GLOBAL FUND OBSERVER (GFO), an independent newsletter about the Global Fund provided by Aidspan to over 8,000 subscribers in 170 countries.

Issue 111: 16 November 2009. (For formatted web, Word and PDF versions of this and other issues, see www.aidspan.org/gfo)

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CONTENTS

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1. NEWS: Main Decisions Made at November Board Meeting

Details are provided regarding all the main decisions made at the Global Fund’s recent Board meeting.

2. NEWS: Global Fund To Implement New Funding Architecture

The Global Fund Board has decided to implement a new funding architecture in order to simplify processes for grant implementers. The centrepiece is the concept of a "single stream of funding" per PR per disease.

3. NEWS: Global Fund Offers Additional Funding for CCMs

The Global Fund has established a new "expanded funding" window for CCMs. The new window allows a CCM to apply for more than $50,000 a year in funding providing it submits a two-year workplan with measurable targets.

4. NEWS: Global Fund Board Approves Proposals for Phase 1 of the "Affordable Medicines Facility – Malaria" (AMFm) Funding Stream

The Global Fund Board has approved 10 proposals under Phase 1 of a small innovative new funding programme called the "Affordable Medicines Facility – Malaria" (AMFm), which is designed to provide support for interventions promoting and facilitating the use of artemisinin combination therapies.

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1. NEWS: Main Decisions Made at November Board Meeting

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On 9-11 November 2009, the Global Fund Board held its twentieth board meeting, in Addis Ababa, Ethiopia. GFO was present, with observer status.

This article summarises the main decisions made at the meeting. The decisions, in chronological order, were as follows. (For precise wording of what the Board agreed, see the Decision Points document at www.theglobalfund.org/en/board/meetings/twentieth. Background documentation will also, in time, be posted by the Fund at the same location.)

Common platform for joint funding and programming of HSS: The Global Fund has held discussions with the World Bank and the GAVI Alliance, with technical support being provided by the World Health Organization (WHO), regarding a possible shared approach to the funding of health systems strengthening (HSS). Two main approaches have been examined. The first is to create a single HSS funding application form that countries would complete and submit to all three agencies (Global Fund, World Bank and GAVI). The three agencies would jointly assess the applications, but different agencies would fund different applications. The second approach is for the three agencies to jointly assess complete national health strategies (rather than just assessing proposals submitted via an application form). The three agencies would jointly decide which ones to fund, and would jointly provide funding for each endorsed national health strategy. The Board authorised the Global Fund Secretariat to continue participation in this assessment work and to broaden the discussions to include additional options. The Board also asked the Secretariat and the Board’s Policy and Strategy Committee to propose how a joint HSS platform could be implemented and funded. [See Decision Point 4.]

Support for the Board’s implementing constituencies: To enhance the engagement of constituencies representing implementing countries in Board deliberations and decision-making, the Board decided to make more money available to support communications, meeting, travel and staff costs incurred for intra-constituency functions. The Board approved an annual budget of $800,000 for this purpose. Each of the seven implementing constituencies may apply for up to $80,000 for 2010, but exceptions to this ceiling may be granted by the Secretariat as long as the overall budget is not exceeded. [See Decision Point 7.]

Coping with limited funding availability: The Board endorsed the "broad lines of thought" contained in the recommendations of the Board’s "Working Group To Manage the Tension Between Supply and Demand in a Resource-Contained Environment." The Working Group’s recommendations dealt with how to reduce the costs of funding approved proposals for Round 9 and the first learning wave of National Strategy Applications (NSAs); how to delay the provision of some of the funding for these approved proposals; how to determine the order in which these proposals should be funded; how to deal with these and related issues in rounds subsequent to Round 9; and new approaches to raising money for the Fund. The Board decided that many of the Working Group’s topics and recommendations require further discussion by the Board. This discussion will take place at a Board retreat to be held in January or February 2010. [See Decision Points 10 and 30.] The Board also adopted some of the specific recommendations of the Working Group, such as an average 10% reduction in the first-two-year budgets of approved Round 9 and NSA proposals; GFO reported on these decisions in the first article in Issue 110, available at www.aidspan.org/gfo. [See Decision Point 9.]

Approval of Round 9 and NSA grants: The Board approved 85 Round 9 grants that will cost $1.99 billion over two years, and five "first learning wave" National Strategy Applications that will cost $0.39 billion over two years. GFO provided details of these decisions in Issue 110, available at www.aidspan.org/gfo. [See Decision Point 11.] [Note: Up-to-date information regarding approved Round 9 and NSA grants, together with information on all earlier grants, is available on a country-by-country basis at www.aidspan.org/grants.]

CCM Guidelines: The Global Fund is planning revisions to the CCM Guidelines. The Board delegated to its Portfolio and Implementation Committee (PIC) the authority to make the changes, except that if the PIC wants there to be any changes to the six CCM minimum requirements, these will have to approved by the Board. [See Decision Point 12.]

Quality Assurance Policy for Pharmaceutical Products: The Fund’s Quality Assurance Policy requires that Finished Pharmaceutical Products (FPPs) can only be purchased using Global Fund money if the FPPs are WHO-prequalified, or have been authorised by a Stringent Regulatory Authority, or have been approved by the Fund’s Expert Review Panel (ERP). The Board agreed to expand the eligibility criteria for products to be reviewed by the ERP, because grant implementers have sometimes found it difficult to find suppliers for qualifying malaria and first-line TB FPPs, leading to the risk of treatment disruptions. The Board also decided that because it will take some time to organise submissions and reviews for products newly eligible as a result of this change, certain additional exceptions to the current policy will be allowed until 31 December 2010. [See Decision Point 13.]

2010 operating expense budget: The Board approved a 2010 operating budget for the Secretariat of $274 million. The size of the Secretariat, at 597 staff, will remain roughly the same as it is in 2009. [See Decision Point 14.]

In-kind non-health product donations: The Board approved, on a trial basis in a limited number of countries, the idea of accepting non-health products as donations to the Global Fund. The trial will last about two years. [See Decision Point 16.]

Expansion of Debt2Health: The Board decided to make Debt2Health a permanent part of the Global Fund’s fundraising effort. (Under this initiative, wealthy countries that have lent money to developing countries choose to forgo repayment of a portion of their loans on the condition that the borrowing country invests an agreed-upon amount in health in their own country through Global Fund-approved programmes. The amount generally equals the payments the country was making to service the debt.) The pilot phase has been completed, with two agreements signed and a third signature pending. These agreements cover debt with a face value of $140 million, which has raised $80 million, after discounts, for the Global Fund. In addition, a further three agreements are being negotiated with a face value of $93 million, with the potential to generate additional funding of $46 million. [See Decision Point 17.]

