Global Fund and Round 8 Guidelines and Proposal Form 26 February 2008

Agenda 2 1.Introduction  Key Actors and Roles in the funding process  Global Fund principles  What the Global Fund will support  The Round 8 'Call for Proposals' timeline 2.CCM Overview 3.Changes from Round 7 and selected topics for Round 8  Health systems strengthening  Gender awareness  Community systems strengthening 4.Planning for success

1.1Key Actors and Roles Key ActorPrimary Role Portfolio Committee Approval of documents Secretariat Prepare funding documents Call new rounds Manage screening services Technical Partners Input in to policy & documents Support proposal development Applicants Develop eligible proposals (where relevant  consistent with the 6 minimum eligibility requirements for CCMs) Board Set new policies Make funding decisions EACH is key to our 'Raise it, spend it, prove it' model There is much inter-linking between each of the key actors at the various stages of a 'Call for Proposals'

1.2Global Fund Key Principles Country driven Inclusive and collaborative Harmonized and aligned with country systems Performance-based Impact on disease morbidity and mortality Routine reporting to measure performance

1.3 What the Global Fund Will Support Continuation and scale-up of proven interventions Innovative evidenced based approaches to increase delivery of, and access to prevention, treatment, care and/or support services – especially for key affected populations historically excluded No 'list' of what should be included – opening up broad opportunity Annex 3: examples of areas of support (modified from Round 7) NEW IN ROUND 8  Interventions related to interactions between the three diseases, including providing access to prevention services through integrated health services, especially for women and adolescents through reproductive health care

1.4Round 8 Timeline 6 Launch of new Round 8: 1 March 2008 'Call for Proposals' released on Website Submission deadline: 1 July 2008 Screening for eligibility: 6 weeks after closing TRP review: Last week August/1 st week September Board Consideration: 18 th Board Meeting

2.1CCM membership – who and why Role of the CCM  Equates to 'custodian' of the proposal's outputs & impact, i.e: It is the CCM which transparently selects the PR based on criteria Invited to apply for Yrs 3-5 (Phase 2) funding Also the 'invitee' for our new Rolling Continuation channel For this reason  Required to have – representation of each in-country sector Do not need CCM membership to be an implementing partner One of the many supporting reasons for a 'CCM' model  …Proposals that come from country-level partnerships, and have been developed through transparent mechanisms are expected to more effectively respond to in-country needs of key population groups

2.2. Practicalities of applying for funding CCM must demonstrate that: (a)Proposal was developed through transparent call & evaluation (b)More than just 'CCM members' were involved (c)Technical partners help to 'write' – but call process is important (d)They will nominate a Principal Recipient and sub-recipients For SRH - propose to CCM for inclusion as one of the Round 8 priority areas where SRH interventions will support improved HIV (especially) outcomes Full list of requirements is in the 'Annex' to this presentation Now – a short focus on a few

2.3 CCM minimum eligibility requirement 3 CCMs are required to put in place and maintain a transparent, documented process to solicit and review submissions for possible integration into the proposal. Messages to take back to the CCM –What kind of public outreach will the CCM use? –Will it be sufficiently broad? –If only small number of sub-recipients are 'capable' why is this so, and how can implementation capacity be expanded through the Round 8 proposal interventions? –How many submissions did the CCM receive and review and what is their process going to be to do this transparently

2.4CCM minimum eligibility requirement 4 CCMs are required to put in place and maintain a transparent, documented process to nominate the Principal Recipients (and oversee program implementation) Principal Recipient capacities ( relevant to this meetings goals) –Receiving and managing funds –Accounting for funds; –Implementing and overseeing implementation; –Efficient disbursement of funds to sub-recipients –Reporting on program performance (Attachment A to the Proposal Form); and –Phase 2 request Messages to take back to the CCM: PR selection to be criteria-based; and reasonably competitive

2.5 CCM minimum eligibility requirement 5 CCMs are required to put in place and maintain a transparent, documented process which ensures the input of a broad range of stakeholders, including CCM members and non-CCM members, in proposal development and grant oversight process. Messages to take back to the CCM : CCM should not be a club of familiars A strong and appropriate gap analysis requires broad participation Prevention is just as important as scaling up treatment Multi-stakeholder drafting committees are recommended (these should not just have 'technical disease experts ')

3.0Introduction - Changes From Round 7 Shorter. Removal of duplication. Simpler. Language is less complex. Streamlined. Most 'instructions' removed to Guidelines. 12

Key Adjustments from Round 7 Eligibility criteria for upper-middle income applicants (no impact for countries in attendance today) Cost sharing principle – How much the Global Fund can support CCM composition & funding Health systems strengthening

3.1Round 8 Revised Eligibility Criteria Low-income country Lower-middle income country Upper-middle income country Focus on poor and/or vulnerable populations May focus on BOTH but must focus on 1 Demonstrate Global Fund country support does not exceed 65% of overall disease program need High disease burden in general population or identified vulnerable population Eligible List of eligible countries by income level category will be provided in Annex 1 to the Round 8 Guidelines for Proposals Multi-country proposals can include other ineligible UMI countries if less than 50% of total country number Demonstrate Global Fund country support does not exceed 35% of overall disease program need

3.2CCM Composition and Funding CCMs recommended (not required) to include key affected populations in their membership (as defined by UNAIDS) Round 8 website will provide resources on this group CCM operating costs not be included in a proposal Instead  Global Fund Secretariat has dedicated a separate budget to assist – largely for infrastructure to help the CCM communicate and operate more effectively

