On 28-30 April 2010, the Global Fund Board held its 21st board meeting in Geneva. GFO was present, with observer status.
The main decisions made at the meeting, in chronological order, were as follows. (For precise wording of what the Board agreed, see the decision points document at www.theglobalfund.org/en/board/meetings/twentyfirst. Background documentation will also, in time, be posted by the Fund at the same location.)
National strategy applications (NSAs): The Board approved the launch of a new wave of funding for NSAs. This will be the second wave; the first wave, in 2009, resulted in five of the seven proposals submitted being approved for funding. Wave 2 is to be launched in time for funding decisions to be made at the Board meeting planned for the fourth quarter of 2011. In terms of access to available resources, the NSAs will have the same priority as other proposals being considered for funding at that time. The Global Fund expects a much larger number of countries will be involved in Wave 2 than were involved in Wave 1. [See Decision Point 4.]
Joint health systems funding platform: The Board approved two actions under Track 2 of this initiative: (1) the development, with the Global Alliance for Vaccines and Immunisation (GAVI), of a joint proposal form "for use as soon as possible, no later than Round 11"; and (2) further development of the option of joint funding requests based on a jointly assessed national strategy, "such that funding requests emanating from a pilot in 4-5 countries could be approved by the Board at the same time as it approves Round 11." (Track 1, which is already underway, and which did not require a Board decision, involves the Global Fund, GAVI and the World Bank working together to explore opportunities for improved harmonisation in countries where the Fund and GAVI have already approved Health Systems Strengthening (HSS) grants and where the World Bank also has HSS investments.) [Further details are provided in Article 6. See also Decision Point 5.]
Additional funding for strongly-performing grants: The Board approved a new mechanism to allow additional funding for strongly performing grants in order to accelerate the programmes covered by these grants. A separate funding envelope has been established for this purpose, with $30 million allocated to 2011 (the amount will need to increase significantly in subsequent years). Under this mechanism, a qualifying CCM will be able to request additional funds at the time that it submits its Request for Continued Funding (under the single stream of funding, this would be once every three years). The Board will consider establishing a funding reserve for 2012 at its last meeting of 2011. [For further details, see Article 4. See also Decision Point 6.]
TRP matters. The Board modified the criteria that the TRP uses to review proposals, by adding criteria related to the Global Fund's strategies on community systems strengthening, gender equality, and sexual orientation and gender identity. The Board also made some minor changes to the terms of reference of the TRP, and approved an exception to these TOR, for Round 10 only, to allow several members of the TRP to stay on for an extra round of funding. [For further details, see Article 5. See also Decision Point 7.]
Salaries for the most senior employees: The Board delegated authority to a newly established Remuneration Group to approve new staff salaries that exceed the threshold of CHF 245,000 that is set in the Global Fund Human Resources Policy Framework. The Remuneration Group, which is made up of the Chair and Vice-Chair of the Finance and Audit Committee plus two others, will have the authority to adjust the threshold. [See Decision Point 10.]
Quality assurance for antimalarial medicines: The Board amended an earlier decision that provided an interim exemption to the Global Fund's Quality Assurance Policy for Pharmaceutical Products (see the item on Quality Assurance Policy in the "Main Decisions" article in GFO 111, available at www.aidspan.org/gfo). The amendment extends the exemptions to include certain life-saving artemisinin-based antimalarial medicines only for use in a given region or country where there is no viable alternative medicine (as advised by the WHO). The exemption is set to expire on 31 December 2010. The Board also asked the Secretariat to urgently work with the WHO to establish a process whereby the Fund's Expert Review Panel can include, in exceptional cases where no adequate alternatives exist for a finished pharmaceutical product, an assessment of the clinical risk of providing ineffective or no treatment, as well as a quality risk analysis. [See Decision Point 16.]
Round 10: Round 10 will be launched on May 20. A cap has been placed on the cost of Round 10. New prioritisation criteria have been put in place for determining which TRP-recommended proposals will be approved when, in the event of limited funding. Special funding has been made available for tackling concentrated epidemics. [For further details, see Article 1. See also Decision Points 17, 18, 19.]
Other points: Other Decision Points dealt with moving some costs for the AMFm from the 2009 budget to the 2010 budget (Decision Point 9), plans to move the Secretariat to a new office building in 2015 (Decision Point 12), plans to review the Fund's Comprehensive Funding Policy (Decision Point 13), and a declaration by the Board that recognised the links between Millennium Development Goals 4, 5 and 6, and that strongly encouraged CCMs to identify opportunities to include maternal and child health issues in their proposals to the Global Fund (Decision Point 20).