An update on The Global Fund’s six special initiatives
The Secretariat has provided an update on Special Initiatives to the Strategy, Investment and Impact Committee and the Financial and Operational Performance Committee. The update has not been made public, but Aidspan has received permission to report on its contents.
In the last issue of GFO, Aidspan reported overall spending updates for the six special initiatives (see Table 1 of GFO article). This article provides more details on progress to date.
The Emergency Fund is set up to ensure continuity of essential HIV, TB, and malaria services which are at risk of interruption in situations such as conflicts, natural disasters, or other disease outbreaks. The $11.6 million committed to date for this special initiative has been granted to five countries: Liberia ($1.62 million), Sierra Leone ($1.63 million), Syria ($3.32 million), Nepal ($2.13 million), and Ukraine ($2.97 million).
The emergency funds for Liberia and Sierra Leone are for malaria prevention in the context of the Ebola crisis. In Liberia, the funds are dedicated to procuring 448,084 long-lasting insecticide treated nets to close the gap in the national campaign after the Ebola crisis altered the distribution strategy. In Sierra Leone, the support is for the country’s mass drug administration campaign, which aims to treat more than 2.3 million people in select chiefdoms with antimalarial drugs, regardless of their disease status. The objective of the drug campaign is to reduce Ebola transmission among malaria patients, which can happen if malaria fever is mistaken for early symptoms of Ebola and patients are quarantined together.
In Syria and Ukraine, the emergency funds are for HIV and TB service maintenance in the context of political instability. In Syria, support is provided for TB prevention among refugee populations, while in Ukraine funds are used for HIV service provision in areas affected by military conflict.
Lastly, the Emergency funds in Nepal are for responding to HIV in the aftermath of the April 2015 earthquake.
There are 15 pre-qualified implementers for the Emergency Fund. These are: the International Organization for Migration, Save the Children, the World Food Programme, UNICEF, World Vision, GIZ, the International Rescue Committee, UNDP, UNOPS, Plan International, Catholic Relief Services, the International Federation of Red Cross and Red Crescent Societies, Population Services International, the International Medical Corps, and the United Nations High Commissioner for Refugees.
Community, rights and gender
In addition to this article, GFO has published two previous progress updates on the CRG special initiative (in March and September 2015). Linking these three updates, Figure 1 below shows a timeline of progress for the provision of short-term technical assistance.
Figure 1: Progress over time on short-term TA provision through CRG Special Initiative
The Global Fund Secretariat has recently indicated that every TA assignment funded through the CRG special initiative has had a key populations focus. Many have also had scopes of work touching on human rights, community responses, youth, and gender.
Funds committed for the six regional platforms, another arm of the CRG special initiative, have now reached the total expected allocation of $4 million. Most platforms are in the implementation phase, using websites and social media, and producing survey reports, all aiming to improve communication and coordination with other Global Fund TA initiatives.
Investments in the eight Robert Carr Network Fund grantees are now at a total of $5 million, up from $2.6 million as of September 2015.
A consultant has been engaged by the Global Fund to carry out a review of the CRG special initiative.
PR capacity building
This special initiative is designed to support first-time principal recipients that do not have the resources to pre-finance grant-making and start-up activities. Upon grant signing, The Global Fund is then to be reimbursed by the PR. Two pre-financing applications have been approved so far for regional programs in Africa: $446,000 for the SARCM grant and $84,446 for the ANECCA grant (see GFO article for summaries of these two grants).
Value for money and sustainability
The value for money and sustainability special initiative aims to bolster the Global Fund’s strategic objectives to invest resources strategically, measure investments and outcomes, mobilize domestic financing, and sustain progress. The $5.5 million committed to date has largely gone towards resource tracking and allocation support. Specific examples include:
- South African expenditure analysis;
- Asian network of national health accounts;
- consecutive rounds of health accounts and disease expenditure in 38 countries; and
- prioritization for national disease programs in 25 countries.
WHO-Stop TB partnership agreements
This special initiative was initially intended solely to support the development of concept notes, but the the scope has since been expanded to include technical support during grant-making.
The WHO has provided concept note development and grant-making support for a total of 423 requests across 97 countries. These investments have been for HIV, TB, malaria, and health systems components. The WHO has spent $18.2 million, and committed the remaining $6.5 million, for a total investment of $24.7 million.
Stop TB has provided support for the development of 71 concept notes with TB components, and supported country dialogue and community engagement around these submissions in 30 countries. For this, $3 million has been spent to date, with an additional $1.3 million remaining to be committed.
One of the community engagements supported by Stop TB through this special initiative was for ex-mineworkers, widows and other TB key populations to engage with the TB in Mines regional program in Southern Africa. Vama Jele, Executive Secretary of the Swaziland Migrant Mineworkers Association, said this support enabled his organizations’ members to express their priorities for the regional grant. “This is to understand what matter most to miners and their families,” he said.
Country data systems
The majority of the $13.8 million committed to date under this special initiative has been dedicated to key population size estimation and programmatic mapping, followed closely by mortality analyses (Figure 2).
Figure 2: Areas of investment for the country data systems special initiative ($US)
Future of special initiatives
It is not yet clear if the Fund’s special initiatives will be renewed during the next allocation period. Many of the investments described above were for short-term assistance leading up to implementation, much of which have now been completed (given that 90% of the anticipated concept notes for the 2014-2016 allocation period are either in grant-making stage or have already resulted in Board-approved grants – see GFO article). However, other components supported by the special initiatives are more long-term in nature. These include the sustainability of the regional platforms and support for countries to conduct iterative rounds of health accounts annual expenditure tracking. Ongoing investment for these will depend on Board decisions later this year.