A Private Sector Guide to the Global Fund’s New Funding Model

Nisa PatelNews

The Global Fund to Fight AIDS, Tuberculosis and Malaria launched its new funding model (NFM) in 2013. The NFM was designed to ensure that Global Fund grants reach areas of greatest need and achieve the highest possible impact against the three diseases. The process countries undertake to develop programs and access funding was re-designed to be more inclusive, predictable and flexible than the previous model. With the NFM’s new ways of working come new opportunities and challenges for Global Fund partners, including the private sector.

The private sector has partnered with recipient country programs and the Global Fund throughout its history, as donors, technical assistance providers, members of Country Coordinating Mechanisms (CCMs), implementing partners, and more.  But what does the new model mean for the private sector? Have opportunities for companies to partner with the Global Fund or to contribute to the fight against AIDS, TB and malaria changed?

The NFM centers on an ongoing, multi-stakeholder dialogue led by countries with the support of the Global Fund. Before developing a grant request, countries must now begin the process with in-depth consultations with key partners to set goals and identify resources needed to fight the diseases and strengthen national healthcare delivery systems, using national strategic plans as a guide and framework wherever possible.  This dialogue is then transformed into a concept note, which serves as a grant application and should articulate not only interventions that will be funded by a country’s indicative envelope, but a full expression of all unfunded need within a country.

Once submitted, concept notes are reviewed by the Technical Review Panel (TRP), an independent panel of experts, and by the Global Fund’s Grant Approvals Committee. These expert reviews can provide additional feedback on strengthening and prioritizing interventions within concept notes. Grant-making negotiations take place in the lead up to formal approval, so that disbursements can take place as soon as possible.

The private sector is a key stakeholder in the successful NFM implementation process. Companies can contribute financial resources to the Fund or directly to country programs, ensuring gaps are filled and services can be scaled up. They can also contribute core expertise, provide guidance to grant applicants, build capacity of recipients and CCMs and help to address implementation risks and bottlenecks. Companies can also align their own corporate workplace and community programs to support national strategic plans or to complement Global Fund programs.

For additional information on how your company can engage with the Global Fund, read below:

  1. What types of private sector entities does the Global Fund work with?

    Different types of private sector entities may collaborate with the Global Fund. These include national, public (state-owned) and private companies; foundations; multinational corporations and enterprises; employers’ organizations, industry associations and business associations; trade unions and local corporations.

  1. The Global Fund is the leading financing agency for the three diseases. How can the private sector ensure that disease programs are adequately funded?

    The NFM is an allocation-based model of funding. A country’s indicative amount is determined at the beginning of each 3-year allocation period, based on disease burden, ability to pay and available funds raised through the Global Fund’s replenishment mechanism. The private sector pledged over $600 million during the last Replenishment Conference in December 2013, which raised funds for the 2014-2016 allocation period. Therefore, the private sector has an important role to play in ensuring that there is a sizeable pool of total resources at the start of an allocation period.

    A company has an opportunity to pledge funds at any time during the 3-year replenishment cycle or to co-invest directly with a Global Fund-supported program at the country level.

    The NFM presents companies with another opportunity to contribute financial resources to the Global Fund. A newly-created register of unfunded quality demand will maintain an accurate listing of program interventions determined by the Fund to be sound financial investments, but for which there was no available funding at the time of grant approval. A country may approach any donors, including the private sector, to finance these additional programs and interventions.

Private Sector in Action: The Global Fund’s 4th Replenishment

Private sector companies and foundations pledged over $600 million at The Global Fund’s 4th Replenishment Conference in Washington, D.C., in December 2013. The amount included over $100 million in contributions from companies and $500 million from the Gates Foundation.  Chevron pledged $5 million over two years to support programs targeting the prevention of mother-to-child HIV transmission in Nigeria. Chevron is the Fund’s largest single corporate donor to-date, with a total 8-year investment of $60 million. BHP Billiton contributed $10 million over three years to help achieve universal malaria prevention coverage in Mozambique, becoming the Fund’s second Corporate Champion alongside Chevron. Vale, a Brazilian mining company, made their first ever pledge to the Fund, contributing $3 million over three years to support malaria efforts in Malawi and Mozambique. Other companies making financial contributions included Takeda Pharmaceuticals, Ecobank, and companies participating through the (PRODUCT)RED campaign. The Replenishment Conference raised $12 billion overall in pledges from government and private sector donors to fund Global Fund programs over the 2014-2016 period.

