PartnersGF - 2004-08-17

GFATM Key Stakeholder Consultations
Three-in-one Summary
HDN Moderation Team
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Introduction:
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This summary brings together the deliberations from three sets of consultations with key GF stakeholders:

- The report and recommendations from the first Partnership Forum (PF) meeting that took place in Bangkok, Thailand in July 2004;
- The summary and recommendations from the first PartnersGF eForum discussion, on country coordination mechanisms (concluded June 2004); and
- The comments made and conclusions drawn from a series of Global Fund Regional Consultations (2004).

Separate reports for each of these processes are available (see www.theglobalfund.org and email details below). These processes should have built on one another – in reality, they were developed almost entirely separately. As a result, the outcomes are deliberations that often repeat, and sometimes diverge from issues raised previously. Nevertheless, broad points of agreement, divergence and further debate can be identified. This summary brings the three processes together in order to:

- Keep track of the main issues and recommendations raised in each of the consultation processes;
- Identify common and divergent themes and recommendations from each;
- Present a general direction of what key stakeholders have identified as critical issues for the GFATM today.

1. Success:
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All three consultation processes acknowledged the Fund's success in moving substantial resources towards responses against AIDS, Tuberculosis and Malaria in a very short time. They recognized that the Fund has initiated and catalyzed responses against the three diseases. In some countries, for example, the Fund has been the only resource for scaling-up provision of antiretrovirals. In others, it has been the main entry point for country mobilization efforts against the three diseases.

The cost, however, at which success is achieved, came under scrutiny in both the PartnersGF eForum and Partnership Forum meeting. Participants felt it would be unethical for the Fund to claim successes at high costs where fewer and well-targeted resources might be more optimal.

General convergence and conclusions:

- Efficiency and cost effectiveness should be included in rationale for allocation of GFATM funds.
- GFATM country experiences should be promptly publicized.
- A procurement strategy should be developed that takes advantage of bulk purchasing, which GFATM-funded programs can use to minimize costs.

2. Resource Mobilization:
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During the Bangkok meeting, resource mobilization took centre stage of the deliberations (and of the GF press release that followed). Participants called on the GFATM to launch Round 5 of Funding during the November 2004 Board Meeting or by February, 2005.

Participants in the other two consultation processes focused more on the optimization of already mobilized country and community resources. They felt tremendous potential resources exist in local partnerships, which require deliberate catalytic investment by the Fund.

General convergence and conclusions:

- Additional local resources should be identified.
- Investment should be made in partnerships, through enhanced information flow between and among the different partners such as bi- and multi-laterals, and Local Funding Agency (LFA).
- The roles and responsibilities of the different partners should be clarified and these functions should be actively utilized.
- Resources that are currently concentrated on AIDS should also be allocated towards tuberculosis and malaria efforts.
- The GFATM resource mobilization strategy should be publicized.

3. Country Co-ordination Mechanisms (CCMs):
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In all three consultation processes considerable debate took place on CCMs. Minimal composition of CCMs, transparency in proposal development, review and implementation, election/nomination of CCM Chair and Vice from different sectors were proposed by the PF meeting as requirements to accessing GFATM resources.

Many other CCM-related issues were raised on the PartnersGF eForum and Regional Consultations.

While the PF meeting applauded the participation of people living with the three diseases in the GFATM Board and CCMs, PartnersGF participants felt that this participation should be augmented with effective constituent consultation and capacity building in specific areas of constituency-felt needs.

General convergence and conclusions:

- CCM leaders should be development professionals to expedite processes.
- Involvement of the media in CCM operations is imperative.
- CCMs should access technical support from GFATM funds including to support fully-functioning CCM secretariats
- GFATM should issue explicit guidelines on nomination or election of constituency representatives on CCMs. It should clarify processes for resolution of conflicts of interest.
- Investment by GFATM and partners in constituency development and functioning, including training in locally felt and identified leadership skills of constituency representatives, should be developed.
- Monitoring and evaluation guidelines of CCM performance should be developed.

4. Capacity Building:
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Capacity Building of the GFATM country institutions invariably occupied substantial space in all the consultation processes; more so in the PartnersGF and Regional Consultations. Deliberations dealt with a range of issues including capacity enhancement in coordination and collaboration of partnerships; program design; evaluation and implementation; resource absorption and staffing.

General convergence and conclusions:

- Technical support in project proposal development and program implementation should be part of GFATM financing. Where possible, local expertise should be utilized.
- GFATM should support the establishment of Regional Capacity Institutes to serve capacity needs of the response against the three diseases.
- The GTZ support programme should be publicized alongside technical support initiatives of other partners.
- GFATM should support efforts to develop and publicize external validation and quality assurance guidelines to improve credibility of country reporting systems.
- Programme design should align with broader goals and objectives of the Millennium Development Goals.

5. Impact of GFATM:
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While the PF meeting felt that it was too early to directly pin down the GFATM impact on the three diseases, the PartnersGF eForum participants felt otherwise. They felt that two years is still sufficient to potentially see the early signs - but not the magnitude - of the GFATM impact in countries and communities.

Participants in all the consultations, however, stated that impact of GFATM funded programs should not be limited to the three diseases. It should also encompass a synergistic response towards all three diseases, involvement of the communities and contributions towards the Millennium Development Goals, and targets espoused in the Declaration of the United Nations Special General Assembly on HIV/AIDS (UNGASS).

General convergence and conclusions:

- The measurement of GFATM-funded programme impact in reduction of diseases and deaths from HIV/AIDS, TB and malaria should be facilitated.
- The measurement of GFATM funded programs towards attainment of the Millennium Development Goals and UNGASS Declaration should be facilitated.
- Measurement of GFATM contribution towards strengthening of national systems responding against the three diseases should take place.
- Measurement of GFATM-funded programs towards reduction of disease-related stigma and discrimination should also be a priority.
- Indicators of community involvement and satisfaction, including but not limited to treatment preparedness, should be developed and implemented.

Overall conclusions and observations:
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In the view of most key stakeholders taking part in the three consultation processes, the success of the Fund in two years of operations appear to be confined to the disbursement of substantial resources towards efforts against the AIDS, malaria and TB. The impact of this disbursement on countries and communities in terms of reduction of diseases and deaths from the three diseases, and the performance of GFATM processes and institutions, are yet to be demonstrated. These would benefit, it appears from the three consultations, from targeted investment in additional resource mobilization, CCM enhancement and national response capacity building.

Clearly, the onus is on the Fund to best utilize the advice it has requested and received from the three consultation processes, among others. Deliberate steps by the Fund in response to this feedback are hopefully anticipated. This should include a more thorough compilation of common conclusions and feedback into an accessible format. This would help to inform and guide future Fund-related discussions and decision-making opportunities, including the forthcoming November 2004 GF Board Meeting. In keeping with existing standards for open consultation processes of this nature, it would not be sufficient to merely conduct appropriate consultation processes, without actively using and giving subsequent feedback and responses to the findings of these processes.

Finally, the GF should make an attempt to strengthen, unify and merge similar consultation processes in the future. Overcoming the current fragmentation of key stakeholder input and feedback – and the extent to which the GF is ready to respond openly to the current feedback - shall be crucial in determining the extent to which the GF can achieve one part of its stated goal of "doing business differently".

Imminent decisions by the GF about the extent to which the overall Partnership Forum process might be kept operational between planned bi-annual meetings, for example, will also be important.

HDN Moderation Team
Email: info@hdnet.org