1. Civil Society, FBOs and the Global Fund Michael O’Connor Manager, Civil Society and Private Sector Team Mauro Guarinieri Senior Civil Society Officer, Civil Society and Private Sector Team

2. Outline 1.Roles of Civil Society in the Global Fund 2.Dual Track Financing 3.Community Systems Strengthening 4.Resource Mobilization

3. Civil Society in the Global Fund The Fund will support programs that Global Fund Framework Document, 2002

4. Governance Board members Non-Government Organizations Faith-Based Organizations Community-Based Organizations Advocates Watchdogs Implementers CCM members Dual Track Financing Affected and Most- at-Risk Populations PRs, SRs, SSRs Program Design Early Warning Grant Oversight Community Systems Strengthening Private sector

5. Entry points in Governance & Implementation

6. Our Governance Model Donors Recipients ● Private Sector Foundations ● NGOs North ● NGOs South ● Communities living with the diseases ● WHO ● UNAIDS ● World Bank Civil Society Technical Partners Private Sector Public Sector (Governments) A partnership of stakeholders

7. The Global Fund recognizes that only through a country-driven, coordinated and multi-sector approach involving all relevant partners will additional resources have a significant impact on the reduction of infections, illness and death from the three diseases.

8. PR/SR Expenditures by Sector

9. Expenditures to Faith-Based Sub-Recipients by Sector Disease Component Amount Disbursed to FBOs by Disease Component Percent of Total Disbursement to FBOs by Disease Component Comparison to Overall Global Fund Percentage by Disease Component HIV and AIDS$187,420,20147.6%56% Malaria$121,567,49230.8%28% Tuberculosis$84,707,21821.6%16% Disease Component Amount Disbursed to FBOs by Disease Component Percent of Total Disbursement to FBOs by Disease Component Comparison to Overall Global Fund Percentage by Disease Component HIV and AIDS$92,275,50260.7%56% Malaria$27,426,85118.0%28% Tuberculosis$32,307,50621.3%16% Disbursements to Faith-Based Principal Recipients by Sector

10. Service Delivery Areas (SDAs) Performed by Faith- Based Principal Recipients, Rounds 1-9 SDAs (Macro-categories) Percentage of SDAs (out of all grants with FBO PR) Care and Support5.79% Health Systems Strengthening (HSS)14.29% Prevention33.20% Supportive Environment22.01% TB/HIV Collaborative Activities3.09% Treatment21.62%

11. CCM Composition

12. Usage of CCM Funding

13. Challenges

14. New Environment for CCMS

15. CCM Funding Policy Promotes strategic focus and performance on core CCM functions: –Oversight –Constituency Engagement: promotes meaningful civil society and private sector engagement –Promotes harmonization and alignment –Improves measurability and transparency of CCM performance and capacity building –Addresses gender & sexual orientation strategies and concerns Two options: Basic and Expanded

16. Challenges up to now CCM’s capacity: work load, priorities, strategic planning, budgeting, organization, record keeping Familiarity with performance framework and indicators Agreement on the role of the CCM Secretariat: number of staff, salary levels, M&E person (?), role vis a vis the PR, number of consultants. Interaction with LFA. Timely submission of applications and reports

17. Dual Track Financing The routine use of DTF has been recommended starting from Round 8 in recognition of the fact that both civil society and the private sector can and should play a role in the development of proposals and the implementation and oversight of grants at the country level

18. The Global Fund recognizes a number of possible benefits of Dual Track Financing Cumulative expenditures by implementing entity (through 2008 expenditure reporting cycle)

19. PR selection The Global Fund has recommended the routine use of DTF starting from Round 8: that both civil society and the private sector can and should play a role in the development of proposals and the implementation and oversight of grants at the country level Experience: Round 8: 48% of proposals with DTF [ 12 EAP ] Round 9: 41% of proposals with DTF [ 5 EAP ] Of 125 active grants in EAP, there are 12 CS PRs and 3 PS PR’s (representing 5 out of 15 countries)

20. PR rating by sector

21. Lessons learned Evidence that NGOs can manage funds and programs carefully, efficiently and effectively, when they are selected as PRs. Evidence that CSOs can engage more effectively if they build coalitions and work together; and when they match representation with the socio epidemiological situation of their countries Oversight role can be strengthened when civil society fulfills its crucial “watchdog” function.

