While the Global Fund to Fight AIDS Tuberculosis and Malaria looked at ways to restructure how it awards and administers grants, the Global Fund Board delegation representing nongovernmental organizations in developing countries conducted its own survey of obstacles in the field that have hindered the best use of those grants.
The result was a report submitted July 9 to Global Fund General Manager Gabriel Jaramillo from the front lines of where Global Fund money goes and can have its greatest impact. Covering procedures involved in program planning, spending, accounting and in responding to realities on the ground, some of the issues it raises are likely to be addressed in the global charity’s new funding model, but some may not be, a delegation representative wrote in response to an inquiry from Science Speaks. Examples of problems that hobbled programs’ effectiveness, collected from the four regions the delegation represents — Africa, Asia, Eastern Europe and Central Asia, Latin America and the Caribbean — included:
- Delays of more than three months in disbursement of funds with no explanation;
- The impact of inflation — between the time money is allotted and received — creating financial problems that affect using and reporting the use of funds;
- A travel policy that changed three times in two years;
- An emphasis on “output” over “impact,” and a program that found communicating HIV prevention principals to “Most At Risk Adolescents” challenged by participants’ “unmet primary needs for food and shelter.”
- A “one size fits all approach” to technical assistance in developing countries that led the delegation to point out “Electronic voting mechanisms do not function in countries where there is a lack of internet in the rural country sides.”
In all, the delegation submitted a list of 14 challenges and accompanying recommendations to the Global Fund Secretariat. While the report has not received a formal reply from the Secretariat, the delegation has been referred to staff members to discuss the points, delegation communications lead Ria Grant wrote to Science Speaks. Grant, who serves as senior adviser to the Cape Town-based TB/HIVCare Association, added that she sought to identify which challenges would be addressed by the new, restructured Global Fund model when she attended a “Better Grants” workshop in Nairobi presented by the Global Fund Secretariat. Many of the challenges would be met, she found, but not necessarily completely.
While, she noted, plans for a new monitoring and evaluation system seemed likely to address most of the issues raised by the delegation in Challenge 1 (“Too much emphasis on programme output and less attention to impact”), a suggestion that reporting tools — across the Global Fund, PEPFAR, and USAID — be standardized is not addressed, nor is the recommendation that analyses of impacts line up with Global Fund strategies on human rights and sexual orientation and identities. The challenge of “numerous changes in reporting and requirements,” she found would be “partly dealt with in the new model.” Challenges in communications and delays are addressed in the new model, she wrote. Responses to some of the challenges, including ill-prepared funding portfolio managers, are already underway, she noted. How other challenges, including ones affecting procurement, sustainability, accountability, and standards of Principal Recipients of funds would be affected by the restructuring remained unclear.
A Global Fund spokeswoman replied to a request for further information on the restructuring process saying the “The Secretariat does not comment on Board discussions.”