Affordable Medicine Facility – Malaria (AMFm): The Board approved 10 proposals in a small new funding stream, the AMFm, at a net cost to the Fund of $18 million after some grant restructuring. The funds are for interventions to support the increased use of artemisinin combination therapies (ACT) for the treatment of Malaria. The proposals were part of a pilot phase in a limited number of countries, which is expected to last about two years. The Board said that it will consider a global scale-up of the AMFm funding stream if an independent evaluation reveals that the initiative is achieving its objectives. [See Decision Points 24 and 25. See also separate article on AMFm, below.]

Partnership Strategy: The Board approved a new Partnership Strategy designed to enhance the Global Fund’s partnerships. The Strategy includes an accountability framework (the Partnerships Performance Framework) to enable the Fund and its partners to assess the effectiveness of the partnership. The Secretariat will develop an implementation plan for the Partnership Strategy by March 2010. [See Decision Point 27.]

Translation and interpretation: The Board approved funding some increased translation and interpretation for Board and committee meetings and documents (or portions of documents). Decisions concerning whether and what to translate and interpret will be left to chairs and vice-chairs. The Board said that this new policy would be implemented incrementally. For example, initially, translation and interpretation (from English) would be limited to two languages. [See Decision Point 28.]

Round 3 Russia HIV grant: The Board approved "on an extraordinary basis" an extension of a Round 3 HIV grant to Russia, for which the PR is the Open Health Institute, and which was due to expire on 31 August 2009. The extension is until 31 December 2011. The cost of the extension is $24 million. The OHI grant, as it is known, includes the provision of ARVs as well as the provision of lifesaving prevention services to vulnerable populations. The Board was responding to the fact that under the current income eligibility policies of the Global Fund, Russia is no longer eligible for HIV funding, and so cannot apply for funding to enable these activities to be continued. In its decision, the Board noted that the Fund’s income eligibility policies are under review, and that this review should be completed by late 2010. The Board also urged Russia to expand its investments in services to vulnerable populations. [See Decision Point 29.]

Launch of Round 10: As reported in GFO 110, the Board decided that subject to confirmation at its next board meeting in April 2010, the Fund will issue the Round 10 call for proposals on or about 1 May 2010. Proposals must be submitted by 1 August 2010, and the board will decide which ones to approve between November 2010 and January 2011. [See Decision Point 30.]

Architecture review: The Board approved a number of measures to simplify processes for grant implementers by introducing a single stream of funding per PR per disease. (The Board had approved this basic concept at its meeting one year ago.) The single stream of funding means that, in future, when there are multiple grants for the same PR for the same disease, they will be rolled into one. The transition to the single stream of funding will occur gradually over the next two years. There will continue to be rounds of funding, similar to the current rounds-based channel, as well as national strategy applications (NSAs). However, as reported in GFO 110, the rolling continuation channel (RCC) will be discontinued. By the start of Round 11, each new proposal submitted to the Global Fund will have to be in the form of a consolidated request for funding, incorporating all then-current Global Fund support to the country for that disease. [See Decision Point 31. See also separate article on the architecture review, below.]

Youth leadership: The Board asked the Secretariat, in consultation with the constituencies represented on the Board, to consider how they can better include young people and facilitate youth-led action at global and national levels; and how to ensure that the ideas and perspectives of youth are better reflected in the work of the Global Fund and the Board – and to report back to the Board on this within two years. [See Decision Point 32]

Other Decisions: Several appointments were made to the Technical Evaluation Reference Group (TERG) to replace people whose terms had expired [Decision Point 5]; the Board approved a new memorandum of understanding between the Global Fund and Roll Back Malaria [Decision Point 6]; the Board decided that a representative of the Partners Constituency on the Board, a non-voting position established at the 19^th Board meeting, would have a seat on both the Policy and Strategy Committee and the Portfolio and Implementation Committee [Decision Point 8]; the OIG (Office of the Inspector General) Charter and Disclosure Policy were amended to clarify working relationships between the OIG and the Secretariat and to enable the OIG to collaborate more closely with partner organisations [Decision Points 21-23]; the Board adopted a Risk Management Framework [Decision Point 15]; and the Board authorised the Secretariat to engage in further negotiations for the construction of a building to be leased by the Secretariat for use as office space, leading to reduced rental costs [Decision Point 19].

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2. NEWS: Global Fund To Implement New Funding Architecture

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The Global Fund Board has decided to implement a new funding architecture in order to simplify processes for grant implementers. The centrepiece is the concept of a "single stream of funding" per PR per disease.

This article explains how the new funding architecture will work. It is based on Aidspan’s understanding of the decisions taken at the recent Board meeting in Addis Ababa, and of information contained in documents submitted to the Board for that meeting. The Global Fund Secretariat will be providing more information on the single stream of funding in the near future.

Under the "single stream of funding" concept, where there currently are multiple grants for the same PR for the same disease, the grants will be consolidated into a single grant. And, in future, if additional funding is approved for that PR and disease, that funding will be rolled into the same grant.

If a CCM submits a proposal and nominates a new PR (i.e., a PR that is not already implementing Global Fund grants for the same disease), and if the proposal is approved for funding, a new grant will be signed with that PR – but thereafter, any additional funding approved for that PR and disease will become part of that same grant.

There will continue to be rounds of funding, similar to the current rounds-based channel, and there will continue to be national strategy applications (NSAs), though the rolling continuation channel (RCC) is being discontinued. Thus, any approved proposal will lead either to a new grant (in the case of a new PR/disease combination), or to an expansion and/or extension of an existing grant.

The transition to the single stream of funding will occur gradually over the next two years. During that time, there will be opportunities for countries to consolidate several grants into one. These opportunities include when new funding proposals are submitted in Round 10 (expected to be launched on 1 May 2010), and when Round 9 grant agreements are signed, and when amended grant agreements are signed as part of Phase 2 Renewal.

The Board first approved the concept of a single stream of funding at its eighteenth meeting in November 2008. At its twentieth meeting in Addis Ababa on 9-11 November, the Board approved the implementation of the single stream of funding, as well as a number of changes to Board policies that are required to make it happen.

The expected benefits of the new architecture include the following:

• Grant implementation and management will be simplified, both for implementers and for the Secretariat.
• Transaction costs related to reporting and disbursements will be reduced.
• The need for formalities involved in grant closures will be removed, except when the funding relationship with a PR comes to an end.
• Support for national programmes will be enhanced.
• Performance-based funding will be enhanced as a result of having a more transparent and holistic view of Global Fund-financed activities in each country.

Other features of the single stream of funding include the following:

• The independent TRP process will be maintained.
• Where there are multiple PRs for the same disease, a single stream of funding will be created for each PR.
• The single stream of funding will be closed when the Global Fund discontinues its funding relationship with a PR.