 

  1. Under the NFM, Country Coordinating Mechanisms (CCMs) remain an essential element of grant management and oversight. They develop and submit funding requests and are the central mechanism for ensuring local ownership, as in the old model. However, specific processes related to their roles have been altered somewhat, including an emphasis on the multi-stakeholder country dialogue throughout and the introduction of streamlined concept notes replacing previous application formats. As an important stakeholder, how can the private sector participate in a CCM?

    As the principal body in-country that coordinates the country dialogue and oversees grant implementation, the CCM is the first entry point of engagement for a private sector company looking to participate in the NFM at the country level. The private sector may participate in CCMs either as a CCM representative or constituency member. The basic structures and guidelines for CCM membership have not changed under the new model; composition, organization, governance procedures and application process for new members are independently determined by each country, and therefore may vary from CCM to CCM. However, the Global Fund strongly encourages countries to ensure wide representation across public and non-public sectors at the CCM and encourages inclusivity in the country dialogue.

    As of 2013, the majority of CCMs include a voting seat for the private sector. Often times, these seats are backed by larger constituencies of engaged companies and organizations. A small number of CCMs that do not have a private sector seat may allow private sector representatives to participate as part of another non-governmental constituency, such as civil society, or, in limited circumstances, in an observer capacity.

    Companies interested in joining a CCM can reach out to the existing private sector representative(s) or to the CCM Chair or Vice Chair expressing an interest and making the case for their positive contribution to the country dialogue. To find out more about the members on a CCM and how to contact them, please search the Global Fund’s grant portfolio database, organized by country. The CCM Team at the Secretariat or Fund Portfolio Managers can also offer assistance in the event of difficulty locating information or getting in touch.

  1. The country dialogue is a country-owned and country-led process that builds upon national coordination mechanisms. Can the private sector participate in this process? What can the private sector bring to these discussions?

    The country dialogue process is an ongoing discussion between stakeholders in a country and the Global Fund to develop strategies and policies to effectively fight the three diseases. The private sector can be a participant in these discussions, together with representatives from the government, public sector, bi-laterals, key-affected populations, academia, faith-based organizations, civil society, and technical partners. The Global Fund participates in the country dialogue to ensure that all steps of the process have been successfully completed. The country dialogue takes place across different stages of the funding process from development of a national strategic plan to designing the concept note and grant implementation.

    CCMs typically make a public call to invite participation at the start of the country dialogue process, at which time companies can express an interest in joining the dialogue. Private sector companies can draw on core competencies and areas of expertise to contribute valuable insights to conversations, such as:

    • Supporting prioritization of interventions, conducting costing exercises and helping to develop a full expression of demand
    • Assessing the impact of programs, including corporate and workplace programs, and documenting the evidence of program impact
    • Understanding the disease landscape and identifying gaps and opportunities for coordination and partnership across sectors
    • Ensuring affected communities and workforces are represented in dialogue
    • Ensuring adequate funding for the disease response
Private Sector in Action: OASYS (Senegal)
OASYS, a Senegal-based financial and management services company, is assisting five CCMs in Burundi, Madagascar, Mauritania, Niger and Senegal in the country dialogue process. With support from BACKUP, an initiative of GIZ (German International Development Agency), OASYS provides technical assistance and conducts consensus-building sessions with CCM members. In April 2014, OASYS also conducted a regional seminar for representatives from five CCMs, Country Teams at the Global Fund Secretariat and other Global Fund technical support providers. OASYS trains CCMs on how to clearly outline program priorities and interventions in the concept note, and conduct inclusive consultations with relevant Global Fund stakeholders at country level.

