A global health partnership Dr. Akram Eltom Director of Partnerships - PowerPoint PPT Presentation

A global health partnership Dr. Akram Eltom Director of Partnerships D li Delivered at ILO side event, d t ILO id t Palais des Nations Geneva 1 st June 2011

The Framework document of the Global Fund to Fight AIDS, Tuberculosis and Malaria “ The purpose of the Fund is to attract, manage and disburse additional resources through a new public ‐ private partnership that will make a sustainable and significant contribution to the reduction of infections, illness and death, thereby mitigating the impact caused by HIV/AIDS, i i i h i d b HIV/AIDS tuberculosis and malaria in countries in need, and contributing to poverty reduction as part of the t ib ti t t d ti t f th Millennium Development Goals .”

A new Public ‐ Private Partnership 1. Operate as a financial instrument, not an implementing entity 2. Make available and leverage additional financial resources g 3. Support programs that reflect national ownership and respect country ‐ led formulation and implementation 4. Operate in a balanced manner in terms of different regions, diseases and interventions 5. Pursue an integrated, balanced approach to prevention, treatment and care 6. Evaluate proposals through independent review processes 7. Establish a simplified, rapid and innovative grant ‐ making process and operate transparently, with accountability. The fund should make use of existing international mechanisms and health plans. 8. Focus on performance by linking resources to the achievement of clear, measurable and sustainable results. bl d t i bl lt

Partnership Approach to Governance p pp A diverse partnership reflected in the Board and Country Coordinating Mechanisms d C t C di ti M h i • NGOs North • NGOs South • Donors Civil Public Sector • Communities living Implementers • Society (Governments with and affected by and Agencies) and Agencies) th di the diseases • WHO • UNAIDS Private Sector • Technical Private • World Bank • Private Foundations Agencies Agencies UNITAID • Sector and • RBM Partnerships • Stop TB Partnership…

Global Governance Structure Advisory Supreme Advisory w Panel BOARD Forum governance body of 40+ members Convened every 2.5 Global Fund B years years al Review tnership Approved by Board 26 members 400+ ad ‐ hoc Meets once a year Meets twice a year participants and via e ‐ for a Technica Part review proposals for Reviews Progress of funding GF objectives Makes funding Makes funding Advises Board on Advises Board on recommendations policies and to the Board strategies Administrative ariat Executive Director appointed by Board ecut e ecto appo ted by oa d Secreta Management of day ‐ to ‐ day operations of the Global Fund

Country Coordinating Mechanisms Coordinate the development and submission of national proposals p p Submit grant proposals to Approve any reprogramming the Global Fund based on and submit requests for and submit requests for priority needs at the priority needs at the CCM CCMs are continued funding national level country ‐ level multi ‐ level, multi stakeholder Ensure linkages and partnerships consistency between Nominate the Global Fund grants and Principle Recipient other national health and development programs . Oversee progress during Grant implementation

The Process Used by the Global Fund The Process Used by the Global Fund Global Fund calls for proposals • CCM collaborates to prepare proposals • CCM submits proposals to the Global Fund and recommends principal recipients • Secretariat screens the proposals for eligibility • Technical review panel reviews proposals and submits to the Global Fund Board • for approval

The Process Used by the Global Fund The Process Used by the Global Fund Global Fund appoints a Local Fund Agent (LFA) • LFA assesses capacity of principal recipients (PR) • Secretariat negotiates a grant agreement with PR Secretariat negotiates a grant agreement with PR • Global Fund signs a two-year grant agreement • Disbursements are made to PR on the basis of performance in a form of progress • updates PR may disburse to sub-recipients as implementers •

Performance Based Funding at the Global Fund g Performance ‐ based funding (PBF) ensures that funding decisions are based on a transparent assessment of results against time ‐ bound targets PBF i i t PBF is integrated into every phase of the lifecycle of a Global Fund grant: t d i t h f th lif l f Gl b l F d t 1. Country ‐ owned proposal development: 1 Country owned proposal development: 2 2. Grant negotiation: Grant negotiation: Funding requests comprising program activities, Legal contract with performance targets to indicators and time ‐ bound targets defined by the measure the achievements of the grant. countries themselves. Investments are made to strengthen M&E systems. 3. Performance ‐ based disbursements: 4. Grant renewal: Continued funding decisions based on a comprehensive Periodic disbursements (every 3, 6 or 12 months) based program review incorporating an evaluation of outcomes on programmatic results, financial performance and and impact. d i t program management. t

