Comments on the Funding Awarded to El Salvador
When the Global Fund Board approved early applicant funding for El Salvador for HIV under the new funding model (NFM), it also approved funding for the renewal of two existing HIV grants. The amount of renewal funding approved was $3.9 million. When combined with the $20.2 million in NFM indicative funding and the $2.9 million in NFM incentive funding, total funding awarded to El Salvador was $27.0 million.
The principal recipients (PRs) for the two existing HIV grants are the Ministry of Health (MOH) and the United Nations Development Programme (UNDP). Both grants are single-stream-of-funding. The early applicant funding will be combined with the funding for two existing HIV grants.
The Global Fund provided one narrative to explain the comments of the Technical Review Panel (TRP) and the Grant Approvals Committee (GAC) for both the new funding and the renewals. This article provides a summary of the comments.
The GAC said that both existing grants performed well in their first implementation period. The main focus for the next implementation period will be doing prevention work in key affected populations, covering gaps in the treatment programme and strengthening the prevention-of- mother-to-child transmission (PMTCT) component. Comprehensive services will be provided for men who have sex with men, transgender populations and female sex workers. In addition, testing and prevention services for prisoners will be provided. In the first implementation period, prevention activities were directed primarily at the general population.
During the first implementation period of the grant being managed by UNDP, work started on transitioning to a new PR. In the concept note, the CCM proposed the local office of Plan International as the new PR. The CCM said in its concept note that the Plan International office received extensive technical assistance and training in 2012. The GAC said that the local fund agent has been asked to assess the capabilities of the Plan International office, and that the Global Fund Secretariat will carry out a more detailed assessment during grant making and will include risk mitigating measures in the grant agreement if any such measures are needed.
When it reviewed the concept note, the TRP asked for several clarifications. When the GAC reviewed the concept note, it recommended that the funding allocation for PMTCT be reviewed and that the government be asked to finance a greater share of this programme; that more of the cost savings from efficiencies be directed towards prevention in key affected populations; that more funding be allocated to improving quality of care for persons living with HIV; and that more be done to improve the quality of epi data.
The TRP clarifications and the GAC recommendations were addressed during grant making. The budget for PMTCT was reduced significantly after the government agreed to a corresponding increase in its share of the co-financing. The PR transition plan was finalised.
The GAC said that there is a need for a more regional response to HIV in Latin America. It suggested that El Salvador is in a good position to push for this because it currently holds the presidency of the regional coordinating mechanism under the Council of Ministers of Health of Central America (COMISCA).
The GAC said that UNAIDS and its partners are initiating a policy dialogue in Central America, with a view to (a) better focusing HIV investments where they will have the greatest impact, with particular attention to men who have sex with men, transgender people and other key affected populations; and (b) supporting countries to access needed resources.
Information for this article was taken from Board Decision B28-EDP-24 and from Board Document GF-B28-ER18, the Report of the Secretariat Funding Recommendations for June 2013. The latter document is not available on the Global Fund website. The text of the Board decision will be included in an electronic decisions document to be released after the Board meeting in Sri Lanka (18–19 June).