 

  1. The concept note is the mechanism to request financing from the Global Fund for HIV/AIDS, tuberculosis and malaria or to strengthen a country’s health system through cross-cutting interventions. How can the private sector aid in the development of a country’s concept note?

    A concept note should explain what a country needs to do to fully address the problem it faces and how much this would cost. With local knowledge of communities where it operates, the private sector is in a unique position to bring this insight. Further, companies with particular expertise can help shape policy in relevant areas. For example: a logistics and supply chain management company can provide guidance on barriers to accessibility in remote parts of a country; information and technology companies can advise on best tools and technology to track stock levels of drugs, incidence of disease, etc.; or financial services companies can advise on budgeting or costing exercises.

    The private sector can also be integrated into a concept note as a partner. Companies can play a valuable role in identifying critical enablers, addressing recurring bottlenecks and improving the overall health care system of a country. These partnerships can either take place at the country level through direct partnership with national programs, or through the Global Fund’s Innovation Coalition, a mechanism for companies looking to contribute their expertise to the Global Fund by solving recurring challenges that affect grant implementation across the Fund’s portfolio. Read more about the Innovation Coalition here.

  1. What kinds of organizations typically implement Global Fund-supported programs? Can the private sector receive grant funds or implement programs?

    Global Fund programs are implemented through a variety of organizations – government ministries, faith-based organizations, and NGOs. Though less common, private sector companies have also been known to successfully receive and implement Global Fund grants. Private sector companies may offer treatment, counseling, free or discounted health products through clinics or through other corporate/workplace programs. Such programs benefit employees and their families and reach large groups of affected populations. In some cases, these programs have been so successful that companies have received Global Fund funding to expand the reach of programs beyond employees to the communities where they operate. The programs contribute to the overall mission of the Global Fund, but are implemented by individual companies.

    Certain companies may also be well suited to implement or partner on interventions that require specific core competencies. For example, procurement and supply chain management (PSM) systems and infrastructure have been identified as a recurring challenge for multiple grant programs in multiple countries. In such situations, the private sector may be well-suited to contribute to specific program components through capacity building, developing monitoring systems, hardware and software for the PSM system, refurbishing storage facilities, or improving transportation of health products.

    Companies can be nominated by the CCM to be a recipient. To date, 18 companies have acted as Principle Recipients for 29 current or past Global Fund grants. Some examples of private sector entities implementing grants as Principal Recipients include: mining conglomerate Anglo Gold Ashanti, currently implementing a $130 million malaria grant in Ghana; Pilipinas Shell Foundation, Inc., the philanthropic arm of Shell Philippines, the PR for a $43 million malaria grant in the Philippines; and Oil Search Foundation, the Principal Recipient for two Global Fund HIV and malaria grants in Papua New Guinea. Additional private sector entities, including companies, business coalitions, chambers of commerce or industry associations, serve as Principle Recipients, Sub-Recipients, or Sub-Sub-Recipients in Bhutan, Guinea, Mali, Myanmar, Nigeria, Papua New Guinea, Sri Lanka and Russia.

Private Sector in Action:Oil Search Health Foundation (Papua New Guinea)
Oil Search Health Foundation, a non-profit registered charity established by Oil Search in Papua New Guinea (PNG), is the recipient of a Round 8 Global Fund malaria grant and a Round 10 HIV grant. The $21 million malaria grant operates in partnership with PNG Industry Malaria Initiative (PIMI) for greater collective impact. Using a social franchising model for village-based malaria diagnosis and treatment, the program has led to a reduction in the percentage of positive malaria tests from 21.8% to 9.6% in Kutubu, Southern Highlands over a two-year period from 2011-2013.