Global Fund portfolio, December 2010 Composition of portfolio by disease, R1-10 •$21.7 billion approved $ •$13 billion disbursed $13 billi di b d •829 grants (479 active) •829 grants (479 active) Composition of portfolio by region, R1-9 •140 countries (117 active) •140 countries (117 active) •58% sub ‐ Saharan Africa •58% sub ‐ Saharan Africa

Success rates by disease, Rounds 5 ‐ 10 90% Round 10 80% 70% 60% • 79 proposals recommended 50% • 32 HIV 32 HIV (41%) (41%) 40% 26 TB (54%) • HIV 30% • 19 MAL (79%) Tuberculosis 20% Malaria l • Phase 1 $1.73 billion 10% Overall 0% Round 5 Round 6 Round 7 Round 8 Round 9 Round10

Global Fund results for selected prevention interventions, December 2010 b HIV prevention Cumulative Cumulative intervention results results % increase (end 2009) (end 2009) (end 2010) (end 2010) ARV prophylaxis ARV prophylaxis 790 000 790,000 1 1 million illi 26% 26% for PMTCT HIV counselling & 105 million 150 million 38% testing sessions Condoms 1.8 billion 2.7 billion 48% distributed

Key Results from GF ‐ Supported Programs (by end 2009) • Provided antiretroviral therapy (ART) currently to 2.5 million people • 1.8 billion male and female condoms distributed • 790,000 HIV ‐ positive pregnant women provided with prophylaxis to prevent mother ‐ to child transmission of HIV (PMTCT) to ‐ child transmission of HIV (PMTCT) • 4.5 million basic care and support services provided to orphans and other children made vulnerable by AIDS y • Provided treatment to 6 million new smear ‐ positive TB cases • Distributed 104 million insecticide ‐ treated nets (ITNs) to prevent malaria Over 19 million indoor residual sprayings of insecticides in dwellings conducted • • 108 million cases of malaria treated in accordance with national treatment guidelines

North Africa USD 1.2 billion* East Africa and Indian Ocean West and Central Africa USD 5.3 billion USD 3.5 billion Southern Africa USD 3.3 billion Total Grants for AIDS, TB, Malaria and Health Systems Strengthening approved in Africa (all regions) Round 1 ‐ 10: USD 13.3 billion * not including approved R10 Multi country grant for North Africa and Middle East totaling USD3.2 million

Evidence of impact: declining HIV prevalence in Tanzania declining HIV prevalence in Tanzania Between 2003 and 2009: • 103,000 HIV-positive pregnant 5 Women ears mothers received complete ARV mothers received complete ARV aged 15 ‐ 24 ye prophylaxis for PMTCT* 1 Men 4 • 5.4 million people were 3 counseled and tested for HIV counseled and tested for HIV ce (%), adults 2 At the end of 2009: At the end of 2009: Prevalenc 1 • 200,000 adults and children (46% of those eligible) were 0 receiving ART* 2 receiving ART* 2 2003 ‐ 4 2007 ‐ 8 Year * 1 Up from 1,800 in 2003 * 2 U The Global Fund Results Report 2010 The Global Fund, Results Report, 2010 * 2 Up from 1,500 in 2003 f 1 500 i 2003

Key Results in Asia by end 2009 • US $ 4.5 billion approved, US$ 2.2 billion disbursed; billion disbursed; Funded 2/3 rd of Asia’s 570,000 people • on ART; on ART; • 4 million smear positive TB cases treated; good MDG progress; treated; good MDG progress; • 21.7 million ITNs distributed (45% > than in 2008), sharp malaria case than in 2008), sharp malaria case incidence; mortality decline 2003 ‐ 9; • Substantial support to expand harm Substantial support to expand harm reduction services for IDU and services for MSM;

LAC ‐ Funds allocated by disease LAC Funds allocated by disease HIV/AIDS LAC Total lifetime budget by disease in millions USD (Total $2,141 M) 45% Caribbean 319 319 Latin America Tuberculosis 55% TB 15% 28% 322 322 C Caribbean ibb Malaria Latin 15% HIV/AIDS America 70% Malaria 72% 26% 26% 1,500 Caribbean Latin America 74% S ource: most recent available data from Global Fund: http:/ / www.theglobalfund.org/ en/ commitmentsdisbursements/