Global Fund TB investment and the New Funding …Mohammed Yassin MD, MSc, PhD Advisor, Tuberculosis...
Transcript of Global Fund TB investment and the New Funding …Mohammed Yassin MD, MSc, PhD Advisor, Tuberculosis...
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
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Divonne, France
Contribution to International Financing for TB,
Source: Global TB report, WHO 2013
Global Fund Financing
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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
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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
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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
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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