Starting with Round 11, all proposals submitted to the Global Fund will have to be based on a consolidated request for funding, incorporating existing grants for the same PR and disease – or, where there is more than one PR, a consolidated request for funding for each PR.

Each time grants are consolidated, a Single Stream Grant Agreement will be signed by the Global Fund and the PR. These Grant Agreements will be subject to a fixed three-year review and commitment cycle, a new feature of the single stream of funding. What this means is that the Global Fund will make an initial commitment for three years. Towards the end of the three years, the grant will be subject to an in-depth performance review, similar to what is done now for Phase 2 Renewals. If the performance review indicates that the grant should continue, funds will be committed for another three years.

Normally, when funds are committed for another three years, the level of funding will be similar to what it was for the previous three years. An as-yet unpublished background paper "Architecture Review – Progress Update" states that if the grant has demonstrated strong performance, the CCM may apply for an increase in funding in order to allow for scale-up of the grant’s activities. In these instances, the CCM can ask for additional funding of up to 20 percent of the funds allocated for the previous three years.

It will also be possible for a CCM to submit a new proposal for the same PR and disease – i.e., if the CCM wishes to add new programmes or activities. This would increase funding for the existing grant with that PR.

The fixed three-year review and commitment cycle is unaffected by the introduction of new funds, which can take place during intermediate years. Thus, if the CCM submits a new proposal for the same PR, as outlined above, and if the proposal is approved, new funding will be committed only up to the next scheduled three-yearly review. This enables the PR to get onto a standard three-year cycle for all its Global Fund-related activities within a disease.

The above-mentioned background paper states that along with the single stream of funding, the Global Fund plans to introduce some changes with respect to information that CCMs have to provide. The Fund will create an online applicant profile, designed to reduce the amount of information the CCM has to provide with each application. And, beginning in Round 10, only those CCM requirements pertaining to proposal development and PR nomination will be reviewed at the time of proposal submission. Requirements relating to CCM membership, as well as program oversight and governance, will be reviewed on a regular basis and on a separate timeline by the Secretariat (in some cases through the LFA).

The background paper adds that as of Round 10, the TRP will be able to "select out" parts of proposals that are not technically sound while recommending the remainder for funding.

The Board has authorised the Secretariat to negotiate revisions to existing grant agreements that may be required to consolidate the grants into a single stream of funding. The Board has also authorised the Secretariat, on an as-needed basis and without Board input, to commit additional funds for a Single Stream Grant Agreement, equivalent to up to 12 months of approved but as yet uncommitted funding in existing grants (e.g., for Phase 2 of a rounds-based grant that has not commenced yet).

In the event that a CCM elects to consolidate an approved Round 8, Round 9 or NSA grant for which a grant agreement has not yet been signed, the Board has approved exceptions to existing Board policies to allow for the Single Stream Grant Agreement to be signed up to 18 months after the Board approved the proposal, and to allow the start date for the Grant Agreement to be up to 24 months after Board approval of the proposal. Current policies require grant agreements to be signed within 12 months of Board approval, and for the grant start dates to be no later than 18 months after Board approval.

The Global Fund says that it will produce a comprehensive communications plan to explain the changes, together with very clear application and guidance materials that will be developed and disseminated with ample time before submission deadlines.

The Board decision outlining the changes to Board policies required to implement the single stream of funding is available at www.theglobalfund.org/en/board/meetings/twentieth (see Decision Point 31). Other features of the new architecture are described in "Architecture Review – Progress Update," a paper prepared for the Policy and Strategy Committee (GF/PSC/11/02) and referred to in the Committee’s Report to the Board (Document GF/B20/4)

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3. NEWS: Global Fund Offers Additional Funding for CCMs

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The Global Fund has established a new "expanded funding" window for CCMs. The new window allows a CCM to apply for more than $50,000 a year in funding providing it submits a two-year workplan with measurable targets. (All references in this article to CCMs apply also to Sub-CCMs and Regional Coordinating Mechanisms.)

The current "basic funding" window for CCMs has been retained, but the annual ceiling for basic funding has been raised from $43,000 to $50,000.

Thus, CCMs can choose to apply either under the basic funding window (which carries a $50,000 ceiling, and for which the requirements are fairly minimal), or under the new expanded funding window, which provides in excess of $50,000, and for which the requirements are more extensive.

A CCM that is currently being funded under the old funding policy (ceiling: $43,000 a year) may submit a request to terminate the funding agreement before its end date, and may reapply for basic or expanded funding. If the request is approved by the Secretariat, unspent funds from the terminated agreement will be transferred to the new funding agreement.

The new policy is in response to concerns that CCMs are under-funded, particularly with respect to areas that are often neglected, such as grant oversight and constituency engagement. According to the Global Fund, the expanded funding window will promote stronger and more transparent performance among CCMs.

Under the expanded funding window, funding requests may be submitted once every two years. All CCMs members must sign the request. There is no upper ceiling with respect to how much funding can be requested. However, if a CCM is applying for funding in excess of $100,000 per year, it must demonstrate that it has obtained 20 percent of the amount exceeding $100,000 from sources other than the Global Fund.

As part of a request for expanded funding, the CCM must submit a detailed two-year budget broken out by cost category and by functional area, and a two-year workplan that includes activities and performance targets. All CCM members are expected to be involved in the preparation of the budget and workplan.

For funding obtained through the expanded funding window, the CCM is required, at the end of both the 10^th and 22^nd months of funding, to submit a report on expenditures and performance.

Under either the expanded or basic funding window, CCMs can apply for funds to support the following types of expenditure:

• Salary of CCM secretariat staff.
• Consultancy work – e.g., technical support for core CCM functions such as civil society participation, programme oversight and alignment with other national bodies. (Costs for hiring consultants to write proposals to the Global Fund are not eligible.)
• Office management, including rent, equipment and supplies, but excluding vehicle purchase or long term lease.
• CCM meetings, including travel costs for members (and non-members invited by the CCM) to attend CCM meetings or participate in grant oversight visits.
• Communication and information dissemination – e.g., call for proposals, minutes of meetings, maintaining a website or newsletter, translation of key information.
• Organisation and facilitation of meetings and workshops on CCM capacity building, or topics related to CCM core functions.

The Global Fund expects that, under the new policy, the costs of providing funding for all CCMs combined may double (to about $12 million in 2011, from about $6 million in 2009). This includes staff in the Global Fund Secretariat required to administer the policy.

The funding for CCMs comes from a separate pool of funds maintained by the Global Fund. Grant funds had been used for this purpose, but that practice ceased in late 2007.

The text of the new "Country Coordinating Mechanism (CCM) Funding Policy" is available in Annex 2 of the "Report of the Portfolio and Implementation Committee," Board Document GF/B20/5, which will shortly be available on the Global Fund website under "Board documents" at www.theglobalfund.org/en/board/meetings/twentieth.

