Global Fund TB investment and the New Funding …Mohammed Yassin MD, MSc, PhD Advisor, Tuberculosis Outline •Overview of Global Fund TB portfolio –Interventions supported –disbursement

Global Fund TB investment and

the New Funding Model

Mohammed Yassin MD, MSc, PhD

Advisor, Tuberculosis

Outline

• Overview of Global Fund TB portfolio

– Interventions supported

– disbursement

• New Funding Model

– Principles and key steps

– Relevance of NSP to NFM

– Tools and guidelines

• Strategic investment framework

• Modular tool

17 Feb 2014

NSP training,

Divonne, France

Grant Portfolio 2002-2013

0

5

10

15

20

25

30

Total HIV Malaria TB HSS TB/HIV

28.9

15.8

7.9

4.7

0.3 0.2

Am

ou

nt

in U

S$ b

illio

ns

Global Fund reports, 2013

17 Feb 2014 NSP training,

Divonne, France

Contribution to International Financing for TB,

Source: Global TB report, WHO 2013

Global Fund Financing

17 Feb 2014

NSP training,

Divonne,

France

Cumulative Budget for TB services

Supportive environment

19%

HSS 14%

Community TB & high risk groups

6%

Diagnosis & treatment

33%

M&E and OR 7%

Engaging other care providers

3%

MDR-TB 14%

TB/HIV 4%

Cumulative budget, as of 2012

17 Feb 2014

NSP training,

Divonne,

France

Trends in TB Disbursements 2002-2013

0

100,000,000

200,000,000

300,000,000

400,000,000

500,000,000

600,000,000

700,000,000

800,000,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Disbursements

17 Feb 2014

NSP training,

Divonne,

France

The New Funding Model

http://www.theglobalfund.org/en/fundingmodel/

• Greater alignment with country schedules, context, and priorities

• Focus on countries with the highest disease burden and lowest

ability to pay, while keeping the portfolio global

• Simplicity for both implementers and the Global Fund

• Predictability of process and financing levels

• Ability to elicit full expressions of demand and reward

ambition

Principles

of the new

funding model

Principles of the new funding model

The new funding model changes the way

applicants apply for funding, get approval of

their proposals and then manage their grants

17 Feb 2014

NSP training,

Divonne,

France

Overview of the new funding model

NSP

Allocation formula

NSP

support

Band allocation

Concept Note Country

dialogue

Determine /

approve adjusted

funding amount

Unfunded quality

demand

Grant-making

TRP

review

Board

approval

Incentive funding

Indicative funding

Grant

Approval

Committee

Determination

of split between

diseases & HSS

17 Feb 2014

NSP training,

Divonne,

France

Ideal approach: continuum of support in line

with the new funding model

• Joint assessment

of DQ & systems

• Identification of key

data gaps

• Quantification of

investment needs

• Strategic

investment in data

systems

• Epi and impact

assessment for

NFM

• Before the

development of a

Concept Note

• Identifies disease

trends, data

limitations and

required actions

• Ambitious yet

realistic goals and

SMART objectives

• Costed M&E plan

• Measurable

indicators, clear

sources of info and

means of

verification

• Joint reviews with a

particular focus on

epidemiological

impact & progress

• Recommendations

to inform a revision

or dev. of new

NSP.

Surveillance

Systems and Data

Quality assessment Epi analysis Program Review

Strategic Plan

Development

Ongoing 1-2 weeks 3-4 weeks 2-3 months

Global Fund application

17 Feb 2014

NSP training,

Divonne,

France

National strategic plans (NSPs):

The basis for Global Fund funding

National strategic plan* Robust NSP*

NSP

Assessment

Concept

Note

with prioritized

programmatic

gaps

Before assessment

Epi analysis &

program

review

Grant funds may be reprogrammed to

support NSP development.

