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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

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slide1

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

global fund is committed to impact on malaria
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

increasing country evidence of malaria impact

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

slide6

Malaria Grants – Rounds 1 to 7

West Pacific

Andean

RMCC

Total lifetime budget (million USD)

Less than 20

20-50

More than 50

performance rating at 18 months
Performance rating at 18 months

* Includes HIV/TB grants

round 8 trp recommendations

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
slide11

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)
board decision point gf b18 dp7 on amfm
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
funding decision
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
decision approval of round 8
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
category 2 composite index 3 and category 2b
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’
slide24

Malaria Grants – Round 8

Total 5-year ceiling amount (million USD)

Less than 20

20-50

HSS component

More than 50

slide25

Malaria Grants – Round 8

Total 5-year ceiling amount (million USD)

Less than 20

20-50

HSS component

More than 50

round 8 specific malaria outcomes

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

topics of discussion 1
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
topics of discussion 2
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
extract of specific recommendations
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