Global Fund to Fight HIV, TB and Malaria GFATM

1
Global Fund to Fight HIV, TB and Malaria
(GFATM)Role of WHO Country Office

• Regional GFATM Task Force
• Jihane Tawilah, MD,MPH
• 18th Meeting of RD with WRs Regional Staff
• EMRO,Cairo
• 7-10 October 2002

2
Overview of the Presentation

• Short Briefing about the GFATM
• Review of GFATM experience to date
• Challenges at country level
• Involvement of WHO/EMRO
• Defining the Role of WHO/EMRO at country and
  regional level

3
GFATM - Objectives

• Initiated by Koffi Annan, in June 2001-UNGASS HIV
  
• Reduce morbidity and mortality in developing
  countries related to HIV, TB and malaria (cause
  of 6 million deaths per year - 10 of all deaths)
  
• US 1.92 billion pledged to date (USA, Japan,
  Italy, UK)
• US 700-800 million to disburse in 2002
• Mobilise further resources
• Political momentum to improve health
• Utilise unused donors contributions
• Deliver rapidly

4
GFATM - Structure

• Partnership Forum
• Informal grouping of interested persons and
  entities
• Express views on Foundation policies strategies
• Review progress
• Platform for debate , advocacy, fund raising
• Sustain coordination, political commitment,
  momentum
• Foundation Board
• 18 voting
• 7 DC (Brazil, China, Nigeria, Pakistan, Thailand,
  Uganda, Ukraine)
• 7 Donors (France, Italy, Japan, Sweden, UK, USA,
  EC)
• 2 NGOs, 2 Private sector
• 4 non voting
• 1 affected person, 1 WHO, 1 UNAIDS, 1 World Bank,
  1 Swiss
• Governing body
• Policies, strategies, guidelines, workplans etc..

5
GFATM - Structure

• Secretariat
• Day to day management
• Oversee proposals
• Review processes
• Commission reviews
• Coordinate with agencies etc..
• World Bank
• Trustee for the moneys
• WHO
• Administrative support
• Technical review process
• France and Thailand chair the working group on
  technical review of proposals - panel of 17
  experts

6
GFATM - Main Principles

• Financial instrument, not an implementing entity
• Additional Financial resources
• Programmes that reflect national ownership
• Balanced approach to different regions, diseases
  and interventions
• Make use of existing international mechanisms and
  health plans
• Scientific technical standards balanced with
  local realities and priorities in service
  delivery
• Rapid and efficient disbursement
• Clear and transparent operations and
  responsibilities

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GFATM - Country processes (1)

• Basic Principles
• National ownership - High-level sustained
  political and commitment
• Promote Public/private partnerships- NGOs
• Respect existing mechanisms and plans- Strengthen
  Health systems
• Support innovative programmes based on best
  practices, scaling up and increased coverage
• Linked to indicators and assessments
• Most affected countries and those with growing
  epidemics
• Build on Consistent with international law and
  agreements (Trade-Related Aspects of Intellectual
  Property Rights)
• Help reduce stigmatization of and discrimination
• Women, children and vulnerable groups

8
GFATM - Country processes (2)

• Coordination mechanism
• Country Co-ordinating Mechanism (CCM)
• Country proposals
• Country Co-ordinated Proposal (CCP)
• One , two or three diseases or crosscutting
• Could be an existing plan
• Integration in National Health programme
• Simple
• Budget tied to designated partner
• Outcomes, targets and results
• Channelling Funds
• Partner of CCM
• Clear indication of how funds are disbursed
• Monitoring
• Country and Global - annual assessment

9
GFATM - Quick StartEMR First round

• Submission (US in first year)
• Afghanistan - 2 proposals for 3.51 million
• Djibouti - 3 proposals, 5.24 million
• Egypt - 1 proposal, 2 million
• Lebanon - 1 proposal, 0.45 million
• Morocco - 1 proposal, 1.27 million
• Pakistan - 2 proposals 6.76 million
• Somalia - 1 proposal, no budget
• Sudan - 8 proposals, 23.63 million