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4. NEWS: Global Fund Board Approves Proposals for Phase 1 of the "Affordable Medicines Facility – Malaria" (AMFm) Funding Stream

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At its recent meeting in Addis Ababa, the Global Fund Board approved 10 proposals under Phase 1 of a small innovative new funding programme called the "Affordable Medicines Facility – Malaria" (AMFm), which is designed to provide support for interventions promoting and facilitating the use of artemisinin combination therapies (ACT).

The total budget of the approved proposals is $127 million. Of this amount, the Global Fund estimates that $98 million will be generated through savings in the approved countries’ existing Global Fund malaria grants, and that a further $11 million will be provided from other sources (i.e., other Global Fund grants, other donor funds and domestic resources). Thus, the total incremental cost to the Global Fund of the approved proposals is $18 million.

All proposals cover a two-year period. Twelve applications were submitted. Of the 10 approved proposals, five were rated by the Global Fund’s Technical Review Panel (TRP) as Category 1 (no issues, or minor issues to be dealt with during negotiations), and another five were rated Category 2 (some clarifications required). The TRP rated two proposals Category 3 (not recommended for funding).

Applications for Phase 1 were on an invitation-only basis. Invitations were extended to 12 CCMs. The countries were selected based on criteria such as having a moderate to high mortality rate, and having previous experience with large scale ACT programmes.

The following table provides more details on the results of the Phase 1 funding process.

¹ After re-structuring of existing malaria grants, and savings from other sources.

² Rwanda submitted a total budget of US$9,796,263. The TRP recommended reducing this to $2,857,752.

AMFm is an innovative financing mechanism designed to expand access to affordable ACT drugs for malaria. ACT is currently the most effective treatment for malaria, but ACT drugs account for only one in five malaria treatments taken and are provided almost entirely by the public sector. Yet over 60 percent of patients access anti-malarial treatment through the private sector, where ACT drugs make up only five percent of treatments provided. The reason that ACT drugs are not more widely used is that they are more expensive than other treatments.

In November 2008, the Global Fund Board approved the first phase of AMFm, among a small group of countries, to enable lessons to be learned before a global roll-out of the AMFm.

AMFm tries to increase the provision of affordable ACTs in two ways: (1) by reducing the cost of ACT drugs; and (2) by ensuring that additional activities (called "supporting interventions") are carried out to assist safe and effective implementation of the AMFm. The proposals that were just approved by the Board consist of these supporting interventions.

With respect to reducing the cost of ACT drugs, the Global Fund has reached agreement with all eligible manufacturers to reduce their ACT sales prices to first-line private sector buyers to the same level as for public sector buyers. This is the first in a two-step process. The second step is an AMFm co-payment to further lower the prices to first-line buyers in all sectors, which will happen when those buyers place orders. First-line buyers include international, regional and national buyers from the public, not-for-profit and private sectors that purchase ACTs directly from the manufacturer, or procurement agents buying on their behalf.

The supporting interventions must include, at a minimum, public awareness campaigns, training and supportive supervision for ACT providers, policy and regulatory measures, pharmocovigilance planning, and programmes to reach poor people and children. Countries are encouraged to add other supporting interventions. For example, the majority of applications to AMFm Phase 1 proposed the introduction or expansion of rapid diagnostic tests to support scale-up, including undertaking operational research where needed to inform scale-up in the private sector. The TRP welcomed this as a sound approach to malaria case management.

The AMFm is hosted by the Global Fund, with some financial support provided by other agencies, including UNITAID, the U.K. Department for International Development (DfID), and the Bill and Melinda Gates Foundation. The Roll Back Malaria Partnership (RBM) provides technical support

It is expected that once the co-payment has been applied, first-line buyers in all sectors will be able to buy ACTs from manufacturers at an average price of about five cents per treatment course. In the private sector, first-line buyers are expected to pass on a high proportion of any savings, so that patients are able to buy ACTs at a price that is competitive with other malaria drugs such as the increasingly ineffective chloroquine, and the undesirable oral artemisinin monotherapies. The idea, therefore, is to increase access to ACT drugs and to displace inappropriate treatments from the market.

The AMFm will not result in separate grant agreements being signed. Rather, funds provided for supporting interventions will be channelled through existing malaria grants. (This will require that the relevant Grant Agreements be amended.)

Invitations to apply for Phase 1 of the AMFm were sent on 20 March 2009. (The invited countries are those listed in the table above.) Applicants were provided with a proposal form and were given a deadline of 1 July 2009. The proposals were reviewed by the TRP in a process that was separate from, but similar to, the review process for proposals under the rounds-based channel.

Phase 1 lasts for two years. It will be independently evaluated before the end of the two-year period. The Global Fund Board has said that the AMFm will be expanded to a full roll-out unless significant failures are observed during Phase 1.

More information on the results of the Phase 1 funding process can be found in the "Report Of The Technical Review Panel And The Secretariat On Applications To The First Phase Of The Affordable Medicines Facility – Malaria (AMFm Phase 1)," Board Document GF/B20/10, which will shortly be available on the Global Fund website under "Board documents" at www.theglobalfund.org/en/board/meetings/twentieth. The Board decision points on the AMFm proposals and Phase 1 of the AMFm can also be found on that site (Decision Points 24 and 25).

General information on the AMFm can be found on the Global Fund website at www.theglobalfund.org/en/amfm. Among the documents available there are "Affordable Medicine Facility – Malaria: FAQs," and the proposal forms and guidelines used for Phase 1.

  "Reproduced from the Global Fund Observer Newsletter (www.aidspan.org/gfo), a service of Aidspan."

Forwarded by:

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 Yours in Global Concern,

 A.SANKAR

Executive Director- EMPOWER

107J / 133E, Millerpuram

TUTICORIN-628 008, TN, INDIA

Telefax: 91 461 2310151; Mobile:   91 94431 48599: www.empowerindia.org

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Global Fund okays $2.4 mn grant for India

The Global Fund to Fight AIDS, Tuberculosis and Malaria has approved grants worth US$2.4 billion over two years. With this grant, the Global Fund has approved US$18.4 billion for 144 countries since it was created in 2002 to fight infectious diseases in developing countries.

India has been granted $128,583,221 for tuberculosis, malaria and HIV. $69,477,410, has been approved for tuberculosis projects over 2 years, with malaria getting a commitment of $38,105,605, and HIV, of $21,000,206.

This is the ninth time the Global Fund Board approved new proposals to support country programmes fighting the three diseases. The total two-year value of the programs recommended for funding was US $2.4 billion; the second largest -ever approved by the Global Fund, following a US $2.75 billion round in 2008. The next round of grants will be launched in May 2010.

