Apr 05, 2006

Summary of Online Discussions and Lead Contributors for Week11: Being more in line with country priorities and systems


What steps can the Global Fund take to be more in line with country priorities and systems (e.g. for monitoring and evaluation, procurement and supply management), therefore reducing transaction costs and ensuring the lasting impact of its funded programs? How can the Global Fund better coordinate with other donors – both at the global and country levels?

Lead Contributors:

Joseph Stephen Mambo (Tanzania), Sammi Fredenburg (WA. USA) Sharwood, NDB Raju, (New Dehli, India), Navaratan Gusaiwal (Jaipur, India), , Tshabalala, Pinaki Mukherjee, (Kolkata, India), Agape (Nigeria), Niloo Vaishnav (India), Oge Franklyn Nkemakolam, (Owerri-Nigeria), Sudhakar Malpe (Mumbai, India), Saiki Shegun (Abuja, Nigeria), Bilal Hasan (Pakistan), Umesh Vanahalli (India), Mohammad Ziaul Ahsan, Stella Attakpah ( Austria), Saiki Shegun (Nigeria), Bruno Moonen (Somalia), Saka Mohammed Jimoh (Nigeria), Spectranine, Ashish Kumar Srivastava, (India), Virendar Khatana,

French Forum: Celestin Ele, Simon Kabore(Burkina Faso), Athanase Loshima, Zingue Dezemon (Burkina Faso), l'ONG Lisungi, Gilbert Kabeji (RD Congo), Adel Zeddam, Edrice Mauricette (Haiti), D'Zata. Russian Forum: Ulyanov (Russian Federation), Spanish Forum: Jacostap (Peru), and Ricardo Valladares Cardona (Guatemala)

Summary of contributor suggestions:

1.) Allocate more funds into the M&E budget: more funding would clearly be needed to solve problems facing countries with regards to harmonizing M&E methodologies and processes, capacity building and encouraging performance management by other sectors. An initial step would be to make programme planning more rigorous, inclusive of all stakeholders, transparent and aimed at ensuring programme sustainability, e.g. through Good Planning Processes and similar methods. The next steps would be to solve perennial challenges e.g. inadequate technical skills, ownership, staff shortfalls, lack of commitment to issues, political interference, lack of leadership skills, unwillingness to collaborate, and lack of financial, M&E, procurement and administrative knowledge.

2.) Support the dissemination of normative frameworks (tools, guidelines for M&E, procurement, etc) and funds to the community level by working more directly (closely) with CBOs and NGOs with wide population reach. This will encourage harmony, build capacities, provide an in-built accountability mechanism and also encourage a focus on often relegated yet critical interventions e.g. Blood Safety. Reducing transaction costs ultimately depends on a reduction in the disease burden of countries. Direct community involvement has been proven over time to lead to better results in general.

3.) To reduce corruption, bureaucracy, and disharmony, the Global Fund should especially analyze /monitor proposals for cost–effective material and equipment supply processes. Also, procurement services should be streamlined and where possible approved in advance to avoid delays, especially during importation. The Global Fund should support Capacity Building for procurement (e.g. on supply chain management), nationally & for authorities in priority areas. Use existing government infrastructure.

4.) The LFA mandates should go beyond financial into technical audits of normative tools (e.g. M&E framework, P&S guidelines) and processes for M&E and Procurement and their efficient application, on a continuous basis, not just annually. Where countries have not prioritized core areas, the Global Fund should consider ‘indirectly forcing’ them to prioritize, and clarify specific processes aimed at ensuring their prioritization.

5.) The Global Fund should also ensure that there is no duplication of duties between the personnel it employs, with those of its partners, as a way of reducing transaction costs and ensuring additionality and harmony. Build govt. capacity, improve policy-making.

6.) The GFATM should take steps to clarify and elaborate performance indicators, and a framework for expected results as early, and in as much detail as possible, while relating it to a country’s own strategic framework (also mentioned in previous weeks). This will add to the country’s own objectives and records. This process could be promoted through national M&E workshops involving the widest range of stakeholders from all sectors.

7.) The Global Fund should evolve into a direct funding mechanism that will engage civil society in direct supervision of projects selected through calls for proposals instead of funding national governments and operations. CCM should lead in engagement; capacity building of stakeholders and M&E. MoH should deal with product and service distribution (drugs, normative framework, and personnel) and similar tasks. Employ country staff and directors to perform programme M&E from grassroots to national level.

8.) Integrate sexual and reproductive health, and similar programmes into HIV/AIDS prevention and treatment health programmes to promote complementarily and avoid competition for donor funds by programme managers. Learn from UNFPA’s reproductive health commodity security model. Work with UN mechanisms to ensure international collaboration. Clarify hierarchy & roles between CCM, MoH, PR and SR.


From the French Forum

Countries still encounter problems during the application of the Global Fund’s financial model, and within its architecture. To ensure harmonization, the Global Fund should:

1. Encourage the CCM to choose Sub-recipients in addition to recipients. It should increase the role played by each country in determining the choices it makes regarding implementers at the grassroots.
2. Increase the civil society’s engagement as sub-recipients and by the Ministry of Health. The Principle beneficiary, in most cases the MoH, should also ensure the involvement of the targeted population.
3. The additionality principle is becoming a contributing factor in the reduction of implementation activities in poor countries since many countries are beginning to under value the resource needs. A number of local partners in extremely poor settings would be encouraged to be more honest and cooperative if the need project co-financing would be waived.
4. The Global Fund should utilize its position in relation to the UN to influence the standardization and harmonization of interventions.
5. Some actions that the Global Fund could perform in order to be more in line with country priorities and methods, and to increase include:

- Provide more grants to grassroots organizations and target projects with more sustainable impacts,
- Assist in the distributions of health products to targeted populations
- Monitor the performance of grants more frequently.
- Build the capacity of National AIDS Control Programmes, Authorities and Commissions with a view to having them take over the CCM’s tasks in relation to HIV/AIDS.
-Define more clearly each partner’s role and invest in projects where its value-added is strongest.
- Develop a more systematic and proactive information and communication policy to increase the visibility and impact of its activities in all countries,
-Ensure the representation of all donors and implementers in its financing model,
- Monitor and build country capacities in procurement and supplies, monitoring and evaluation, etc.
- Clearly elaborate the roles that national and international donors can play in advocacy and provision of support structures.
- Develop a clear framework towards a more inclusive, operational, coordination structure that focuses mainly on integration, decentralization and coordination.