Launch of the 10th funding round and other outcomes from the Global Fund

Asia Russell, Health GAP

The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), met in Geneva 28–30 April and on 20 May Round 10 was formally launched. Below is a brief summary of important decisions made by the Global Fund Board.

Round 10 launched

The Board decided to launch the Global Fund’s 10th Funding Round—the Round 10 proposal form and guidelines was released on 20 May and the deadline for proposals is 20 August. Civil society helped to prevent the imposition of arbitrary restrictions to the size of Round 10, despite an effort by some donors to impose funding ceilings, in either a fixed dollar amount or a percentage of the total resources available for 2011-2013. However, the launch of Round 10 did include a decision to restrict spending on Round 10 grants only to the resources raised by the Global Fund by the end of 2011. This restriction applies only for Round 10.

Advocates must ensure that donors pledge the resources needed now to ensure that all applications considered by the Global Fund’s Technical Review Panel (TRP) to be technically sound and recommended for approval, receive funding. Increased pressure on G20 countries is urgently needed, in order to expand funding available for Round 10—and beyond.

The next donor replenishment of the Global Fund—the main mechanism for Global Fund fundraising—will take place in October 2010 at a meeting at the UN, shortly after the UN Millennium Summit, which will attract heads of state from around the world. The Global Fund needs at least $20 billion over 2011-2013 to support scale up of programs to reach the Millennium Development Goals. $8.5 billion is needed to continue funding existing successful programs.

Round 10 and prioritisation criteria

When insufficient funding prevents immediate approval of all technically sound grant proposals recommended for funding by the Technical Review Panel (TRP), the Global Fund uses the criteria of technical merit, disease burden, and poverty to rank the grants in a “queue.”

The Global Fund Board decided to revise those criteria for prioritisation in Round 10. By giving technical merit weight that is comparable to disease burden and poverty, lower- and upper-middle income countries could be at a greater risk of being ranked lower in the queue, waiting longer for funding or risking not being funded at all if donors do not fully fund Round 10.

Round 10 and most-at-risk-populations

In order to ensure the needs of “most-at-risk-populations” (MARPs) are protected, particularly in lower- and upper-middle income countries, the Board decided that for Round 10 a pool of resources totaling $75 million (for the budget of the first 2 years of 5 year programs) will be set aside for HIV proposals focused on those populations. (Each proposal is subjected to an upper limit of $5 million—a figure derived based on assessment of the size of similar proposals in previous funding Rounds.)

Countries may either apply through the “normal” funding Round or through the special MARPs funding pool for HIV/AIDS only. Proposals to the MARPs funding pool that are recommended for funding by the TRP will not be subjected to the prioritisation criteria applied to the normal funding Round for as long as the resources allocated have not been exhausted.

National Strategy Applications: The Global Fund Board decided on its next steps in support of National Strategy Applications (NSAs). NSAs allow countries to request funding based on part or all of a national disease strategy, rather than through a Global Fund Rounds-based application. The Global Fund completed a “First Learning Wave” of NSAs in 2009 and based on lessons from that process, the Board decided to approve another NSA funding opportunity, which will not be funded until the fourth quarter of 2011—at the same time Round 11 is approved. Meaningful civil society involvement is needed at the global and country levels in shaping the second NSA funding opportunity, in order to ensure high-quality involvement of a range of civil society experts, advocates and implementers in developing evidence-based, ambitious strategies; preparation of NSA applications; and program implementation.

Joint health systems platform

The Global Fund Board decided to authorise the creation of a Joint Health Systems Funding Platform between the Global Fund, GAVI, and the World Bank.

There are many unanswered questions regarding how the Joint Platform will actually help make it easier for countries to receive funding based on ambitious, high quality, results-focused requests to address the major health systems bottlenecks undermining progress in the fight against AIDS, tuberculosis and malaria, such as increasing production and retention of health workers. This is particularly true given the substantial differences in core principles and governance between GAVI and the Global Fund on the one hand, and the World Bank on the other. As with the design of the second NSA funding opportunity, civil society should be closely engaged in monitoring and contributing to the development of the joint platform.

It is widely expected that the G8 summit in Canada in July will generate a new MCH initiative; the Board directed the Secretariat to ”review…potential options…for enhancing the contributions of the Global fund to MCH, recognising the urgent need for additional and sufficient financing for MCH as well as for AIDS, tuberculosis and malaria.”

These options will be reviewed by the Policy and Strategy Committee at its next meeting, with a decision by the Board at its final meeting of 2010.

These notes are edited from a longer report.

The Global Fund Board decisions are posted online:

Links to other websites are current at date of posting but not maintained.