1. THE GLOBAL FUND SUSTAINING THE GAINS AND IMPACT Uganda November 2013

2. UGANDA PORTFOLIO Portfolio Background and Context Total portfolio signed to date of US$ 579M Total disbursed since 2003: US$ 490M 9 active grants: – 2 Health Systems Strengthening (HSS): MoFPED/MoH - TASO – 2 HIV: MoFPED/MoH - TASO – 4 Malaria: 3 MoFPED/MoH – 1 TASO – 1 TB: MoFPED/MoH

3. Investments in Uganda (US$) Active grants Disease / Number of grants Signed grantsAmount disbursed to date % disbursed HIV/AIDS2 171,235,647130,441,07377% TB1 17,516,7119,855,55556% Malaria4 273,836,962237,660,24987% HSS2 14,444,4689,820,44368% Total 477,033,788387,777,32081.3%

4. Key milestones in 2013 and 2014 20.5m nets distributed which will translate to 3 nets distributed per household and should have a significant impact on malaria control in Uganda, including averting deaths in the next 3 years Full roll out of option B+ and scale up of Prevention of Mother-to- Child Transmission (PMTCT) Scale up of Antiretroviral Therapy (ART) Sustaining DOTS Establishment of MDR TB wards and scale up of treatment TB prevalence survey Health Information Systems (HIS) strengthening Supply chain management strengthening

5. Investing for Impact: Uganda (malaria) Global Fund supports mass LLIN distribution to achieve universal coverage Support reprogramming for impact: – Moved from targeted coverage (Under 5 and pregnant women) under Phase 1 to Universal coverage in Phase 2 Reinvest grant saving to achieve coverage Additional 4 million LLINs being procured – from savings Strengthening Partnerships: Additional resource mobilization feasible to achieve desired impact – Gap of ~ 5 million nets to achieve universal coverage covered – Partners: Government, President’s Malaria Initiative (PMI), Department for International Development (DFID) and World Vision Mass distribution planned in 2013. 5

6. Investing for Impact: Uganda (HIV)  Reversal of HIV trends noted in Uganda. Scale up of ART: 566,000 patients  Contributing factors: Low levels of comprehensive knowledge Multiple sexual partnerships Low condom use  Programmatic level: Sub-optimal attention to prevention programs Loss of intensity and focus 6  Strategic Investment: Reinvigorate prevention programs Targeted programs for key populations Strengthening delivery of defined, quality comprehensive prevention program packages Scale-up ART/ PMTCT /TB-HIV/Safe Medical Male Circumcision to desired coverage levels to make an impact

7. Investing for Impact: Uganda (tuberculosis) Amongst the 22 high burden countries. Contributes to 0.8% of the global TB burden. Generalized HIV epidemic is the key driver of the epidemic Steady decline in TB incidence, prevalence and in mortality Strategic investments – Expand and consolidate high quality DOTS. Strengthen TB/HIV collaborative activities – Strengthen TB control in Uganda prisons – Ensure availability of anti-TB medicines for both susceptible and drug resistant TB patients – Strengthen programmatic management of drug resistant TB to ensure all diagnosed MDR TB patients are enrolled on treatment

8. CCM oversight

9. 1.Operate as a financial instrument, not as an implementing entity 2.Make available and leverage additional financial resources 3.Support programs that reflect country ownership and respect country- led formulation and implementation 4.Operate in a balanced manner in terms of different regions, diseases and interventions 5.Focus on performance by linking resources to the achievement of clear, measurable and sustainable results at every phase of the lifecycle of a grant (allocation of funding, request for funding, grant making, disbursements). The Global Fund Guiding Principles

10. Partnership Approach to Governance Donors Recipient Countries Private Sector Private Foundations ● NGOs from Global North ● NGOs from Global South ● Communities living with, and affected by, the diseases ● WHO ● UNAIDS ● World Bank ● UNITAID ● RBM ● Stop TB Partnership Civil Society Technical Agencies and Partnerships Private Sector Public Sector (Governments and Agencies) A diverse partnership reflected in the Board and Country Coordinating Mechanisms

11. CCM oversight

16. CCM Oversight What; How and Who?

17. What is CCM Oversight? CCM Oversight consists of providing strategic guidance to PRs to ensure and enable effective grant management and performance Most important CCM function upon grant approval A continuous process throughout grant cycle Focused on broad objectives of improving performance, not micro-issues

18. What is CCM Oversight? Constituency engagement is a key approach for CCM effective oversight as : Are the programs relevant  Reflect the views and concerns of diverse stakeholders in CCM discussion, decisions and ultimately programs brought up from the constituencies  Empower communities to express demand  Use the expertise and experience of different sectors to identify and manage bottlenecks and risks  Ensure program performance, impact and accountability

19. Focus Areas: 1.PROPOSAL DEVELOPMENT- policies, strategies and country priorities 2. PROGRAMMATIC PERFOMANCE Achievement of output, outcome, impact results 3. MANAGEMENT Effective and timely work plan implementation 4. FINANCE Efficient and appropriate use of funding

20. 5 key questions for every grant & PR 1.Where is the money? 2.Where are the commodities ? drugs, the nets, and other medical supplies and equipment 3.Are the sub-recipients receiving resources and technical assistance as planned and delivering to the intended beneficiaries ? 4.Are the grants being implemented as planned in line with the set strategies and priorities? 5.Are the results meeting the performance targets?

21. How Through committes: Executive Committee Program Oversight Committee Finance and Procurement Committee Resource Mobilization and Proposal Development Committee The representatives from the your CE seats at these committee where most of the work happens

22. QUESTIONS