"These grants are based on the countries' own needs and priorities and they are therefore a particularly effective source of financing," said Dr Tedros Adhanom Ghebreyesus, Ethiopian Health Minister and chair of the Global Fund Board.

India has used Global Fund grants to upscale its nationwide antiretroviral (ARV) treatment programme for people with HIV and AIDS. In three years, the number of people on free antiretroviral drugs used to treat the infection rose from 24,000 to more than 233,000. In India, 2.31 million people have HIV and AIDS.

Over 1.9 million of the world's 9.1 million people with tuberculosis live in India, but Multidrug Resistant TB (MDR-TB) is increasing. The new funding will be used to treat MDR-TB, which has a prevalence of 3 per cent in new cases and 12-17 per cent in re-treatment cases.

India has an estimated 10.6 million annual cases of malaria, with 1,044.7 million people at risk of malaria. The mosquito-borne disease causes 1,000 deaths, mostly in Assam, Orissa and West Bengal. Almost all deaths and 44.3 per cent of all cases in India are caused by the P falciparum strain.

http://www.topnews.in/global-fund-okays-24-mn-grant-india-2236675

Cross posted: AIDS INDIA

Forwarded by:

---------------------------

 Yours in Global Concern,

 A.SANKAR

Executive Director- EMPOWER

107J / 133E, Millerpuram

TUTICORIN-628 008, TN, INDIA

Telefax: 91 461 2310151; Mobile:   91 94431 48599: www.empowerindia.org

·         You are invited to join an e FORUM AIDS-TN. To join this free e Forum kindly send an e  mail    to AIDS-TN-subscribe@yahoogroups.com

·          You are invited to join an e FORUM CIN - Confederation of Indian NGO’s. To join this free e Forum kindly send an e mail to ConfederationofIndianNGOs-CIN-subscribe@...

·          This e Forums are moderated by   EMPOWER, a Non-profit, Non-Political, Voluntary and Professional Civil Society Organisation.

GLOBAL FUND OBSERVER (GFO), an independent newsletter about the Global Fund provided by Aidspan to over 8,000 subscribers in 170 countries.

Issue 109: 6 November 2009. (For formatted web, Word and PDF versions of this and other issues, see www.aidspan.org/gfo)

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CONTENTS

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1. NEWS: Global Fund Report Reveals Lenient Interpretation by Secretariat of CCM Requirements

The Global Fund Secretariat determined in Round 8 that all proposals received from CCMs were eligible for consideration by the TRP, even though some of the CCMs had not complied with at least one of the six minimum requirements that have been established by the Global Fund Board.

2. COMMENTARY: CCM Requirements: How Much Flexibility Is Appropriate?

"Some of the decisions of the Global Fund’s Screening Review Panel are scandalous – or at least, they would be if it wasn't so obvious that its members are trying to do what is ‘best’ in a complex world. Does the Secretariat believe that the Fund’s minimum requirements regarding CCMs are too stringent? If so, why doesn’t the Secretariat ask the Board to soften the requirements?"

3. COMMENTARY: Pointless PowerPoints

"If I am ever granted the job of World Dictator, my first act will be to ban the use of PowerPoint."

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1. NEWS: Global Fund Report Reveals Lenient Interpretation by Secretariat of CCM Requirements

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In Round 8, a year ago, the Global Fund Secretariat determined that all proposals received from CCMs were eligible for consideration by the Technical Review Panel (TRP), even though some of the CCMs had not complied with at least one of the six minimum requirements that have been established by the Global Fund Board.

Also, the Secretariat recommended that consideration be given to changing the proposal guidelines to make "Non-CCM proposals" eligible if they address the needs of vulnerable populations that have been left out of the national response.

These points are revealed in a Global Fund report entitled "Report of the Round 8 Screening Panel." Copies of the undated report are available at www.theglobalfund.org/documents/ccm/Screening_Review_Panel_Report_Round_8.pdf. (A report regarding the screening process for Round 9 proposals is expected within the next few months.)

As explained in the report, all applications submitted in Round 8 were screened by the Global Fund Secretariat for eligibility. Only proposals deemed to be eligible were passed on to the TRP for review. The Global Fund imposes a number of eligibility criteria; they vary depending on the type of applicant. The screening had nothing to do with evaluating the quality of the proposal – that was left to the TRP; it just evaluated whether the applicants had followed certain requirements. If they had not, the TRP never saw the proposal.

The screening was a two-part process. First, the applications were reviewed by a Screening Team, made up of 16 people who receive special training. The Screening Team rated each application as fully compliant (FC), indeterminate compliant (IC) or non-compliant (NC). An "IC" rating meant that the members of the Screening Team had some doubts concerning whether the application met the eligibility criteria.

Second, a more senior Screening Review Panel (SRP), made up of staff from various parts of the Secretariat, reviewed the applications and the recommendations of the Screening Team. For those applications rated FC by the Screening Team, the SRP reviewed a small sample of the applications. If the SRP was satisfied that the Screening Team had rigorously and appropriately reviewed the sample, it then voted to accept all FC recommendations as a block. For all applications rated IC or NC by the Screening Team, the SRP examined each one individually.

In its deliberations, the SRP did not rely entirely on the information contained in the applications. It also sought clarifications from the applicants, from other Global Fund staff, and from the Fund’s partner organisations.

Of the 123 applications, 96 were ultimately determined by the SRP to be eligible. The numbers break down as follows:

• Ninety-three of the 95 applications from coordinating mechanisms were deemed eligible (all 88 applications from CCMs, three of the four applications from Sub-CCMs, and two of the three applications from RCMs).
• Three of the eight applications from Regional Organisations (ROs) were deemed eligible.
• None of the 20 applications from Non-CCMs were deemed eligible. (Non-CCMs are national organisations other than the CCM – usually NGOs or faith-based organisations [FBOs].)

These results are similar to the results of the screening process for Round 7, except that in Round 7 all applications from ROs were deemed eligible. (See GFO 92 for details on the Round 7 screening.)

Below, we provide more information from the "Report of the Round 8 Screening Panel" on the screening process for (a) applications from coordinating mechanisms; (b) applications from ROs; and (c) applications from Non-CCMs.

A. Applications from coordinating mechanisms

In its "Report of the Round 8 Screening Review Panel," the Global Fund provided details of the screening that was done on the 95 applications submitted by coordinating mechanisms. The Screening Team and the Screening Review Panel assessed whether applicants met a number of criteria related to (a) the composition and operations of the coordinating mechanisms and (b) the proposal development process. (These criteria are known as "the six CCM minimum requirements.")

