18 Jul 2011

Agenda covers almost all aspects of Fund's operations, an approach that is not without its critics

The Global Fund Board has approved additional funding for 2011 of $4.93 million to accelerate the implementation of its Plan for Comprehensive Reform (also known as the "reform agenda"). This funding includes $1.4 million in staffing costs to allow the Global Fund Secretariat to fill 25 new positions. The positions will be temporary. The Global Fund said that the Secretariat will return to the existing head count levels over the course of 2012 (reduction of 15 positions) and 2013 (reduction of 10 positions).

The Board decision was taken by electronic vote. A briefing note provided to Board members said that the call for additional funding resulted from a request from the Board that the Global Fund Secretariat work with the Finance and Audit Committee (FAC) to evaluate what it will cost to successfully implement the reform agenda. Earlier, the FAC had said that additional funds would be required to accelerate the implementation of the country team approach, a key feature of the reform agenda.

The Secretariat estimated that it would need the equivalent of 75 full-time positions in 2011 and 2012 to implement the deliverables in the reform agenda. However, the Secretariat said that it could come up with 50 of the 75 positions by reallocating current staff.

The reform agenda

The Board endorsed the broad directions of the Plan for Comprehensive Reform at its meeting in May 2011. The plan was put together by the Comprehensive Reform Working Group (CRWG), which was established by the Board in December 2010. The CRWG hired some consultants and undertook consultations with the Secretariat, the Office of the Inspector General (OIG), Board constituencies, and a broad range of Global Fund stakeholders. The consultations included four regional meetings and an online survey.

In a report prepared for the Board meeting, the CRWG said that the Global Fund needed to "move away from the one-size-fits-all approach of financial, management and programmatic engagement that has predominated the first nine years of the Fund's existence." Instead, the CRWG said, the Fund should embrace "a differentiated and calibrated model" that allocates money based upon the potential health results, the risks and the financial situations of different countries.

The Plan for Comprehensive Reform touches on almost all aspects of the operations of the Global Fund. The Plan sets out nine objectives, as follows:

1. enhanced fiduciary control and risk-management;

2. improved resource allocation and increased value for money;

3. improved proposal development and review processes;

4. improved grant management and reduced transaction costs;

5. improved Global Fund internal management;

6. improved partnership and in-country structures;

7. improved governance;

8. enhanced resource mobilisation; and

9. increased sustainability and efficiency.

For each of the nine objectives, the Plan describes the problem and the rationale for reform, and outlines specific deliverables, a timeline, and a statement of the desired impact and benefit. For example, under the fourth objective, improved grant management and reduced transaction costs, one of the problem statements reads as follows:

"Inconsistent performance-based funding decisions, and gap between performance-based funding policies and practice."

The following four deliverables are shown for the fourth objective:

  • improved methods for target setting and strengthened measurement of quality, coverage and impact in Global Fund-supported programmes;
  • application of improved criteria for assessing the Global Fund contribution to targets;
  • strengthened oversight on performance-based funding, defined and implemented as part of the roles of country coordinated mechanisms (CCMs), local fund agents (LFAs) and principal recipients (PRs); and
  • strengthened guidance to countries, including through capacity building and intensified work with partners.

Many of the objectives and deliverables in the Plan for Comprehensive Reform are not new. Some objectives and deliverables were included in the design of the new Global Fund funding architecture (e.g., the transition to a single stream of funding, and the requirement for consolidated proposals). Others are associated with Round 11 (e.g., use of a common Global Fund-GAVI proposal form for the health systems strengthening component.) (GAVI is the Global Alliance for Vaccines and Immunisation). Still others stem from processes that were launched some time ago (e.g., development of the new CCM Guidelines).

However, several of the deliverables have not yet been implemented or fully implemented. Here are some examples:

  • enforcement of minimum requirements at the level of PRs and key sub-recipients (SRs) for financial management and controls;
  • introduction of PR/SR self-assessment;
  • implementation of a risk-tailored approach to disbursement request processing (by ensuring that internal sign offs and reviews better reflect risks); and
  • model revisited for a global and regional multi-stakeholder technical assistance (TA) and capacity development coordination platform.

At its May 2011 meeting, the Board made decisions in five areas where the CRWG believed "early gains" in the reform agenda could be made: fiduciary controls, value for money, partnerships, business model and governance. (See GFO article on Board decisions.)

This all-encompassing approach to the reform agenda has not been without its critics. In its report to the May 2011 Board meeting, the Portfolio and Implementation Committee (PIC) said that the areas of reform in the Plan for Comprehensive Reform were "too broad." The PIC also expressed concern about the lack of a Global Fund-wide strategy to provide a framework for, and to drive, the reform agenda.

The Plan for Comprehensive Reform is available as an annex to the Report of the Comprehensive Reform Working Group on the Global Fund website here. Look for Board Document GF/B23/13.

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