3.3HSS - Round 8 'Flexible' Approach Applicants may apply for support for HSS interventions within: 1.A disease specific program: Both for disease specific interventions that respond to health system weaknesses or gaps; and/or Cross-cutting HSS interventions which benefit more than one of the three diseases; and/or 2.s.4B – the distinct 'HSS cross-cutting part' only for interventions that are cross-cutting – included in one disease only Recognized not without some degree of complexity Only exceptions – large infrastructure and vaccine research SRH – can be disease specific (s.4.5.1) or cross-disease (s.4B)

3.4Round 8 HSS worked example Option A Disease specific response only needed Option B Some disease specific + some cross-cutting HSS split b/w the diseases Option C Some disease specific + some cross-cutting HSS included in s.4B distinct part HIV s – description of disease specific response HIV Still s only HIV specific + X% of cross-cutting response HIV s HIV specific response only + s.4B HSS cross- cutting part to ensure cross- disease response when relevant WITHIN ONE DISEASE ONLY TB s – description of disease specific response TB Still s only TB specific + Y% of cross- cutting response TB s TB specific response only Mal s – description of disease specific response Mal Still s only Malaria specific + Z% of cross-cutting response Mal s Malaria specific response only

3.5TRP Flexibility When Reviewing Proposals Historically – TRP required to review 'disease proposal' as a whole Recognized this may have acted as a disincentive to cross-cutting work Round 8 TRP will be mandated to review and recommend: The whole 'disease proposal' including the cross-disease part (s.4B); or The disease interventions (s.4.5.1) but not the cross-disease part (s.4B); or The cross-disease part (s.4B) but not the disease interventions (s.4.5.1). Intent: To remove unintended barriers to cross-disease responses

New Topics in Round 8 Dual-track financing Community systems strengthening Encouraging gender sensitive responses Grant consolidation (not a focus of today's discussion)

3.6Dual-track financing Implement's our full commitment to multi-sectoral approaches Recommended routine inclusion of government and non- government Principal Recipients for each disease proposal. Goal – expand service delivery potential + increase access  Will be achieved by elevating capable civil society and private sector applicants to a lead implementer role Recommended in Round 8 Explanation required if not implemented. Round 8 encourages significant sub-recipient capacity building Supports a stronger Round 9 approach

3.7 Community Systems Strengthening Intent: Strengthen capacity of community based organizations to be service delivery partners and build sustainable systems. Areas of Focus: Capacity building: of the core processes of CBOs Physical infrastructure development Organizational systems development Partnership building: at the local level to improve coordination, enhance impact, avoid duplication, build upon one another’s skills and abilities and to maximize coverage Sustainable financing: creating an environment for more predictable resources over a longer period of time with which to work Important for successful requests for funding – demonstrate support is linked to improved service delivery and outcomes for the three diseases.

3.8Encouraging Gender Sensitive Responses Recognition that gender sensitive programming (especially for HIV) requires a different approach between women & men, and boys & girls. Significant attention to 'know your epidemic' approach Proposal Form – a step towards a stronger approach in Round 9 CCMs comment on overall capacity and expertise on gender Consideration given to gender issues when undertaking analysis on disease program and health systems weaknesses and gaps Epidemiological information disaggregated by age and sex Statement of how the proposal enhances gender equality Focus – encouraging a meaningful dialogue on issues affecting women 22

4.Planning for success Think beyond 'project approach' –Encourage broad gap analysis to show overall country position –Identify if same 'key services' are supported by others –Plan the proposal drafting –Who? How? –Who is going to 'read it all through at the end? Round 8 National Budget (incl World Bank loans) Bilateral Donors ( e.g. USAID, ADB etc ) Existing Global Fund grants

Annex of supporting material

6 CCM minimum eligibility requirements

HSS: Instructions for Applicants (s.4.5.1) How to include health systems strengthening in Round 8 proposals 1.The Global Fund acknowledges that the responses to identified health systems weaknesses or gaps that constrain the achievement of outcomes for the three diseases may differ substantially in different settings. The Global Fund intends therefore to allow applicants maximum flexibility in addressing these weaknesses and gaps. We provide this flexibility from Round 8 by allowing applicants to apply for funding to respond to these issues either through a program (by-disease) approach, or by a cross- disease approach. 2.If the most appropriate response to a system weakness can be made through a disease program, applicants are encouraged to include the relevant response (activities/interventions) in the program description of the disease proposal (s.4.5.1) as any other disease program activity.

HSS: Instructions Cont’d (s.4.5.1) 3.However, part or all of the response to system weaknesses that affect outcomes for the three diseases may be more appropriately undertaken on a cross-cutting basis. If so, applicants may request support for these activities/interventions by either: a)including the activities/interventions in the various disease proposals (if appropriate), separated between the disease proposals as the applicant believes most appropriate; or b)including relevant activities/interventions in only one disease proposal as an optional additional “cross-cutting” group of activities. If so, these activities are included in s.4B (s.4B is available as a download from the Global Fund website). The financial information relating to these interventions should then be included in a corresponding s.5B of the same disease (s.5B is available as a download from the Global Fund website). 4.HSS cross-cutting interventions included in a one disease proposal in s.4B cannot be the only interventions included in that under a disease proposal. That is, there must also be program activities described in s This is because there is no separate funding window for HSS.