The incentive funding stream should be eliminated and the money reallocated to countries that need it the most to save lives. This was a central recommendation of the Technical Review Panel Report on Windows 1 and 2 of the new funding model. The first two windows were in May and June of 2014.
The TRP said that incentive funding was not achieving its intended outcome – to stimulate ambitious and innovative approaches in concept notes – and was instead creating additional burdens for applicants.
The TRP said that in an attempt to secure additional funding, many applicants placed essential core services in the above-allocation portion of their request instead of in the base funding portion where they belonged.
According to the TRP, the current allocation methodology is flawed and should be revised for the next allocation period. The current methodology awards disproportionate amounts of funding to countries that will have a relatively low impact on reducing mortality, the TRP said.
The TRP recommended that in their concept notes, applicants indicate clearly the priority of the interventions in both the base funding request and the above-allocation request, and that applicants present a strong evidence-based rationale for their prioritization. The TRP said that while some improvement in this area was noted from Windows 1 to 2, it remains an issue.
TRP reviewers said that the overall quality of three-quarters of the concept notes in Windows 1 and 2 was “good” or “very good.” To achieve even better quality, the TRP said, applicants would benefit from more guidance and assistance.
“Perhaps of most concern,” the TRP said, “was the number of poor quality concept notes coming from countries that have, apparently, relatively weak systems and capacity. It is imperative that appropriate technical assistance be prioritized for [these] countries.”
Use of data
The TRP said that some countries are not using many sources of information, provided to or known by the TRP, to inform their choices of target populations and their decisions concerning which areas of the country to prioritize. The TRP said that countries should consider investing in a central data hub, which gathers multiple sources of epidemiological, behavioral and programmatic information in one location, regardless of funder or implementer.
The TRP said that countries should also seriously consider investing Global Fund resources in building sustainable national analytic capacity to use the large amount of data collected to guide future program decisions, rather than relying too heavily on external consultants.
The TRP recommended that partners and the Secretariat provide more support to countries to enable them to strengthen their data systems.
The TRP also recommended that countries ensure that implementers regularly track the outcomes of interventions in the field through routine program management data collection. The data should be used to make mid-course adjustments to programs, the TRP said. In addition, the data should be referenced in future concept notes to demonstrate the strategic value and potential impact of the support requested.
The TRP said that it understands that a shorter implementation period may be appropriate for some grants, but that the concept notes in question should explain where funding will come from to cover the period to December 2017. The TRP said that it may request another iteration of a concept note if it has “unanswered concerns that a shorter time frame puts the continuity of programs at risk in the event that the necessary funding does not materialize or falls short.”
In a separate report on Windows 1 and 2, issued by the Secretariat, it was revealed that in its concept note Thailand included plans to transition away from Global Fund support. The TRP applauded the decision and said that more applicants should move in this direction.
NFM progress report
Meanwhile, in its October NFM progress report, the Secretariat said that is has lowered its forecast of disbursements for 2014 from $3.9 billion to $3.1 billion. In 2013, $3.9 billion was disbursed. One of the reasons for the lower forecast, the Secretariat said, is that many countries are deciding to take more time to develop their concept notes.
However, the Secretariat still anticipates that about 40% of the expected 280 concept notes for 2014-2017 will be reviewed by the TRP in 2014. This amounts to 111 notes with a value of $8.5 billion. Thirty-three notes were reviewed in the first two windows combined, and an additional 39 notes were reviewed in Window 3 in August. For Window 4 in October, 46 notes are currently being screened.
The progress report also provided updates on two special initiatives: the technical partnership agreements with the WHO and UNAIDS; and technical support for community, rights and gender.