Oil Search also became the PR for a $22 million HIV grant to support community clinics in increasing HIV testing, reaching 66 clinics across five provinces, including remote areas. The program also conducts teacher training workshops as part of its HIV prevention efforts on topics such as reduction and management of sexually transmitted infections and gender-based violence. In workforces and affected communities Oil Search has also scaled up HIV prevention, testing, treatment and support of people living with HIV in 2 PNG provinces. Read more about the grants here.

 

Private Sector in Action: Industrial and Building Electricity Company (Benin)
Industrial and Building Electricity Company (SEIB) in Benin is one of the 3 PRs for Global Fund HIV grants, along with the Benin Ministry of Health and Plan Benin. The grant aims to accelerate access to services for the prevention and treatment of HIV and building community support. Total signed grant funds till date amount to $9.5 million.

The HIV program aims to reduce new infections and provide treatment, with a focus on vulnerable populations. SEIB implements preventative interventions to reduce HIV transmission among women and key populations. The program also extends coverage to families of patients, providing nutritional, psychological, legal and socio-economic services. The 3 PRs also work to improve the national response to HIV in Benin by reinforcing coordination, management, monitoring and evaluation, and the reinforcement of the health care system.

 

  1. Are there other ways that concept notes or specific interventions may include the private sector, outside of acting as a recipient or implementing partner?

    Countries may choose to include interventions that target the private sector as part of their grant programs. For example, recent guidance developed by the Global Fund on health systems strengthening concept notes mention private sector health systems as a key critical enabler to improving national health systems overall. Some countries may therefore choose to prioritize interventions that help strengthen this key component of a country’s health care delivery system.

    Another example of a specific program activity the targets the private sector is the private sector co-payment mechanism for malaria. This mechanism (formerly known as Affordable Medicines Facility-malaria, or AMFm) offers countries the opportunity to invest part of their malaria grant funds toward acquiring discounted quality-assured ACTs (QAACTs). QAACTs procured through this mechanism are provided at deep discounts by participating private sector companies and are sold at a fraction of the price through private sector channels. The co-payment mechanism aims to increase the use of QAACTs, bridging gaps in access, and to phase out the use of ineffective anti-malarials.

  1. What oversight mechanisms are employed through the NFM? Can the private sector play a role in grant oversight?

    Regular oversight of grants at the country-level is carried out by the CCM and by Local Fund Agents (LFA), in-country assurance providers contracted by the Fund. The Global Fund’s Board also plays an oversight role. The private sector has a seat as one of twenty voting constituencies on the Board through the Private Sector Delegation (PSD). The PSD is a group of companies that ensures Global Fund initiatives actively engage the business sector, while bringing assets and core expertise to help improve the Global Fund’s governance and efficiency of operations. As a Board Member, the PSD helps fill grant oversight roles in two ways.

    First, the Board was responsible for oversight of the design and launch of the NFM, and will provide on-going monitoring of the performance of the new model and overall grant efficiency. Secondly, when individual countries submit concept notes, after they are reviewed by internal and external expert bodies, they are recommended to the Board for final approval, when the PSD and other Board constituencies will review and cast votes on whether or not to approve them. Learn more about the PSD here.

  1. What are some other ways that the private sector can support the NFM and the Global Fund?
    In addition to contributing financial and in-kind resources to scale up the fight against the three diseases, the private sector can use its voice to be an advocate for the Global Fund. Companies have participated in many successful advocacy and cause-marketing campaigns to raise awareness of the three diseases and the Global Fund’s work. Campaigns such as Goodbye Malaria, Comic Relief, United Against Malaria and (PRODUCT) RED are global advocacy campaigns that have been key to increasing public awareness of the Global Fund and raising funds to support Global Fund programs. Learn more about these advocacy campaigns here.

    Companies can also choose to support the Global Fund by working through Friends of the Global Fund networks. These independent groups exist across the world to promote a good understanding of the Global Fund’s mission and mobilize political and financial support. Learn more about the Friends networks here.

Nisa PatelA Private Sector Guide to the Global Fund’s New Funding Model