23. What challenged? What worked?  CCMs are not responsive or supportive to civil society  Civil Society lack time, technicalities and experience to develop well written, technically sound proposals  Civil Society lacks capacity to manage and disburse large in the scope of Global Fund resources  Strengthen political capacity through networks  Clear articulation of comparative advantage and division of labor  Long Term planning and early involvement  Capacity building including support for civil society from development partners and technical partners  Innovative collaboration – e.g. skills transfer from private sector to civil society

24. Community System Strenghtening Community systems strengthening refers to initiatives that contribute to the development and/or strengthening of community- based organizations in order to improve knowledge of and access to improved health service delivery to achieve improved outcomes for HIV, tuberculosis and malaria prevention, treatment, and care and support programs. Physical infrastructure development (e.g. obtaining office space) Organizational systems such as development of management and financial systems and monitoring and evaluation capacities Technical support to improve programmatic quality, size and scale of programs (e.g. training of local authorities to support scale up) Human resources e.g. trained community health services providers or task shifting to community base organizations

25. CSS: Indirect but Still Essential CC 1: Enabling environments and advocacy CC 2: Community networks, linkages, partnerships and coordination CC 3: Resources and capacity building CC 4: Community activities and service delivery CC 5: Organisational and leadership strengthening CC 6: Monitoring & evaluation and planning Quality services are available and used by the community Health is improved at the community level Strengthening interventions Input OutputImpact

26. Linked: Health and Community Systems Like Health Systems, Community Systems are critical to effective service delivery. They are often part of a continuum of care, such as when peer outreach workers refer PLHIV to testing or care centers, health systems deliver medical care, and then peer counselors deliver follow-up information and counseling. Community System Health System Impact Refer to VCT/ART VCT/ARTCounselling Reduced Mortality Refer to MMT/NSP MMT NSP VCT ART Counselling Reduced HIV+ Reduced Mortality

27. Outcome and CSS for recommended proposals 44% of the 88 proposal parts recommended for funding by the TRP included CSS activities.

28. CSS by Region

29. CSS by SDA for all proposals including CSS activities

30. Challenges to CSS for Civil Society Lack of awareness by beneficiaries of the existence of the CSS opportunity Lack of political capacity to get CSS component endorsed by CCM Lack of evidence-based documentation to show impact of CSS Lack of resources and appropriate technical assistance to help civil society contribute good CSS components to proposals Communities do not have the space to articulate technical assistance needs even if they have identified them Lack of consultants with relevant, adequate skills on CSS Technical assistance often focuses on proposal development and less on implementation

31. Why are these mechanism important? Civil Society are integral to all Global Fund processes Civil Society are the Global Fund most effective implementers Civil Society work with the most vulnerable and marginalised communities But to be equal and effective partners Civil Society needs to strengthen and build its capacity If this happens Civil Society can bring all its skills, knowledge and expertise to support Government programmes and ensure a comprehensive response to HIV and TB

32. Civil society engagement has been crucial to Global Fund, however there is potential to better leverage civil society capacity Challenges with CSO partnership include –Access to finances & Community Systems Strengthening –Full inclusion of civil constituents in CCMs and as implementers –Fit with the new global health architecture

33. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Third Replenishment (2011-2013) Outcome of Pledging Conference US$ 11.7 billion in pledges and projected contributions at the New York Third Replenishment Conference, 2010. 20% increase from the Second Replenishment Conference in Berlin, 2007. Increased share of firm pledges. More than 40 countries, the European Commission, faith-based organizations, private foundations, and corporations committed funding at the pledging session in New York.

34. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Replenishment: A Collective effort UN Secretary General Global Fund Board Civil Society –Unprecedented effort for coordination of Resource Mobilization activities Partners (UNAIDS, RBM, Stop TB, WHO, UNICEF) Friends of the Fund Organizations High-level political outreach –Both in donor and implementing countries –Executive Director met with 40+ Heads of State or Government –Global Fund Replenishment featured in G8 Communiqué, AU Summit Declaration, MDG Summit Document

35. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Evolution of contributions (2002-2013)

36. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Outcome Pledging Conference 2011-2013: Pledges from Donor Governments ( Original currency (millions) USD equiv (millions) % Increase from 2nd Replenishment Australia AUD210.0203.256% Canada CAD540.0528.420% China USD14.0 133% Denmark DKK525.096.51% European Commission EUR330.0452.310% Finland EUR12.016.426% France EUR1,080.01,480.320% Germany EUR600.0822.4 Japan USD800.0 28% Korea (Republic of) USD6.0 Kuwait USD1.5 Luxembourg EUR7.510.3 Monaco EUR0.20.3RETURNING Namibia USD0.8 NEW Nigeria USD10.0 RETURNING Norway NOK1,350.0230.220% Russia USD60.0 South Africa ZAR15.02.11400% Switzerland CHF21.021.6 Tunisia USD2.0 NEW United States USD4,000.0 40%

37. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Additional Pledges Since New York Additional resources for 2011-13 pledged by: –Anglo-American PLC (US$ 3 million) –Gift from Africa (US$ 2 million on top of the US$ 3 million pledged in New York) –Government of Rwanda announced a contribution of US$ 1 million –Government of Malaysia – US$100,000

38. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 The Funding environment for the Global Fund has changed dramatically A perfect storm? –Pre-existing ‘AIDS fatigue’ among some donors Funding for AIDS has far outpaced maternal, newborn, and child health, malaria, tuberculosis, non-communicable diseases –ODA at risk due to record public debt among most OECD DAC donors –The Euro crisis – is it behind us? –Misleading media reports on corruption have created reputational damage. –Signs that US pledge is under severe pressure

39. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 The New Reality The $11.7 billion Replenishment outcome is in danger of not being achieved. Round 10 is in danger of not being fully funded. Round 11 is in danger of being squeezed (including NSA and joint HSFP proposals) Should we be moving from ‘going for growth’ to ‘holding the line’ ?

40. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 OIG Corruption cases: What are we doing?  Responding vigorously to the cases identified and systemically:  Suspended grants, re-tendered LFA contracts, implemented additional safeguards, pursued funds recovery, cooperated with law enforcement agencies, closer focus on higher risk activities  Enhanced LFA training; revised LFA terms of reference, increased CCM oversight; developed joint work plan with OIG  Announced independent high-level review of fiduciary controls  Communicating with stakeholders:  Responding vigorously to misleading/inaccurate reporting  Keeping the Board informed through statements and messages  Press releases, interviews, media briefings, website, social media  Coordinating with our allies and champions on key messages  Reaching out to donors and other stakeholders (meetings, phone calls, letters)

41. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Resource Mobilization: Immediate Term  Reassuring donors that our systems remain solid –Independent Review by high-level panel –Continued roll-out of reform agenda –Intensive relationships management  Maintaining the pressure  Ensuring the ‘results message’ isn’t lost  The Global Fund remains an excellent investment  Millions of lives have been saved, the tide is turning against the three diseases, and these gains must not be put at risk.  Donor public deficits are the result of structural economic problems – ODA is not the cause

42. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Civil society Civil society activism continues to underpin the strong levels of support enjoyed by the Global Fund –Critical in maintaining funding in Germany, securing increases in France and the USA –Has become all the more vital as the Global Fund comes under financial and political pressure (eg Sweden, the Netherlands and Abuja targets) Holding governments to account, setting the record straight, mobilizing and lobbying Resource mobilization has involved both NGOs from the North – the source of major donor funding and NGOs from the South –The role of emerging economies and co-financing from recipient block is become crucial –Scope for enhanced engagement with new partners, new strategies and new urgency.

43. Strategy Meeting on Resource Mobilization Amsterdam, 16-18 February 2011 Timeline post Replenishment 1st GF Strategy 2nd GF Strategycontinued 3rd Cycle of Replenishment – Funding for 2011-2013 4th Cycle of Replenishment – Funding for 2014-2016 MDG Summit 3rd Replenishment pledging conference Board Retreat to start strategy development process 10 years UNGASS Review Mid-Term Replenishme nt Review MDG Revie w Pledging conference (4th Repl.) MDG Target G8 Preparatory conference (4th Repl.)

44. "A positive attitude will not solve all your problems, but it will annoy enough people to make it worth the effort." - Herm Albright

45. Civil Society Officers Mauro Guarinieri (Asia) Mauro.Guarinieri@TheGlobalFund.org Katja Roll (Africa) Katja.Roll@TheGlobalFund.org Vitaly Zhumagaliev (EECA) Vitaly.Zhumagaliev@TheGlobalFund.org