1. UPDATE ON GAVI ALLIANCE, THE GLOBAL FUND AND WORLD BANK COLLABORATIVE EFFORT FOR MORE EFFECTIVE HSS SEPTEMBER, 2009 Exploring a potential common platform for health systems strengthening

2. Growing support for harmonising and aligning HSS efforts WHO Maximizing Positive Synergies Collaborative Group High Level Task Force on Innovative International Financing for Health Systems …”Establish a health systems funding platform for the Global Fund, GAVI Alliance, the World Bank and others to coordinate, mobilize, streamline and channel the flow of existing and new international resources to support national health strategies”… …”Improve alignment of planning processes and resource allocations among Global Health Initiatives, and between Global Health Initiatives and country health systems”… Letter from GAVI and TGF to the High Level Task Force …”We intend to begin jointly programming GAVI Alliance and the Global Fund resources towards health systems strengthening”...

3. Rationale Reduced transaction costs for countries and accelerated progress towards MDGs Practical step to make global health aid architecture more effective Increased global focus on health system strengthening Possible longer-term predictable donor funding for HSS Global financial crisis: innovation, focus, and efficiency more critical. GAVI and GF have demonstrated innovative approaches

4. Proposed Principles Flexible/differentiated approach for different countries – NOT one size fits all Commitment to IHP+ principles Improve information sharing between the 3 agencies Focus on country results and value for money Common frameworks for HSS and Harmonized approach to program development, approval, and implementation Strong analytical basis for HSS

5. Possible Components of a Joint Approach to HSS 1. Support for national health strategy development 2. Joint HSS Processes – including Joint Assessment of National Strategies for funding HSS components 3. Common monitoring framework using annual review processes for monitoring performance 4. Common funding/disbursement channels

6. 1. Development of National Health Strategies Support assessments to identify HSS challenges and identify program specific and cross-cutting elements of HSS strategies Coordinate and harmonise processes to strengthen national health plan and disease specific strategy development

7. 2. Joint HSS Processes Move towards a joint HSS process:  Jointly assessed national health plan as the basis for funding (in line with IHP+)  Common list of principles, guidelines, and documentation for HSS  Harmonize deadlines and align with national budget and planning cycles  Harmonies guidelines and definition of HSS (i.e. what joint funds can be used for) Issue of independent element for GAVI and the Global Fund

8. 3. Common monitoring using annual review process Joint performance measurement, M&E and common indicators (aligned with IHP+) Adequate financial support for strengthening HMIS systems where necessary One Report – aligned with country reporting cycle One joint partner supervision mechanism aligned with country annual join review

9. 4. Common Funding 3 agencies are exploring options for pooled funding at the country level Possibility of pooling funds at global level if new funds become available Tightening links across separate funding decisions to reduce duplication

10. Proposed Process Potential options developed Aug – Oct 2009 Present early options to management and governing bodies by November 2009 Consultation and learning by doing – consider 2-3 countries in 2010 Present commonly agreed options to governing bodies in mid-2010 Develop policies for roll-out in late 2010