Overview of the Global Fund: Guiding Principles Grant Cycle / Processes & Role of Public Private Partnerships Johannesburg, South Africa Tatjana Peterson, Senior Fund Portfolio Manager Southern Africa Regional Team 12th October 2010

Global Fund Guiding Principles Operate as a financial instrument, not an implementing entity Make available and leverage additional financial resources Support programs that reflect national ownership and respect country-led formulation and implementation Operate in a balanced manner in terms of different regions, diseases and interventions Pursue an integrated, balanced approach to prevention, treatment and care Evaluate proposals through independent review processes 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. Focus on performance by linking resources to the achievement of clear, measurable and sustainable results. By: Kirsi Viisainen (Program Effectiveness Team Manager) and Daniel Low Beer (PIE Unit Director), May 2010 Language / Principles are fixed – please do not alter. Source: THE FRAMEWORK DOCUMENT OF THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA http://www.theglobalfund.org/documents/TGF_Framework.pdf

Global Fund: Key Milestones - Global Fund created at first Board meeting Round 1 proposals approved at second Board meeting 1st voluntary Replenishment - G8 endorsed new AIDS, TB and malaria targets 2nd Replenishment: US$ 9.7 billion pledged Round 8 approved (US$ 3.1 billion – largest so far) 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 - African leaders committed to greater response in Abuja - UN General Assembly endorses need for a “global fund” - Round 2 and 3 proposals approved Annual Rounds for proposals started First Partnership Forum (Bangkok) Twentieth Board meeting: Round 9 approved Cumulative disbursements reach US$ 10 billion - 3rd Replenishment US$ 11.7 billion pledged 3

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

How money flows to people

Grant Lifecycle Management Process

Global Fund Approved Proposals By Disease Component (Rounds 1 – 9) Source: Global Fund Grant Data OP/140709/2 7 7

Global Fund Approved Proposals By Region (Rounds 1-9) Source: Global Fund Grant Data OP/140709/2 8 8

Global Fund Financing Contribution to International Financing for HIV/AIDS, 2008 Global Fund The Global Fund contributed 19% of the overall international HIV/AIDS financing in 2008 19% Other Agencies (PEPFAR, World Bank, other Bilaterals, UN Agencies) Source: UNAIDS/Kaiser Foundation Report, 2009 81% OP/140709/2 9 9 9

Global Fund Financing Contribution to International Financing for TB, 2009 Budgets The Global Fund accounted for 64% of overall international financing for tuberculosis in 2009 Source: WHO Stop TB Department, 2009 OP/140709/2 10 10 10

Global Fund Financing Contribution to International Financing for Malaria, 2008 The Global Fund contributed 57% of the overall international financing for malaria in 2008 Source: Roll Back Malaria, 2010 OP/140709/2 11 11 11

Global Fund Financing HIV/AIDS Grants: Coverage by Country (Rounds 1-9) 140 countries US$ 10.8 billion (Approved Grant Amount) US$ 17.4 billion (Total Lifetime Budget) Source: Global Fund Grant Data OP/140709/2 12 12

Global Fund Financing Tuberculosis Grants: Coverage by Country (Rounds 1-9) 112 countries US$ 3.2 billion (Approved Grant Amount) US$ 5.8 billion (Total Lifetime Budget) Source: Global Fund Grant Data OP/140709/2 13 13

Global Fund Financing Malaria Grants: Coverage by Country (Rounds 1-9) 83 countries US$ 5.3 billion (Approved Grant Amount) US$ 8.3 billion (Total Lifetime Budget) Source: Global Fund Grant Data OP/140709/2 14 14

Global Fund Financing by Principal Recipient Type (mid-2010) Source: Global Fund Grant Data 15 15

Additionality of Global Fund Financing Global Fund should “make available and leverage additional financial resources” NOT displace other donor or government commitments Global Level: Total official development assistance (ODA) disbursements for all three diseases have been increasing since 2002 The Global Fund has provided substantial funding to fight AIDS, tuberculosis and malaria Country Level: Government expenditure on health as well as on TB and malaria control in Global Fund top disbursing countries has been mostly increasing or levelling

Key Performance Indicators (KPIs): Framework Overview The Key Performance Indicator (KPI) framework is designed to assess the core functions of the Global Fund Secretariat, grant performance and the effectiveness of Global Fund financing, and the impact achieved on the three epidemics. Ultimate measure of the success in fighting the 3 diseases and reaching the MDGs Operational performance Grant Performance Impact System Effects - Portfolio management - Administrative effectiveness Resource mobilization CORPORATE Performance Assesses the development of sustainable (health) systems in Global Fund recipient countries Cornerstone of performance-based funding; measures grant results against their targets SECRETARIAT Performance Measures the performance of the core functions of the Global Fund, including the Secretariat

Performance-Based Funding (PBF) Performance-based funding (PBF) ensures that funding decisions are based on a transparent assessment of results against time-bound targets. PBF lies at the heart of the Global Fund’s operating model: Raise it Invest it Prove it “In making its funding decisions, the Global Fund will … focus on performance by linking resources to the achievement of clear, measurable and sustainable results”. Framework Document of the Global Fund (October 2003)

The Global Fund’s model of performance-based funding PBF at the Global Fund The Global Fund’s model of performance-based funding was developed to: Link funding to the achievement of country-owned objectives and targets Invest in measurement systems and promote the use of evidence for decision-making Ensure that money is spent on delivering services for people in need Provide a tool for grant oversight and monitoring within countries and by the Global Fund Secretariat Provide incentives for grantees to focus on programmatic results and timely implementation Free-up committed resources from non-performing grants for re-allocation to programs where results can be achieved Encourage learning to strengthen capacities and improve program implementation

Grant Performance by Principal Recipient (end 2009) Exceeds expectations A2 Meets expectations B1 Adequate B2 Inadequate but potential demonstrated C Unacceptable Source: Global Fund Grant Data Latest disbursement ratings for the 378 active grants evaluated as at 1st January 2010.

Four Roles of the Private Sector Contributor of Resources Implementation Partner Provider of Goods & Services Supporter of Advocacy & Governance BG/290607/2