In its initial review of applications from CCMs, the Screening Team rated 73 applications as fully compliant (FC) and 15 as either indeterminate compliant (IC) or non-compliant (NC). The Screening Review Panel (SRP) confirmed all 73 FC ratings and, after reviewing the 15 IC- and NC-rated applications, the SRP decided that all of them were also fully compliant.

With respect to the other coordinating mechanisms, the SRP found only one sub-CCM (Congo Kasai) and one RCM (Andino) to be non-compliant.

In the report, the Global Fund Secretariat concluded that applicants had less difficulty demonstrating compliance compared to previous rounds. The Secretariat said that

"Contrary to Round 7, more CCMs submitted comprehensive documentation to prove an inclusive and transparent PR selection process. Also, most CCMs easily demonstrated that new non-government representatives had been selected in a transparent manner. There was also clearer linkage between proposal solicitation and the review of submissions received."

The following is a summary of what the report said about the screening conducted for each of the six minimum CCM requirements.

Requirement No. 1 – All CCMs are required to show evidence of membership of people living with and/or affected by the diseases.

Most applicants were able to demonstrate compliance fairly easily. Only three – CCM Democratic People’s Republic of Korea (DPRK), Sub-CCM Russian Federation and Sub-CCM Congo Kasai – were rated IC or NC initially by the Screening Team in regard to this requirement. Sub-CCM Congo Kasai was then determined to be non-compliant by the SRP because it failed to provide any supporting documentation. CCM DPRK and Sub-CCM Russian Federation were determined to be fully compliant by the SRP. In the case of CCM DPRK, although the proposals from that country were signed by one person previously treated for malaria, and one person previously treated for TB, there were no representatives of people living with HIV/AIDS on the CCM. However, the SRP noted that DPRK had no official data on HIV/AIDS and concluded that the CCM had shown "sufficient effort at meeting the spirit and intent of the requirement."

In the case of the Sub-CCM Russian Federation, which submitted a TB proposal, it had submitted no evidence of membership of persons living with the diseases. However, after clarification, it was revealed that a person living with TB had been added to the CCM.

Requirement No. 2 – CCM members representing the non-government sectors must be selected by their own sector(s) based on a documented, transparent process, developed within each sector.

Seven applicants were initially rated IC or NC by the Screening Team with respect to this requirement – two first-time applicants to the Global Fund (Sub-CCMs from Kyrgyzstan and Russian

Federation), plus Sub-CCM Congo Kasai and CCMs from Algeria, DPRK, Bangladesh and South Africa.

The SRP determined all but Sub-CCM Congo Kasai to be fully compliant. Even though each of the other six applicants failed to provide the necessary documentation to demonstrate compliance, the SRP judged them to be compliant based on additional information obtained from the applicant, information provided by the regional teams in the Secretariat or special circumstances in the country in question, or a combination of the above. In several cases, the decision might have been a close call, but the SRP gave the applicant the benefit of the doubt. The SRP said that the Secretariat should work with the applicants involved to improve their selection processes.

Requirement No. 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.

The SRP said:

"On the whole, CCMs demonstrated better understanding of this requirement [compared to previous rounds], in particular the need to link both parts of the requirement in order to be determined eligible. CCMs mostly used local newspapers and/or the internet to solicit ideas from interested stakeholders for possible incorporation into the final proposal. Furthermore, CCMs clearly documented their processes to review submissions received with many of them providing justifications for including or excluding submissions received."

Nevertheless, seven applicants were initially rated IC or NC by the Screening Team with respect to this requirement. Three CCM applicants (Gabon, Iran and Sri Lanka) had a clear proposal solicitation process but could not show evidence of a transparent and documented review process. The Sub-CCM Russian Federation had a documented review process but could not show evidence of an inclusive solicitation process. CCM Kazakhstan and Sub-CCMs from Kyrgyzstan and Congo Kasai had neither.

The SRP determined all but Sub-CCM Congo Kasai to be fully compliant. Once again, the SRP relied on clarifications from the applicant and input from the regional teams in the Global Fund Secretariat. And once again, the SRP gave several applicants the benefit of the doubt. For example, Sub-CCM Russian Federation did not publicly call for submissions. It stated that all organisations that had meaningful input to the proposal development process were already on the sub-CCM. The regional team confirmed this. But while the SRP determined Sub-CCM Russian Federation compliant with this requirement, it said that the SRP was

"concerned about legitimizing this trend of substituting documented open processes, with a claim that all relevant organizations had been involved in the process. The panel noted that this could, in the long run, result in proposal development processes being limited to selected organizations and institutions and thus not meeting the board’s requirements on openness and accountability."

The SRP said that the Global Fund "needs to communicate to all applicant types, and especially those in [Eastern Europe and Central Asia] region, the need to reach beyond known or familiar networks to ensure a broad and inclusive process in meeting the requirement." The SRP added that applicants should be reminded that open transparent processes must be documented for two aspects of proposal development – i.e., for both the solicitation and the review of stakeholder inputs.

Requirement No. 4 – CCMs are required to put in place and maintain a transparent, documented process to nominate the Principal Recipient(s) (PR) and oversee program implementation.

With respect to the PR nomination process, the SRP said:

"In general, applicants understood the need to reach beyond current PRs and consider other potential candidates. Most applicants placed a public call soliciting ‘Expressions of Interest’ from interested organizations. Others linked discussions for potential PR and/or sub recipients (SRs) to the proposal solicitation and review processes, designating authors of proposal submissions as PRs or SRs. Still, others reverted to current PRs after having considered alternative options. The common denominator in all of these cases was the applicants’ recognition of the need to designate PRs based on some evaluation criterion, at least an implicit one, and to ensure that the process employed was transparent and documented."

The SRP also said that, in general, applicants recognised the need to describe their oversight processes fully.

Nevertheless, 11 applicants were initially rated IC or NC by the Screening Team with respect to this requirement: CCMs from Algeria, Benin, DPRK, Gabon, Kenya, South Africa, Sri Lanka and

Yemen; and Sub-CCMs from Congo Kasai, Kyrgyzstan and Russian Federation.

Once again, only Sub-CCM Congo Kasai was determined to be non-compliant by the SRP. The other ten applicants were determined to be fully compliant, mainly after clarifications from the applicants and input from the regional teams in the Secretariat.

In at least one case (CCM Gabon), the decision was a close call. The CCM nominated the Ministry of Health as PR for its HIV proposal, but provided no documentation concerning a selection process. As well, the SRP said that the CCM’s description of its oversight plan was "lacking" and that "[i]t was clear that the CCM misunderstands its oversight role and responsibility." The SRP was tempted to declare the CCM ineligible with respect to its HIV proposal, but the regional team argued that there were restructuring efforts underway in the CCM and that the Round 8 HIV proposal was very important to ongoing projects in Gabon. In the end, the SRP was unable to arrive at a consensus. The decision to find CCM Gabon eligible was based on a majority vote.

