaucracy stifles openness and transparency; complexities make it a process for the elite that can afford to employ individuals or organizations that specialize in proposal writing. 

Communication 

11. The overall flow of information about the CCM and Global Fund grant opportunities is poor and, because of internet access, only open or transparent to a small, albeit well-intentioned, urban elite. 

12. The structural hierarchy distances the sub-recipients from the decision makers; for the majority of people working in the field, the proposal development process is arcane, byzantine, and too far away. 

13. Communication and information dissemination must be improved, which must reach all sectors. The development process must be made public, through the broadcast media at the national level, as well as the criteria CCMs use to select proposals. 

Responsibility of actors 

14. The issue of transparency is almost always leveled at the CCM, whereas the transparency of NGOs and other community groups/implementing partners also needs to be held to account.  

15. Interpretation of “transparency” and meaningful participation” by the CCM and to which groups varies widely among CCM and non-CCM actors, impacting on the proposal development process. 

16. The provisions on CCMs are often formal and not applied in practice. 

17. There is transparency, but there is often difficulty for certain stakeholders, including NGOs, to accept and follow the processes as presented by the CCM. 

Capacity 

18. Although the proposal development process is clearly open to a wide range of stakeholders, what is needed is more targeted and time-limited attention to building the capacity and understanding of CCMs to the issues of governance and inclusion. 

19. Many NGOs do not have the necessary capacity to participate, and in practice, it is difficult to ensure the participation of all NGOs. 

General 

20. Even though there are improvements in the process of developing proposals, it is interesting to see that Latin America is one of the regions with the lowest rate of approval of proposals. The role that the CCM plays is central when evaluating the failure or success in this regard. The transparency and the mechanisms of participation are critical elements that are not always present when the proposals need to be prepared. 

21. A good example of transparency and participation is seen in Guatemala's CCM, though consultations with committees and sub-committees together with the PR. These committees reach a consensus which is presented to the CCM. Everyone has the chance to make observations and suggestions to the proposal regarding indicators, objectives, budget, timelines and its strategies. 

Contributions by: 

English: Lafay, Dr Hilary, Ene Otimanam (1) (2), Jkperfect, Aishath Shifana, Natalia, C.Ravichandran (1) (2), Nformi, Edward Komusong, Stanley, Tarig, Mahesh Sharma, Jane, Hyleslie, Sawsan El-Sheikh, Rob, Safe, Underprivileged (1) (2), Ashish Srivastava (1) (2) (3) (4). 

Spanish: ALDO ARAUJO, Gracia Violeta Ross, vargasdany, RJSOTO, elena reynaga, Hugo Rolando Valladares Morales, alejandra victoria portatadino. 

Dear friends

Regarding this week discussion, the CCM is having their own recipients regarding the Gobal Fund project implementation process. But most of the participants of the program are Non-Government Organizations and community based organizations. In our country  

I think the CCM is actively working in implementation of the Global Fund’s programs. The PRs and sub PRs are not receiving any correspondence about the Global Funds implementations. I have posted many letters to the Global Fund’s secretariat regarding this, but there is no response till date. At this juncture what I can speak freely or suggest for this program.

Thank You

C. RAVICHANDRAN

INDIA

1.      Understanding and interpretation of “transparency” and “meaningful participation” of community groups varies widely among CCM and non CCM actors, therefore proposal development process and timing is often used as an opportunity to advocate/pressurize for ones own issue only, regardless the national priority, information and the data about epidemics trend in the particular group.

2.      Different groups now tend to have developed a territorial attitude – not allowing others to enter into its “territory” with programme design/intervention or information requests. Territorial attitude is manifested in different ways and forms such is territory of geography, territory of case/ethnicity, territory of sex, territory of behavior and so on. Most of the groups are more assertive than before in “demanding their rights’ but appeared to have grossly neglected their “responsibility” Needless to say rights and responsibility are two sides of a coin.

3.      Transparency is almost exclusively leveled at CCM only. But when transparency, quality of service and inclusiveness is demanded from NGOs, community groups, and implementing partners, it is often blamed of being suppressive, authoritarian, homophobic and so on.

I insist on the idea that the CCM has to assume the role of "Project Board" for the GFATM grants in the country. This is because the nature of CCM members is that they are not a full-time member of staff and they receive regular "highlight reports" from the PR. Any approach to involve the CCM intensely in the grant running will jeopardize the grant predicted deliverables. CCM can be concerned in the proposal development through its "Subcommittees" as they are the technical arms of the CCM. NGOs, CBOs and FBOs can be involved in these technical Subcommittees according to the relevance of the proposal to their mandate. The mother CCM can be involved in the following steps:

• Indicating whether the country needs to apply for the current proposal or not.
• Assigning the potential entities and institutions for proposal development.
• Monitoring the proposal development process through its secretariat.
• Final endorsement of the proposal.
• Submission of the developed proposal to the Global Fund HQ.