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Optimizing GFATM contribution to HTM in WPR: Role of Technical Assistance. GFATM Working Group. WHO-WPRO. Outline. Background HTM goals, strategies and progress GFATM support in the WPR Role of TA in optimizing GFATM results WHO role (TA and coordination of TA)

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Optimizing GFATM contribution to HTM in WPR: Role of Technical Assistance

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Optimizing gfatm contribution to htm in wpr role of technical assistance l.jpg

Optimizing GFATM contribution to HTM in WPR:Role of Technical Assistance

GFATM Working Group

WHO-WPRO


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Outline

  • Background

    • HTM goals, strategies and progress

    • GFATM support in the WPR

  • Role of TA in optimizing GFATM results

  • WHO role (TA and coordination of TA)

  • Issues and challenges in the provision of TA


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Western Pacific Region


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HTM goals, strategies, progress


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GFATM Funding Support (WPR)

  • Overview GFATM grants in WPR (Round 1-6)

  • Total of US$ 982 million

  • 52 grants from Round 1-6


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GFATM Funding Support (WPR)

Most countries have multiple grants within disease components


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GFATM Funding Support (WPR)

  • Majority of funding are in the bigger countries


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Round 7 Proposals (WPR)

  • 7 countries+ Pacific multi-country

  • Total value of proposal – US$ 322.6 million


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RCC Proposals (WPR)

  • 6 grants are so far eligible (China, Mongolia, Lao PDR, Philippines, Solomon+Vanuatu)

  • Proposals submitted so far:

    • Mongolia TB (US$ 8.5 m)

    • Solomon and Vanuatu Malaria (US$ 40 m)

    • China TB (US$ 70.3 m)


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Projected size of GFATM support in the WPR (incl. successful Round 7)

  • More than US$ 1 billion in grants

  • Close to 70 grants for HTM

  • 7 countries + most of Pacific island countries and areas

We have the money and strategies.

HOW TO MAKE OPTIMAL USE OF THESE RESOURCES?


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Role of Technical Assistance (TA)

Why do we need TA?


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Role of Technical Assistance (TA)

What type of TA is needed?


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Proposal management

Grant negotiation

Phase 2 renewal

Proposal management

Grant negotiation

Term 2 renewal

Implementation

(performance-based)

Implementation

(Performance-based)

Demand for TA for GFATM

Round-based (yearly*)

RCC (quarterly**)

Proposal development (incl strategic planning)

Agreements, incl. prep. M&E and PSM plans

Activity implementation, technical guidance, management

Review, planning and budgeting, agreement negotiations


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Role of Technical Assistance (TA)

TB example: Round 6 approval rate

  • Approvals:

  • 89 of 205 (overall)

  • 35 of 55 (TB)

  • 44 of 114 (HIV)

  • 19 of 59 (malaria)


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Role of Technical Assistance (TA)

TB example: TA behind the success

  • Coordinated TA provision (HQ, RO, CO)

    • RO/HQ coordinate with CO (WHO staff country missions, recruitment of consultants, desk reviews by RO and HQ focal points

    • Country-based or mission series (not one-off)

  • Sound Regional Strategic Plan and national TB control plans

  • Streamlined/well-focused TA

    • TA based on needs of countries

    • Planning frameworks/guides prepared (E.g. Stop TB/HQ)

    • Support from existing TWGs

  • Intensive communication


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Key Issues and Bottlenecks in TA

  • Insufficient recognition of importance of TA

    • Countries often forget or reluctant to include TA

  • Late identification of TA needs

    • Countries request TA after plan is developed/or already experience severe bottlenecks

  • Lack of coordination of TA among partners

    • no coordination mechanism among partners

  • Perception that somebody else is paying for TA

    • perception that TA is not a direct support to countries with direct (tangible) outcome

    • TA is not FREE and quality TA is expensive!


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WHO-WPRO and TA

WHO-WPRO’s inputs so far?

  • Technical assistance to Member States – WHO core function and mandate

  • WHO-WPRO is already active in providing TA for most grants

  • WHO TA is not FREE! TA provided is mostly funded from WHO resources, incl. own regular budget; mostly staff-time (technical and managerial)

  • WHO/CO is a member in all CCMs and all TWGs in the Region


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Key Issues for WHO in TA

  • Limited or overstretched capacity

  • Decreasing WHO staff numbers = increasing work load remaining staff

  • Uncertainty of long-term financing

  • Limited number of qualified consultants to meet increasing complexity of TB control

  • Consultancy fee policies


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  • Limited or overstretched capacity

TB example: Increasing GFATM Grants Globally

Grants in US$

Number of grants


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  • Limited or overstretched capacity

But less regional and country WHO TB Staff


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Key Issues for WHO

2. Synergy of TA delivered by WHO & partners

  • More effective coordination needed among at least 15 technical partners

    • Competition for funding rather than sharing

    • Exchange of technical expertise and experience

  • Existing mechanisms often insufficient


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STB Partnership

ICC

Technical Partners

NTP

WHO

STB Partnership

ICC

Financial Partners

Financial Partners

STB Technical Working Groups

Stop TB Partnership

Technical Partners

Technical Partners

WHO

WHO

  • Synergy of TA

  • Country-based support and external missions

  • Capacity-building workshops

  • Regional coordination and support

TB TEAM – model for better coordinated TA

CCM

Structure

Financial Partners

Country

Global

Regional


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Key Issues for WHO

3. Difficulties in mobilizing funds for TA

TB Example: Comparison of NTP TB budgets (incl. GFATM) and WPRO TB budget between 2002 and 2007


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Key issues for WHO

4. Building and utilizing local capacity

  • Limited capacity of local partners

  • Limited involvement local partners in technical issues

  • Low credibility of local partners

  • Local partners frequently not involved in Technical Working Groups

  • Complexity of requirements of funding donors (E.g. GFATM)


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5. Issues in including TA in Global Fund grants

  • Including TA in the GFATM grant

    • WHO is in all CCMs, MOH is often the PR in WPR

    • Now included in a few grants

      • PNG (HIV: US$1.3 m)

      • Philippines (Malaria: US$150,000)

      • Lao PDR (Malaria: US$ 240,000)

      • Cambodia (TB: US$ 104,000)

  • Advocating TA at higher level in WHO and GFATM

    • Separate agreement between WHO and GFATM (E.g. Funding for GLC services)


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Conclusions

  • TA is important to ensure resources are optimized to achieve HTM goals

  • Quality TA is needed in every step of the GFATM “life cycle”. Need for TA should be identified and requested early.

  • TA is not free. Quality TA is expensive.

  • Country-based TA is crucial. External TA can contribute

  • Mechanism should be in place to better coordinate TA in countries.

  • Mechanism should be in place to ensure TA is available for all GFATM grants (imbedded in GFATM grants + separate from it)


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