1. TNCM Oversight Committee and GF Flow of Funds Presentation to DPG-Health May 6, 2015

2. TNCM STRUCTURE AND FUNCTIONS Governance Coordination and Oversight

3. Structure of the TNCM Prime Minister's Office Tanzania National Coordinating Mechanism Management Committee TNCM Secretariat Oversight Committee Task Teams/Temporary Committees

4. Role of the Prime Minister’s Office Authority over the control, supervision, and execution of the day-to-day functions of the government Oversees the Ministries, Departments, and Agencies (MDAs) in executing the mandates of the TNCM Coordinates government services and promotes the involvement of civil society

5. TNCM Core Functions Coordinate the development and submission of national proposals for the Global Fund Nominate Principal Recipients Oversee grant implementation, approve reprogramming, and request continued funding Ensure linkages and consistency between GF grants and other national health and development programs Participate in national strategic plan discussions Agree on GF funding split for HIV, TB, Malaria, and HSS

6. Standing Committees Management Committee Provide analysis and facilitate decision making Handle urgent communications arising between meetings Nominate and oversee temporary task teams Manage day-to-day activities of the secretariat Manage implementation of conflict of interest policy Oversight Committee Receive and review PR grant reports Identify and analyze issues in grant implementation (programmatic, financial, procurement, and management) Ensure funds are used appropriately, timely, and effectively Follow-up on the decisions and recommendations of the TNCM

7. Key Oversight Questions Finance: Where is the money? Is it arriving on time? Is it being distributed properly and promptly? Who is benefiting? Procurement: Are the commodities being ordered and delivered on time? Are beneficiaries receiving them? Implementation: Are activities on schedule? Are the right people receiving the intended services? Results: Are targets being met? Reporting: Are reports being submitted accurately, completely, and on time? Technical Assistance: What grant bottlenecks exist? What technical assistance is needed to build capacity and resolve problems? What is the outcome of technical assistance?

8. Recent Oversight Committee Actions TFDA blocked lubricants for MSM as not being in the national interest. OC analyzed and brought the issue to the TNCM, which directed TFDA to release the commodities for distribution. Action completed Vehicle procured for a PLHIV organization with GF funds was confiscated by the district council. OC analyzed and brought the issue to the TNCM, which agreed to return the vehicle to the organization. Action in progress

9. GF FLOW OF FUNDS Analysis and Recommendations

10. MoF Funding Flow Analysis Global Fund grants have continued to experience significant delays in the flow of funds resulting in delayed implementation and a low grant burn rate Because of delayed funding, implementers may rush to spend funds, potentially leading to poor quality service and misuse of funds Funding delays have been roughly 3X the desired standard of 30-45 days from GF to implementers

12. MoF Funding Flow Process

15. GF Recommendations Exclude GF Funds from Exchequer system to hedge against foreign currency exchange loss and disburse directly to LSRs (as is done with MoHSW funds for commodities) After receiving GF disbursement notification, MoF to immediately prepare distribution schedule and to follow-up daily with BoT on funds availability PS MoF to appoint staff member in the commissioner of budget responsible for all documents requiring the signature of the PS

16. GF Recommendations Track the timing on the total cycle of funds flow as a Key Performance Indicator PR to fast-track delivery of notification letters to LSRs PR to allow alternative officials in MoH and PMORALG (besides Commissioner of Planning and PS) to approve the TFN 538 form

17. OC Follow-up of MoF Funding Flow MoF to report to OC on steps taken to address GF recommendations and challenges OC has requested the MoF to report on the time spent on each step for every disbursement going forward The OC will request feedback from the MoF for any delays that result in disbursements reaching LSRs after more than 45 days