The country coordinating mechanism (CCM) and the Ministry of Health and Child Welfare in Zimbabwe have released a report describing the country’s experience submitting a concept note in the transition phase of the new funding model (NFM) of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
In June 2013, Zimbabwe, as an early NFM applicant, was awarded $279 million for its HIV programmes.
The 32-page report, which is based on interviews with a range of stakeholders that participated in the process, provides a chronology of the NFM application as well as a discussion of specific aspects of the process, such as the country dialogue, use of the modular tool, the role of the CCM, the participation of civil society and feedback from the Technical Review Panel (TRP).
The report was commissioned by the United Nations Development Programme (UNDP), which serves as the principal recipient (PR) for all Global Fund grants in Zimbabwe.
GFO has written before about the concept note development process in Zimbabwe, most recently here. In this article, we report on some of the issues and observations in the report that were not covered in the earlier articles.
According to the report, the fact that Zimbabwe was provided with an indicative funding amount was seen as the “major positive intervention of the NFM. The fact that a specific sum was ‘on the table’ in advance … was seen to greatly increase the predictability of Global Fund financing and served as a significant source of motivation to meet the challenging deadline.”
There was confusion about precisely what was meant by “country dialogue,” the report said. Some people thought it referred to the ongoing dialogue that takes place in Zimbabwe in a range of forums about the HIV response. Others thought that the country dialogue was as an additional (and Global Fund–specific) process that needed to be specifically undertaken “as a prerequisite to an application to the Global Fund.” This is how the CCM interpreted it.
However, the report pointed out, one document on the NFM prepared by the Global Fund stated that the country dialogue is “not a Global Fund process” and referred to the “alignment of the Global Fund’s processes to existing country dialogue.” The report said that “this language could be interpreted as meaning that adequate documentation of existing dialogue processes could be sufficient for the purposes of the NFM. Some clarification of this issue in future guidance may be warranted.”
To add to the confusion, the country dialogue concept was understood by some people to refer to the dialogue that is between (a) the country and (b) the Global Fund Secretariat and the TRP during the process of developing the NFM concept note.
Use of the modular tool
The report discusses several challenges encountered in the use of the modular tool. (In the NFM, the modular tool replaces the performance framework used in the rounds-based funding.) According to the report, the purpose of the modular tool was not clear, the tool was difficult to use, and completing it significantly increased the workload compared with the process used in the past.
“The need to enter detailed targets, activities and financial and budget inputs into the template felt disconnected from the country dialogue process and inconsistent with the stated aims of the NFM to promote high-level impact and strategic investment thinking,” the report said. “Interviewees were strongly of the view that this level of detail would be appropriate at a later stage of the NFM process.”
The report said that attempting to translate the national AIDS plan into the detailed modules was particularly challenging – described by one interviewee as “an exercise in fitting a square peg into a round hole.” The modular tool assumed that national plans are generic and contain a significant level of detail, which was not the case in Zimbabwe, the report said. “Accounting for cross-cutting issues, such as community systems strengthening (CSS), was also difficult, as these did not fit easily into the tool’s ‘compartmentalized’ modular format.”
Interviewees said that the Global Fund’s CSS Framework, developed in 2010, was not well reflected in the NFM’s modular tool.
Role of the CCM
Regarding the role of the CCM in the process, there was a general consensus among the people interviewed for the report that the process was “appropriately CCM-led” and that the NFM had enabled a broader national participation. However, a small number of interviewees said that the process was substantially driven by the Global Fund country team, rather than by the CCM. These people said that the specific role of the CCM in the process needs to be made more explicit.
Emphasis on human rights
Most of the people interviewed welcomed the emphasis on human rights under the NFM, but they added that the TRP needs to understand the difficult social and political context that exists in some countries. The report said that the Global Fund could be more flexible in its funding arrangements – for example, by using “alternative language” that may allow issues for key populations to be addressed more implicitly.
The interviewees described the NFM process as “demanding” and said that for CCMs with insufficient capacity, there is a risk of the government or development partners dominating. They said that these CCMs might need some capacity building.
The report said that countries would benefit from additional information about the process that the Global Fund follows after final submission of the concept note, including the role of the new Grants Approval Committee.
The report said that Zimbabwe produced a number of materials during its NFM application process that may be of interest to other countries. These include its report on the stakeholder gap analysis meeting as part of the country dialogue, and detailed roles and responsibilities for the concept note writing team. The report suggested that the Global Fund consider making these and other materials produced by early applicant countries available to future applicants.
The report, “The Experience of Zimbabwe with the Global Fund’s New Funding Model,” June 2013, can be downloaded directly in PDF format here.