Strategic investment approach

17 Feb 2014

NSP training,

Divonne,

France

17 Feb 2014

NSP training,

Divonne,

France

Robust NSP meets JANS criteria:

• Sound situational analysis and

programming

• Inclusive development and

endorsement process

• Sound and feasible costs and

budgetary framework

• Effective implementation and

management arrangements &

systems

• Effective monitoring, evaluation and

review mechanisms

Increase

country

funding

Access to incentive

funding

Higher probability of

Funding from Register

of Unfunded Quality

Demand

Speed up

GF

process

Faster CN development

Improved CN quality

Simplified grant

management

procedures/grant types

Robust NSPs are Important

Tools and guidance for NFM

http://www.theglobalfund.org/en/fundingmodel/support/infonotes/

TB Strategic Investment Framework

• Developed with partners

• Aligned with guidelines from technical partners

• Informs Global Fund investments on TB

• Could be used during

– Country dialogue and Concept Note development

– Grant/program implementation and reprogramming

• Provides information on key references and tools

17 Feb 2014

NSP training,

Divonne,

France

Care and

prevention TB/HIV MDR-TB CSS

Removing

legal

barriers

HIS &

M&E

Program

Management

Case detection

and diagnosis

Treatment

Prevention

Engaging all

care providers

Community TB

care delivery

Key populations

Collaborative

activities with

other programs

TB/HIV

collaborative

activities

Engaging all

care providers

Community TB

care delivery

Key

populations

Collaborative

activities with

other programs

Case detection

and diagnosis:

MDR-TB

Treatment: MDR-

TB

Prevention for

MDR-TB

Engaging all care

providers

Community TB

care delivery

Key populations

Collaborative

activities with

other programs

Community based

accountability

monitoring

Advocacy for

social

accountability

Social

mobilization

Institutional

capacity building,

planning

Law reform

Legal aid

services and

literacy

Training on

rights for health

professionals

Community-

based monitoring

of legal rights

Policy advocacy

on legal rights

Routine

reporting

Analysis,

review and

transparency

Surveys

Administrative

and finance

data sources

Vital

Registration

Policy, planning and

coordination and

management

Grant

management

Supporting

procurement and

supply management

Core Modules Supporting Modules

Prioritization of modules and their interventions depends on country context and epidemiological situation

Main programmatic areas which guide TB strategic

investment in high impact interventions

The modular approach

The modular approach is a framework used to

structure the information that defines a grant

It runs throughout a grant's lifecycle, providing

consistency at each stage

• During the concept note stage, a funding

request is defined by selecting a set of

interventions per module to align with

national strategy

• During the grant making stage, each

approved intervention is further defined by

identifying and describing the required sets

of activities

• During grant implementation, progress of

each intervention is monitored as laid out in

the prior stages

Program level

Module

Intervention

Activity

17 Feb 2014

NSP training,

Divonne,

France

Modular approach process

Modules /

interventions &

performance info

• Selected

modules &

interventions

• Program goals &

objectives

• Impact, outcome,

and coverage /

output indicators

with associated

information

• High level budget

Detailed list of

products &

PSM costs by

intervention

Detailed

budget &

assumptions

Integrated

summary

view of

performance

indicators,

budget, &

GIMs for

grant

agreement

1 2

4

GIM Selection 3

GAC

approved

funding

ceiling

Concept note Grant-making

TRP

GAC

Grant signing

Modular template

• Aligns terminology with normative guidance from technical partners

• Incorporates terminology already being used by countries and partners

• Replaces the former SDAs whose terminology differed from technical

partners and was applied inconsistently, presenting challenges for portfolio

level analysis

• Bring together activities, funding, and performance tracking into a single view

• Allows for comparison between funding and performance at intervention level

• Minimizes the use of separate documents

• Streamline existing documents across the grant lifecycle with all information

organized by the module / intervention framework

• Enables the content developed in one stage (e.g., concept note) to follow into

the next stage (e.g., grant making)

• Lessens the use of successive tools throughout the grant lifecycle and avoids

the repackaging of similar information in different ways

17 Feb 2014

NSP training,

Divonne,

France

Modular template

Quality assurance

Procurement agent

fee

TB

Malaria

HIV

TB care and

prevention

TB/HIV

MDR-TB

Case detection & diagnosis

Treatment

Prevention

Purchase microscopy

Drugs, reagents

Transport samples

Training

CSS

Engaging all care providers

Communities

TB screening Other sectors

Cost Inputs

Product cost

Transportation

Storage

HSS

Activities Interventions Modules Components

....

TB and HIV

HIS and M&E

Program

Management

Removing legal

barriers to access