International Cooperation: Working with the Global Fund to Fight AIDS, Tuberculosis and Malaria

Key Priorities  |  Global Fund Technical Resources

The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), which began operations in 2002, is an international partnership among a number of collaborating stakeholders: governments, civil society, the private sector, and communities affected by HIV/AIDS, tuberculosis (TB), and malaria. This innovative financing partnership has the goals of dramatically increasing the resources available to address the effects of these three diseases and channeling them to areas of greatest need. To achieve these goals, the Global Fund works in close collaboration with other bilateral and multilateral organizations, governments, as well as broad networks of partner organizations.

How the U.S. Government Works in Partnership with the Global Fund
The U.S. Government (USG) is the largest contributor to the Global Fund and has given almost $3.3 billion since 2001, or about 27 percent of total contributions.  USG representatives chair the Global Fund Board’s Finance and Audit Committee, and represent the USG on the Board’s Policy and Strategy Committee. Recent Board achievements supported by the USG include the approval of Round 8 grants, which represented the most successful and largest round to date; the adoption of a new and strengthened quality assurance policy for pharmaceutical products; a review of the Global Fund architecture, leading to recommendations for streamlined and strengthened application and implementation processes; the adoption of a gender equality strategy; and the presentation of a report and recommendations on the Partnerships component of the Global Fund Five-Year Evaluation.

The USG also provides direct technical assistance to Global Fund grantees that are experiencing implementation bottlenecks, using U.S. legislative authority to withhold up to 5 percent of contributions for this purpose. Such funds are used to improve institutional and program management; strengthen governance and transparency; strengthen procurement and supply-chain management; and improve monitoring and evaluation (M&E) systems. Because of the close link between TB and HIV/AIDS, the USG also provides technical assistance funding to improve treatment for multidrug-resistant TB and to enhance the Advocacy, Communication and Social Mobilization components of country TB programs. The USG also provides funds for Global Fund technical assistance through the Roll Back Malaria international partnership and the three UNAIDS Technical Support Facilities in sub-Saharan Africa.

U.S. President’s Emergency Plan for AIDS Relief ‘s (PEPFAR's) country teams work closely with the Global Fund grant programs in host nations. USG representatives sit on Global Fund Country Coordinating Mechanisms (CCMs) in 94 percent of PEPFAR countries, the vast majority of which support Global Fund proposal development. PEPFAR country programs have allocated more than $10 million annually to technical assistance for Global Fund grantees. To promote deeper coordination, the USG has entered into Memoranda of Understanding in several countries. These documents bring together Ministries of Health, PEPFAR, and the Global Fund to clarify collaboration and partnership activities, particularly in the area of drug procurement for antiretroviral therapy.

In Partnership with PEPFAR, USAID Contributes to Global Fund Technical Assistance
In 2007, the USG designed a mechanism to supply critically needed technical support to Global Fund grantees through a project called Grant Management Solutions (GMS).  Like the Global Fund’s innovative approach to health development, the GMS project provides a unique brand of urgent, short-term technical support to countries managing Global Fund grants.  Through a participatory process that emphasizes transparency and national ownership, GMS brokers relationships to strengthen and extend multisector partnerships.  This course of action allows grantees multiple options to institute reforms and strengthen systems, and also facilitates open discussions and follow-through on decisions.

Key Priorities

Governance and leadership
GMS works directly with the CCM, a national body made up of public and private entities that is responsible for developing Global Fund grant proposals, coordinating grant activities, and providing grant oversight through sound leadership practices.

Financial and grants management
Each Global Fund grant has a Principal Recipient (PR), an existing institution or organization identified by the CCM through a rigorous procurement process, which is responsible for grant implementation. Working directly with the PR, GMS seeks ways to strengthen financial and management systems and procedures.

Procurement and supply management of pharmaceuticals and commodities
GMS works with the PR to ensure that its procurement and supply management systems are appropriate for the resources available in country. This assistance might range from helping the PR with its procurement and supply management planning and forecasting of how many and what kinds of medicines and pharmaceutical supplies the nation needs, to streamlining importation and customs procedures and finding ways to better manage the supply chain.

Monitoring and evaluation and reporting
The progress and success of grants are vital to a grantee receiving the next round of funding, which makes comprehensive M&E absolutely essential. GMS assistance may range from Monitoring and Evaluation Systems Strengthening Tool workshops—a planning process now required by the Global Fund—to improving reporting procedures and ensuring adequate M&E staffing.