A transition preparedness assessment framework has been developed for the Global Fund by Curatio International Foundation (CIF), a Georgian NGO. The framework is designed to allow countries to assess their readiness to fully fund and implement their TB and HIV programs once they no longer receive financial support from The Global Fund and other donors.
The framework was developed by the CIF as part of a larger study designed to enhance the understanding of factors affecting sustainability.
The framework does not look only at financial readiness. Rather, it holistically reviews the local environment – including political, legal, fiscal and governance factors, country systems and capacities – as well as programmatic needs.
The assessment, which involves both a literature review and interviews with the stakeholders, is one of the tools available to support countries in transition planning. It helps identify the strategies and actions necessary to assure responsible and gradual transfer of HIV and TB programs.
The CIF developed a draft framework and tested it in Belarus, Bulgaria, Georgia, and Ukraine. CIF researchers then revised the tool, incorporating lessons learned from the pilot countries.
A report was produced in each of the four pilot countries and shared with local stakeholders. A synthesis report was also produced to help researchers refine the framework. There are no plans to make these reports public, though they may be made available upon request.
Nicolas Cantau, The Global Fund’s Regional Manager for Eastern Europe and Central Asia, told GFO that “a key advantage of the transition readiness assessment framework is that it reviews both contextual and operational factors necessary for responsible transition.” For example, he said, in Eastern Europe a key gap to ensure sustainability of programmatic interventions is the absence of a legal framework that allows governments to contract NGOs to provide services. He added:
“We are supporting a shared responsibility and a shared process. We can offer the methodology, which is very important, but we also offer a flexibility, as country teams are free to modify the tool or to use other tools as well. The assessment is a starting point for looking at the internal problems and thinking about the development continuum. The ownership of the countries is vital. This tool will help countries in developing their costed transition plans, which potentially show all potential gaps.”
Mr Cantau said that The Global Fund is currently developing a policy on transition and sustainability, which will establish some general principles. The policy will be supported by a number of methodological tools, including the assessment framework developed by the CIF. Mr Cantau said that he expected the policy will be adopted by June 2016.
The framework tool may be used in a few countries in the next few months, and then become more widely available once the policy is adopted. Although the tool was developed in the EECA, it is intended for use in all regions. It is expected that the tool will be also used as the basis for developing operational guidance on transition for country teams at The Global Fund.
Dr Ketevan Chkhatarashvili, President of the CIF, said that the assessment “has revealed the complexity of issues that are crucial for responsible transition and similarities between countries. Not all issues might be fixed at a national level,” she said. “There are problems that can and should be dealt with at a regional level. The Global Fund’s regional programs might be appropriate for this.”
Reports have been shared with Georgia and Ukraine stakeholders. So far, reactions have been positive. “We are planning to hold validation workshops in Belarus and Bulgaria in the Spring of this year,” said Dr. Chkhatarashvili. “We very much hope that this framework will help countries to undertake a thorough planning of transition period and to avoid negative consequences that have been experienced by countries that have transitioned earlier.”
Editor’s note: The author of this article, Tinatin Zardiashvili, was part the international team of professionals who helped to develop the framework. Tinatin participated in the desk review and the piloting of the tool in Georgia.