10
GFATM-Quick Start First round Results

• More than US 5 billion requested for 300
  proposals over 5 years
• 58 separate proposals from 40 countries totaling
  US 1.6 billion over five years were approved.
  US 616 million was committed for disbursement
  over the next two years.
• 67 of this funding is for HIV/AIDS, 23 for
  tuberculosis, and 10 for malaria
• Funds distributed across regions Africa 57,
  Americas 11, Eastern Mediterranean MOROCCO 1,
  Eastern and Central Asia 7, Southeast Asia 18,
  and Western Pacific 7.

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GFATM Next Steps

• Initiate First Round Proposal Disbursements-
  Assess PR and LFA Grant agreements with CCM.
• Review the Second Round of Proposals - the Board
  will award Grants in January 2003.
• Develop a Policy and Planning Framework- define
  the financial prospectus of the GFATM within the
  global needs efficient and effective mechanisms
  of governance policies for the procurement and
  distribution of products the technical review of
  proposals grant performance monitoring and
  evaluation.
• Build a Highly Effective Secretariat (50 People )

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GFATM Challenges at Country Level in the EMR
(1)

• Developing the country mechanism
• Competing country applications and the fear from
  geo-political and social influences
• Uncertain eligibility of the countries with low
  epidemic levels
• Short Deadlines and timing during summer
• Rapid dissemination of information among partners
  
• Urgency for broad partnership formation- CCM
• Additionality among partners vs competition
• Engaging high political commitment
• Obtaining legitimacy of the CCM
• Democratization of the CCM process to reflect
  national response and concerns not only MOH

13
GFATM Challenges at Country Level in the EMR
(2)

• Developing the proposal
• Incomplete National Strategic Plans (validation,
  costing, ME capacity, lack of epidemiological
  data)
• Linking proposals to NSP
• Decisions on disease priorities
• Quality and balanced proposals (prevention and
  care standards vs. service delivery)
• Annexes are heavy partners information, budget
  and workplans
• Demonstrating impact and additionality
• Identifying Appropriate financial and
  implementation arrangements (management and
  auditing systems)
• Language barriers (Persian and Arabic)
• Costing and budgeting- Hire consulting agency
• LOTS OF WORK AND GOOD WILL

14
GFATM EMROS RESPONSE

• Regional Task Force for GFATM-Coordination and
  support
• Revised Arabic translation of the GFATM documents
• Full support and direct involvement of WRs
• Advocacy Rapid dissemination of information
  web page www.emro.who.int/GFATM/
• Regional Capacity Building, 1-3 July 2002
• Northern and Southern Sudan Sectors Meeting
  18-19/9/2002
• Mobilizing funds and Direct Technical Assistance
  through RA visits, Intl and local consultants,
  WHO offices and global partnerships (RBM, Stop
  TB,UNAIDS)
• Draft proposal review Monitoring of process in
  EMRO
• Active coordination with GFATM secretariat

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GFATMEMR Submissions for Round Two

AFG ATM Integrated proposal for 2 years EGY AT
IRA ATM JOR A PAK ATM SOM TM SUD ATM
for each of Northern and Southern Sectors YEM
ATM _______________________________________ LEB
decided to present in next round DJI started
preparations but gave up IRAQ did not complete
required forms
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GFATM Defining the role of WHO/EMRO and country
offices

• Continue to deliver timely response what are the
  funding and technical implications?
• Sudden increased demand on existing limited
  technical expertise in the region
• Accelerating National Strategic Planning
• Strengthening the CCM process
• Clarify WHO Role vis-a-vis LFA, PR and other
  GFATM managerial processes at country level
• WHO Technical role in implementation remains the
  priority strategic information, monitoring and
  evaluation- but no formal agreement with the
  GFATM and partners
• Countries in Complex emergencies