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Malaria Round 8 Lessons Learned & Outcomes of 18 th Global Fund Board Meeting

Malaria Round 8 Lessons Learned & Outcomes of 18 th Global Fund Board Meeting Roll-Back Malaria Board Meeting 10 November 2008 Professor Rifat Atun Director, Strategy, Policy and Performance Cluster The Global Fund Global Fund is committed to impact on malaria

MikeCarlo
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Malaria Round 8 Lessons Learned & Outcomes of 18 th Global Fund Board Meeting

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  1. Malaria Round 8 Lessons Learned & Outcomes of 18th Global Fund Board Meeting Roll-Back Malaria Board Meeting 10 November 2008 Professor Rifat Atun Director, Strategy, Policy and Performance Cluster The Global Fund

  2. Global Fund is committed to impact on malaria • Dedicated to targets of GMAP • Working with partner on prevention, scaling up effective treatment & on TA in areas such as procurement • Providing flexible financing while adhering to PBF for impact Round 8 represents a significant step in increasing value of funds – GF is integral to the fight against malaria

  3. Results: people reached with services

  4. Acceleration of scale up

  5. 2007 2002 2006 2001 2003 2005 Increasing country evidence of malaria impact Declining malaria in health facilities after intervention: Rwanda, 2001-2007 Incidence↓~64% 2004 Year

  6. Malaria Grants – Rounds 1 to 7 West Pacific Andean RMCC Total lifetime budget (million USD) Less than 20 20-50 More than 50

  7. Performance rating at 18 months * Includes HIV/TB grants

  8. Percent of 5 2 Year Upper 5 Year Upper Number Percent of 2 Year Within disease Year Upper Ceiling all Ceiling all Disease Proposal recommended Upper Ceiling success rate Ceiling Recommended Recommended for funding Budget Budget (US$ millions) (US$ millions) HIV (including HSS requests) 37 of 76 49% 1,196 38% 3,416 46% Tuberculosis (including HSS requests) 29 of 57 51% 344 11% 960 13% Malaria (including HSS requests) 28 of 41 68% 1,623 51% 3,014 41% TOTAL 94 of 174 54% 3,163 100% 7,390 100% Round 8: TRP Recommendations

  9. Round 8: TRP Recommendations

  10. Category 2B Proposals: Composite Index 3

  11. Round 8: Key Outcomes - Number of Proposals Overall success rate: 54% (94 of 174, highest to date) • Within the Diseases: • Malaria: 68% • Tuberculosis: 51% • HIV: 49% Health systems strengthening 'parts'fared well • Overall success rate: 56% (25 of 45, as part of 174)

  12. Board Decision Point GF/B18/DP7 on AMFm • Policy Framework and Implementation Plan approved • GFATM to host and manage the AMFm in Phase 1 in a limited number of countries • Pre launch overseen by AMFm Ad Hoc Committee • 19th Board meeting: decision on the Governance structure for the oversight and performance monitoring of implementation of Phase 1 • Independent technical evaluation of AMFm roll-out • Work and support of the RBM Task Force, UNITAID and other partners acknowledged and their support requested to develop and implementation of AMFm

  13. Funding Decision • Round 8 Phase 1: proposals to be approved for funding—collectively subject to a 10% efficiency adjustment: max. limit of $2.753Bn for P1 • Category 1’ and ‘Category 2’ with composite indices 8, 6, and 5 • Round 8 Phase 2: Collectively be subject to a maximum limit of $3.087Bn* (75% of the P2 amounts in the R8 recommended proposals). • New Rolling Continuation Channel (RCC): RCC 1 approved by the Board each be subject to a limit of 140% of the amount of the incremental funding approved for the P2 period of the relevant expiring grant. • Phase 2 and RCC: Efficiency savings of 10% (US$0.5Bn) until 31 December 2010, in P2 renewals of existing grants and upcoming RCC renewals • Round 9: deadline for submission of proposals extended to 6/2009. • *Limit may be partially or fully relaxed If new resources become available

  14. Decision: Approval of Round 8 • The Board approves for funding for an initial two years those Round 8 proposals recommended for funding by the Technical Review Panel (TRP) as ‘Category 1’ and ‘Category 2’ with composite indices 8, 6, and 5

  15. Category 1

  16. Category 2: Proposals with Composite Index 8

  17. Category 2: Proposals with Composite Index 6

  18. Category 2: Proposals with Composite Index 5

  19. Category 2 Composite Index 3 and Category 2B Round 8 proposals recommended for funding by the TRP and identified as ‘Category 2’ proposals with composite index 3 and ‘Category 2B’ will be approved for funding for an initial two years (subject to): • through Board confirmation by email (or, if appropriate, at the 19th Board Meeting), as funds become available under the terms of the Comprehensive Funding Policy; and • based on the composite ranking of such proposals in compliance with Board’s decision entitled ‘Prioritization in Resource Constrained Environments’

  20. Category 2: Proposals with Composite Index 3

  21. Category 2B Proposals: Composite Index 8

  22. Category 2B Proposals: Composite Index 6

  23. Category 2B Proposals: Composite Index 5

  24. Malaria Grants – Round 8 Total 5-year ceiling amount (million USD) Less than 20 20-50 HSS component More than 50

  25. Malaria Grants – Round 8 Total 5-year ceiling amount (million USD) Less than 20 20-50 HSS component More than 50

  26. Malaria – proposal support working well

  27. 5 6 7 8 Round 8 – specific malaria outcomes 1800 80% 1600 70% 1400 60% 1200 50% 5 1000 6 40% 7 Proposal success rate 800 Total 2-year ceiling amount (million USD) 8 30% 600 20% 400 200 10% 0 0% 2-year ceiling amount Success Rate

  28. Topics of discussion (1) • Gender • Overall, fewer proposals were 'gender transformative' • However, more diversity (and strength) when included • No proposal 'not recommended' if did not include gender • Opportunity for 'case studies' to be released for R9

  29. Topics of discussion (2) • Health Systems Strengthening: • Cross-cutting HSS requests 'possible' in Rd 8 formulation • Yet, WHO Building Blocks not optimal as 'operational framework' on which to prepare integrated responses to constraints, leading to 'formulaic' elaborations of HSS needs (Note: Few requests in Financing; Leadership/Governance) • Community Systems Strengthening • Most proposals included some level of CSS activity • Covered the full range of activities • However, not easily 'extracted' for analysis/proof of concept

  30. Extract of specific recommendations • Delay applying for funding if no track record for performance:Especially when applicants are requesting 'scaling up' of activities from an earlier grant that has not started/not signed, or just beginning • Value for money: pre-TRP financial review of 'large budgets' • Health workforce salary requests: recommendation for Global Fund to identify principles that guide requests for salary support – with particular focus on National HR plans • Eligibility for multi-country proposals: Reduce proposals that 'select' eligible countries rather than focusing on epidemiological/social/political issues

  31. Indexing

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