In its report, the SRP commented that "preselecting government PRs without due process definitely contradicts the spirit of openness and transparency" in the CCM requirements.

The SRP noted that most CCMs were quite willing to implement dual-track financing (DTF), and that "DTF discouraged many applicants from simply reverting to current PRs, as has been normal practice in the past, since they were being requested to solicit for expressions of interest from potential civil society PR candidates."

Requirement no. 5 – CCMs are required to put in place and maintain a transparent, documented process to ensure the input of a broad range of stakeholders, including CCM members and non-members, in the proposal development and grant oversight process.

Initially, eight applicants – CCMs in Algeria, Gabon, Iran, South Africa and Sri Lanka; sub-CCMs in Congo Kasai and Kyrgyzstan; and the SADS RCM – were rated NC or IC by the Screening Team.

Once again, the SRP determined Sub-CCM Congo Kasai to be non-compliant and the others to be fully compliant. As was the case with Requirement No. 4, the SRP was split concerning CCM Gabon, and finally determined the CCM to be eligible based upon a majority vote.

The SRP pointed out that applicants often revert to documentation submitted for Requirements No. 3 and No. 4 to prove compliance with Requirement No. 5 since all three requirements are seemingly linked.

Requirement No. 6 – When the PRs and Chair or Vice-Chair of the CCM are the same entity, the CCM must have a written plan in place to mitigate the inherent conflict of interest.

Most applicants had no problems demonstrating compliance with this requirement. All were determined to be fully compliant by the SRP. However, in one case – CCM China – the decision was not automatic.

CCM China nominated the State Council AIDS Working Committee Office within the Ministry of Health as PR. The chair of the CCM comes from the Ministry of Health. The CCM said it did not recognise the need for a COI policy, insisting that the two entities (the Committee and the Ministry) were different. The regional team explained the close links between all entities and the government in China. The SRP considered having someone go back to the CCM to clarify the relationship between the two institutions. According to the report, "After much deliberation, the SRP agreed to screen CCM China in as compliant on condition that the regional team works with the CCM to write a COI plan."

Further note concerning Sub-CCMs

Current guidelines allow a Sub-CCM to be deemed eligible to apply as long as it can provide any of the following documentation in support of its independent operations: (a) statutes or other legal

documents confirming the independent authority of the sub-CCM; (b) international agreements or conventions that recognise the independent nature of the Sub-CCM's territory; and (c) proof of the CCM's acceptance of the sub-CCM's independence. The SRP recommended that the guidelines be revised to ensure that Sub-CCMs and their respective CCMs justify the programmatic need for the sub-CCM as a complement to the national CCM. The SRP said this would prevent "the creation of multiple coordinating mechanisms in any single country and promote the coordination of

proposals at a national level."

RCM Andino

RCM Andino, which covers certain countries in South America, was deemed ineligible, not because it failed to meet any of the requirements outlined above, but rather because it failed to obtain endorsements of its proposal from all of the national CCMs in its region.

B. Applications from regional organisations

Eight Regional Organisations (ROs) applied in Round 8, all for HIV/AIDS proposals. The SRP determined that only three ROs were eligible because the others had failed to submit endorsements from national CCMs in all of the countries included in their proposals.

The SRP commented as follows:

"Regional Organizations are a potential force in the effort to mobilize demand to fight HIV/AIDS, TB and malaria. Being cross border and multi-country in nature, these proposals could complement national programs and help prioritize activities otherwise excluded or ignored due to in-country politics, negative attitudes and/or ongoing stigma and discrimination. Unfortunately, very few of these proposals [reach the TRP] due to ROs inability to secure CCM endorsements."

C. Applications from Non-CCMs

In its "Report of the Round 8 Screening Review Panel," the Global Fund provided details of the screening that was done on the 20 applications submitted by Non-CCMs. The Global Fund actively discourages applications from Non-CCMs. It only accepts Non-CCMs proposals if they are from countries:

• that are without legitimate governments;
• that are in conflict, facing natural disasters, or in complex emergency situations; or
• that suppress or have not established partnerships with civil society and non-governmental organisations.

If a Non-CCM submits an application on the basis that its country suppresses or has not established partnerships, it has to demonstrate that it contacted the CCM in an attempt to get its suggestions included in a national proposal.

At 20, the number of applications from Non-CCMs in Round 8 was up from the 16 applications in Round 7, but was still considerably lower than in earlier rounds. Non-CCM proposals were received from applicants in 13 countries, almost twice the number of countries for Round 7.

The SRP deemed all 20 applicants ineligible. It said that none of them met the criteria; that all 13 countries has functioning CCMs with civil society representation; and that none of the applicants proved that they had contacted their respective CCMs. The SRP said that 19 of the 20 applicants did not even explain why they had applied outside their CCM.

Despite the fact that no Non-CCM proposals were deemed eligible, the SRP said that "the non-CCM window remains an opportunity for groups marginalized as a result of stigma and discrimination in government policies." The SRP recommended that proposals from Non-CCMs be examined more closely and that consideration be given to changing the proposal guidelines to make Non-CCM proposals eligible if they are addressing the needs of vulnerable populations that have been left out of the national response. The SRP also recommended that the Secretariat develop a fact sheet providing more guidance for Non-CCMs and to "increase their chances at meeting compliance."

Editor’s note: Most of the information for this article came from the "Report of the Round 8 Screening Panel." Supplementary information was obtained from the Global Fund Secretariat. The following article is a Commentary on this whole process.

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2. COMMENTARY: CCM Requirements: How Much Flexibility Is Appropriate?

by David Garmaise

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Some of the decisions of the Global Fund’s Screening Review Panel (see previous article) are scandalous – or at least, they would be if it wasn't so obvious that its members are trying to do what is "best" in a complex world.

In July 2008, I wrote a commentary in GFO in which I said that in Round 7, three years after the "CCM minimum requirements" were adopted by the Board, the Global Fund Secretariat continued to exercise a considerable amount of discretion in applying these requirements to the screening process for proposals.

Since then, nothing much has changed. In Round 8, virtually all of the applications from CCMs, Sub-CCMs and RCMs were "screened in" (i.e., were deemed eligible for consideration by the TRP). Yet, as happened with Round 7, it is also clear that this was done even though many CCMs were still not meeting the minimum requirements. Further, in Round 8, for the first time, the Screening Review Panel (SRP) was unable to reach a consensus in a small number of cases.

Consider two examples of decisions made by the SRP with respect to the requirement that the representatives of non-government sectors on the CCM must be selected through a documented and transparent process run by the sectors themselves.

