The Global Fund and its stakeholders would be better served if the Fund released more information related to concept notes

2. COMMENTARY
23 Feb 2016

The Global Fund is more transparent that probably any other major funder, but there are nevertheless gaps in transparency that the Fund needs to address. This is the first in a series of commentaries on this topic.

The iterative, back-and-forth process for concept notes that was introduced under the new funding model has resulted in much stronger proposals than was possible under the rounds-based model. Unfortunately, by declining to make public information on how the concept notes were strengthened, the Global Fund is missing an opportunity to build on lessons learned and to live up to its commitment to transparency.

Let me explain what I mean by using the example of an HIV concept note submitted by Country X in Eastern Europe and Central Asia. This is a true story, but I have to use “Country X” instead of the real name of the country (and I need to alter some details) because some of the information I am about to give you is not in the public domain.

The modular template for Country X’s HIV concept note – which is made public, but only after the grant agreements emanating from the concept note are signed – lists about 10 modules, one of which is “Prevention activities for people who inject drugs and their partners.” One of the interventions shown for this module is “Provision of opioid substitution therapy.” The intervention is described as follows:

“The four existing sites will be maintained and three new ones will be added. Support for the sites includes human resources, tests, equipment and office supplies. Methadone will be procured. In addition, technical assistance will be obtained to (a) ensure coordination among service providers and (b) provide monitoring and evaluation. Regular workshops will be organized to ensure the quality of project implementation. The activities under this initiative include providing outreach to PWID and their families to improve (a) enrolment for OST and (b) treatment adherence.”

The modular template for Country X indicated that the percentage of individuals receiving OST for at least six months was 45% at baseline; the target for Year 1 was set at 57% and was maintained at that level for Years 2 and 3.

Feedback from the Technical Review Panel was summarized in the concept note review and recommendation form, which is not made public. The TRP said:

“The OST targets are two low and there are concerns about the quality of services. The applicant is requested to explain how it will improve quality and how it plans to scale up OST services.”

In the applicant response form, which is also not made public, the CCM described measures taken or planned to improve services. The measures included updating OST clinical protocols in line with World Health Organization recommendations; establishing home-base treatment for patients in stable remission; increasing the capacity of medical and care providers; and strengthening Country X’s multidisciplinary approach to providing medical and psychosocial support to OST clients.

The concept note review and recommendation form provided information on additional measures that were agreed to during grant-making – i.e.: (a) the PR will closely monitor the OST program scale-up, new enrollment and adherence support; and (b) the PR will conduct an assessment of OST services at the end of 2015. In addition, the OST targets were increased.

None of the information in the concept note review and recommendation form and the applicant response form has been made public with the exception of the revised targets which appear in the performance framework (which forms part of the grant confirmation form).

This information would be useful to other applicants preparing concept notes and to technical assistance providers. It would also be of interest to organizations that monitor The Global Fund at country, regional, and global levels.

The Global Fund has a mixed record with respect to which documents related to the concept notes are made public. The table below provides a summary.

 
Table: List of documents related to the concept notes and the ensuing grants, showing which are made public
 
Category
Document
Available publicly?
Concept note
Concept note form
Modular template
Financial gap analysis and counterpart financing table
Programmatic gap table
Concept note review and grant-making
Concept note review and recommendation form
Applicant response form
Grant agreement documents
Framework agreement
Confirmation form (summary program description, summary budget, performance framework)
Implementation arrangements map
Grant management workplan (implementation milestones, actions to address capacity gaps and risks)
Grant implementation
Workplan 1
Detailed budget 2
 

Notes:

  1. The Secretariat told Aidspan some months ago that the grant implementation workplan is being discontinued.
  2. Some version of the detailed budget may be made public in future.
 

The implementation arrangements map, which is not made public, describes the arrangements that have put in place for the implementation of the grant. It shows the various implementing agencies and procurement agents, and the relationships among them. Country stakeholders are entitled to have this information.

And we think stakeholders are also entitled know what the grant implementation milestones are, and what specific actions will be taken to address capacity gaps and to mitigate against risk – all elements of the grant management workplan, which is not made public.

As I indicated above, the concept note form and its three attachments are not posted on the Global Fund website until the grants emanating from the concept notes are approved, a process that can take several months. Why are these documents not made public when they are submitted?

Finally, the concept note form and its attachments only describe the program that the applicant initially proposed. These documents do not tell you what will eventually be implemented because they are not updated during the concept note review process or during grant-making. There is no public document that describes the program that will be implemented. There is a potential solution to this problem. Of all of the documents that are made public, the modular template provides the most detailed description of the proposed program. The modular template should be updated by the Global Fund when the grants are approved, and the updated version should be released publicly.

That would involve some work on the part of staff in the Secretariat. But if The Global Fund is truly committed to the principle of transparency, and if it is really one of the its priorities, the Fund has to accept that transparency requires an investment of time and resources. 

 


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