The Global FundDecember 2005

2000 July G8 endorse new AIDS, TB and malaria targets in Okinawa

2001 AprilJuneJuly

African leaders commit to greater response in AbujaEndorsement of the need for a global fund at UNGASSOver US$ 1.5 billion in pledges made by G8 in Genoa

2002 JanuaryAprilJulyNovember

Global Fund created at first Board meetingRound 1 proposals approved at second Board meetingExecutive Director assumes roleInitial disbursements of grants commence

2003 JanuaryJuneOctober

Round 2 proposals approved at fourth Board meetingAdditional funding pledges made by G8 in EvianRound 3 proposals approved at sixth Board meeting

2004 June Round 4 proposals approved at eighth Board meeting

Global Fund: History and key milestones

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2005 February First 24 grants undergo Phase 2 Review

Unique structure and operations

• Additional resources for the three diseases– US$ 8.8 billion has been pledged to the Global Fund through 2009-10.

– Non-traditional sources include private foundations and corporations – resource mobilization efforts on-going.

– Funding from donors and for recipient countries is expected to be additional to existing contributions and health budgets.

• Broadened public / private / civil society partnerships– At country level, public sector, NGOs, development partners and private sector participate in

a country-led coordination mechanism for proposal design and implementation.

– The Global Fund itself is governed by a Board with representation from donor and recipient governments, NGOs, communities, foundations and private sector.

• Performance-based funding aligned with harmonization efforts– Grant recipients to focus on results rather than on inputs.

– Building on existing systems and common/harmonized donor arrangements.

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Unique structure and operations

• Lean organizational structure – The Global Fund has no field offices and does not implement programs; its small

Secretariat is based in Geneva.

– Local Fund Agents are contracted to conduct program, budget & report assessments and to monitor activities.

– An independent Technical Review Panel of disease & development specialists meets to review grant proposals and to make funding recommendations to the Board.

• Transparency, openness, flexibility, responsiveness– Transparency as a key operating principle means all approved proposals, program details,

contact information and up-to-date financial data are available on the website at www.theglobalfund.org

– A Partnership Forum is held every two years – the first took place in July 2004 in Bangkok, second in Durban in 2006 – to invite the input and recommendations of all stakeholders, particularly those without a direct voice on the Board.

– Commitment to changing in response to lessons learned and valid criticisms.

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Model for grant accountability aims to find the right balance between key priorities

Sustainability/

Ownership

Speed

• Rely on local stakeholders at the country level to implement programs and manage grant proceeds

• Encourage the use of existing standards and processes

• Monitor and evaluate programs and make decisions on future funding based on performance and accountability

• Promote rapid release of funds to support target populations

Accountability

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The Global Fund grant process

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•China

•Mongolia

Countries with grants from multiple rounds are assigned the round in which they received their first grant.

Countries with Global Fund grants

With Round 5, the Global Fund has approved• Over 350 components • in over 125 countries • 2-year budget: US$ 3.5 billion• 5-year budget: US$ 8.8 billion

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Americas ($256 M),

9%

Eastern Med ($135 M),

4%

Western Pacific

($232 M), 8%

Europe($220 M),

8%

Southeast Asia ($340 M),

11%

Africa ($1885 M),

60%

Distribution of Global Fund commitments Two year budgets

Malaria ($881 M)

29%

HIV/AIDS ($1666 M)

54%

TB ($397 M)

13%

Integrated ($22 M)

1%

HIV/TB ($94 M)

3%

Expenditure by disease

Expenditure by region

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Grant portfolio details

Drugs & Commodities

(49%)

Human Resources &

Training (20%)

Infrastructure (13%)

M&E (6%)

Administration (7%)

Other (6%)

Academic and Educational institutions

5%

Government51%

NGOs25%

Private sector5%

Faith-based organizations

5%

Other5%

People living with

HIV/TB/malaria4%

Components by sector of recipientsRound 2-4 only. Data not available for Round 1.

Components by expenditure category Round 1-4

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Building the measurement framework

Operational performance

Grant performance

System effects

Impact

Sample Measurementse.g. declining mortality from HIV, TB and malaria

e.g. additionality, sustainability and partnerships

e.g. coverage, people reached by services

e.g. actual against target disbursements

Indicators and measurement tools have been developed with relevant partners for all levels

Proposal Management & Grant Negotiation

Proposal ManagementProposal Success Rates

Building the measurement framework

Operational performance

Grant performance

System effects

Impact

Secretariat Cost Base

Key Highlights Core IndicatorsResource Mobilisation

Resources vs. Need

0

50

100

150

200

250

Round 1 Round 2 Round 3

US

$ M

illio

ns

Submitted Eligible Approved by Board

16

16

16

16

22

19

14

19

11

10

10

10

5

4

4

3

n=

n=

0

20

40

60

80

100

120

140

Q1 03 Q2 03 Q3 03 Q4 03

Op

era

tin

g E

xp

en

ses (

US

$ m

illio

ns)

P rojected Expenditure Actual Expenditure

n=

Disbursement & Grant Support

n=n=

n=

n=n=

n=

$500

$2,000

$1,200

$3,000

$0

$1,000

$2,000

$3,000

$4,000

$5,000

Cumulative Contributions Cumulative GrantCommitments

US

$ (

mill

ion

s)

Money already Disbursed Cumulative Contributions since 2002

Cumulative Grants Signed Cumulative Grants Approved by Board

0 10 20 30 40 50 60 70 80 90 100

Percentage of TotalDisbursement

Amount Requestedto Date

Percentage of 2Year Grant Period

Elapsed

Percentage

Initial focus on operational performance:the Executive Dashboard

Proposal Manageme

nt

Performance-Based Funding

& Grant Support

Business Services

Grant Negotiation

Resource Mobilisation

Building the measurement framework

Operational performance

Grant performance

System effects

Impact

A suite of tools has been developed to support grant performance management and track grant progress

GSC

Month: 0 12 16 18 20

Grant Performance Report

Implementing the grant performance systemPerformance data in real time

Grant Proposal

Form

CCM Request for continued

funding

Annual

Review

Grant Scorecard

Grant Agreement

Attachment 1

Annex A

Grant Performance Report

Disbursement Request/ Progress Update

Performance rating system

Decision category Grant Performance rating

Contextual considerations

“Go”Phase 2 grant committed for the remaining proposal period (years 3-5)

Aexpected or exceeding

expectations

andNo or minor

contextual issues

“Conditional go”Phase 2 grant committed conditional upon time-bound actions to be taken by the PR/CCM (maximum 1 year)

B1Adequate

and/or

Major contextual issues that can be addressed by the

PR/CCM

“Revised go”CCM/PR reprogramming (targets and Budget substantially revised for Phase 2) subject to Global Fund approval

B2inadequate but

potential demonstrated

and/or

Major recent improvements in

program supporting environment

“No go”*Phase 2 grant not committed *requires Board Decision C

unacceptableor

Critical contextual risks beyond PR

and/or CCM control

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Performance based funding works

• Grants are split into four categories based on performance. Grants that under-perform have only received 45 percent of the scheduled disbursements.

Share for the Global Fund

Using conservative approaches, estimates suggest:

• For malaria, the Global Fund contributed 45% of all international funding in 2004. This will greatly increase in 2005

• For tuberculosis, the Global Fund provides 66% of all international funding in 2005

• For HIV/AIDS, the Global Fund contributes 20% of all international funding in 2004

Conclusion

• A great experiment• Passed its first tests• A tool for national efforts to fight disease• A flexible instrument for change• Ownership: stakeholders has the freedom

and responsibility to develop the Global Fund so it remains useful

• A Public-private partnership opportunity