First, for CCM Algeria, the report tells us that:

• The CCM did not provide required documentation regarding the selection processes.
• The CCM had been reconstituted by the Minister of Health in 2006 as a result of corruption allegations regarding the previous CCM.
• The Minister appointed all 48 CCM members directly, including civil society representatives, and "ensured that all interested NGO stakeholders were represented."

According to the report, the SRP nevertheless decided that CCM Algeria was "fully compliant." It did so based on the following: (a) regional teams in the Global Fund Secretariat said that while Algeria had previously received funding (in Round 3) from the Global Fund, the CCM was still "new" to the Global Fund’s requirements; and (b) the list of CCM members attached to the proposal included a number of the NGOs that are most active in the fight against the diseases.

How can it be said that CCM Algeria was compliant? There was no "open and transparent" sector-led selection process of CCM members, as is required. It’s not enough for someone to determine that people appointed by the Minister to the CCM include "all interested NGO stakeholders."

Second, for CCM Bangladesh, the report tells us that four of the six new civil society representatives who had joined the CCM since it was last determined eligible in Round 7 were personally picked by the CCM. There was no selection process run by the sector. According to the report, the SRP determined that CCM Bangladesh was fully compliant because (a) the majority of its non-governmental representatives were on the CCM at time of the Round 7 screening when the CCM was determined to be fully compliant with this requirement; and (b) to be compliant with this requirement, it is sufficient if 50 percent or more of the sector’s representatives were transparently selected by the sector.

This is exercising discretion to the point of bending over backwards. In Round 7, the SRP came up with the 50 percent rule, even though there is nothing in the requirement itself that states that the CCM needs to be only 50 percent compliant. For Round 8, the Global Fund said that CCMs that had met certain requirements in Round 7 would not have to meet them again in Round 8, which is fair. But the Global Fund also said that any new non-governmental representatives added since the Round 7 submission had to be selected in an open and transparent process run by the sectors themselves. That did not happen here.

Consider also one example of decisions made by the SRP with respect to the requirement that CCMs put in place and maintain a transparent, documented process to nominate the PR(s) and oversee program implementation.

For CCM Gabon, the report says that the CCM simply nominated the Ministry of Health as PR for its HIV/AIDS proposal because of its track record as PR on other grants. There was no process. There was no evidence that the CCM had evaluated the MOH’s performance "in comparison with other options or likely PR candidates." The report also says that CCM Gabon’s description of its program oversight plan was lacking.

The rest of what the report has to say about this case reads like a debate:

• "The SRP was faced with the dilemma of whether to declare the CCM as ineligible and thereby reject both proposals (it also applied for malaria) or only accept one based on the adequacy of documentation submitted."
• "This sparked an appeal from the regional team which noted all the ongoing restructuring efforts within the CCM as well as the importance of the Round 8 HIV/AIDS proposal to ongoing projects in Gabon."
• "The SRP reminded the regional team of the equal weight for each of the six minimum requirements."

In the final analysis, the SRP could not reach consensus, so CCM Gabon was declared compliant on the basis of a majority vote.

Clearly, however, the requirement was not met.

Finally, the SRP screens proposals against each of the CCM minimum requirements, one by one, but it does not appear to take into account any "cumulative effect." Sub-CCM Russian Federation was given the benefit of the doubt for no less than four of the six requirements. If a CCM or Sub-CCM squeaks through on four of six requirements, doesn’t that raise questions about whether that applicant is fully compliant overall? The following applicants were also given the benefit of the doubt for multiple requirements: Sub-CCM Kyrgyzstan (also four requirements); and CCMs from Gabon, Algeria, Sri Lanka and South Africa (three requirements each).

Does the Secretariat believe that the minimum requirements are too stringent, even though CCMs have by now had several years to become compliant? If the answer is Yes, why doesn’t the Secretariat ask the Board to consider softening the requirements, and why doesn’t it inform all CCMs that until the Board makes a decision, it will not enforce the requirements strictly? Whereas, if the answer is No, why does the Secretariat treat some non-compliant CCMs as if they were compliant, and why doesn’t the Board complain about this? If the requirements are considered to be too stringent, they should be changed, not ignored.

David Garmaise (garmaise@...) is a Senior Analyst with Aidspan.

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3. COMMENTARY: Pointless PowerPoints

by Bernard Rivers

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As you read this article, thousands of people around the world – possibly millions – are sitting in meetings where speakers are projecting PowerPoint slides onto a screen. The speakers assume that these PowerPoint slides are helping the audience. But, with rare exceptions, they are wrong.

If I am ever granted the job of World Dictator, my first act will be to ban the use of PowerPoint.

Why? Because PowerPoint slides usually have far too many words on them, as a result of which, they distract the audience from what the speaker is actually saying.

I recently went to a conference where there were presentations by, among others, a senior official from the World Bank and another from the European Commission. Each of these two people spoke to a series of excessively verbose slides. I spent one third of my time trying to read what the slides said (but being distracted by the speaker), one third of my time trying to listen to what the speaker said (but being distracted by the slides), and one third of my time feeling really grumpy. Furthermore, if a slide dealt, at length, with points A, B, C and D, the speaker often spoke to only one of these, or to some point E that didn’t even feature. What, please, was the point of these slides? I felt lost and – did I mention? – grumpy.

Here are some tips, from a frequent PowerPoint victim. If you are giving a talk and you want to provide your audience with a detailed record of your talk – OK, go ahead, create detailed slides. But then print them, and make the printout available at the end of your talk. During the talk itself, either use no slides at all – leading to the wonderful result that your audience will actually look at you and listen to you – or create some extremely simple slides with four or five bullets on each slide, with each bullet consisting of only four or five words. If possible, arrange your slides so that each new bullet only appears on the screen when you’re ready for it, so your audience sees a brief summary of what you have said and of what you are talking about right now, but not of what you will say during the next few minutes.

PowerPoint has destroyed the art of public speaking. Down with pointless PowerPoints!

PS: Slides produced by the Global Fund are actually pretty good, in contrast to those mentioned above.

Bernard Rivers (rivers@...) is Executive Director of Aidspan and Editor of its GFO.

 "Reproduced from the Global Fund Observer Newsletter (www.aidspan.org/gfo), a service of Aidspan."

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 Please find attached the response of UNAIDS to the Second Independent Evaluation.

 Translations of the Executive Summary of the Evaluation are now available in French, Russian, Chinese, Arabic, Spanish and Portuguese on the website of the NGO Delegation- www.unaidspcbngo.org.

 If you have comments or input, please send them to me by end November so that the NGO Delegates can use them in their preparation for the PCB meeting in Geneva to be held December 8-10. Thank you!

  Kind regards,

 Sara

  Sara Simon

Focal Point

Communications Facility of the UNAIDS PCB NGO Delegation

www.unaidspcbngo.org

Skype: pcbcf.ssimon

+32.479237876