Overview of the Global Fund 1.doc


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  1. 1. Geneva, July 2002 GUIDELINES FOR PROPOSALS Section Page I. Overview of the Global Fund 1 II. Who Can Apply 1 III. Conditions for Global Fund Support 5 IV. Scope of Proposals - What the Global Fund Will Cover 7 V. Budget Requirements 8 VI. Financial and Programmatic Management 9 VII. Monitoring and Evaluation 11 VIII. Procurement and Supply Management 13 IX. The Proposal Review Process 14 * * * * * * * * * * * * * * * * Annex I: General Characteristics of A Successful Proposal 17 Annex II: Illustrative Country Level Programme Indicators 19 Annex III: Sample Indicators for Activities 22 PLEASE READ THESE GUIDELINES FOR PROPOSALS CAREFULLY BEFORE STARTING TO FILL OUT THE PROPOSAL FORM These guidelines for proposals have been developed in consideration of the urgent need to make additional resources available as quickly as possible to scale up the fight against HIV/AIDS, tuberculosis and malaria. As the Global Fund is a new venture and an essential learning experience for all involved in the fight against HIV/AIDS, tuberculosis and malaria, the proposal process will continue evolving to achieve a simplified, more responsive and flexible system.
  2. 2. I. Overview of the Global Fund PrinciThe Global Fund was set up in January 2002 as a financial instrument, 1. ples complementary to existing programmes addressing HIV/AIDS, of thetuberculosis and malaria. Glob al2. The purpose of the Global Fund is to attract, manage and disburse additional resources through a new public-private partnership that Fund will make a sustainable and significant contribution to the reduction of infections, illness and death, thereby mitigating the impact caused by HIV/AIDS, tuberculosis and malaria in countries in need, and contributing to poverty reduction as part of the Millennium Development Goals. 3. The Global Fund will base its work on programmes that reflect national ownership and respect country partnership-led formulation and implementation processes. The Global Fund will promote partnerships among all relevant players within the country and across all sectors of society. It will build on existing coordination mechanisms, and promote new and innovative partnerships. 4. The Global Fund will strengthen and reflect high-level, sustainable political involvement and commitment in making allocations of its resources. 5. The Global Fund will support existing and new innovative programmes both within and outside the health sector that promote public, private and nongovernmental efforts for scaling up the prevention, treatment, care and support to those that are directly affected. As such, countries are encouraged to submit a coordinated proposal, hereafter referred to as the Coordinated Country Proposal (CCP) through a Country Coordinating Mechanism (CCM). (Please refer to Section II. Who Can Apply for a description of the CCM). 6. Proposals submitted to the Global Fund should focus on performance by linking resources to the achievement of clear and measurable results (Please refer to Section VII. Monitoring and Evaluation). 7. The details of the Global Fund’s basic principles summarized here can be found in The Framework Document on the Global Fund website at http://www.globalfundatm.org II. Who Can Apply Who Can 8. The Global Fund will accept proposals from the following: Apply? • National Country Coordinating Mechanism (CCM) • Regional CCM (Multiple Countries/Small Island States) • Sub-national CCM • Individual Organizations Guidelines for Proposals 2 of 25
  3. 3. Applications from a National CCM The following basic information of the principal roles, responsibilities and structure of the Country Coordinating Mechanism (CCM) is provided to guide applicants applying through a national CCM. Role of CCM 9. The CCM functions as a “national consensus group” that coordinates proposal submission from its national partners. The CCM should facilitate the proposal development process, including the translation of national strategies into concrete implementation plans with clear responsibilities, timing of activities, budgets and expected outcomes; approve and endorse the final version of a single country coordinated proposal (CCP); and follow up on the implementation of proposed activities. 10. The CCM is a body that functions as a forum to promote true partnership development and multi-sectoral programmatic approaches. At the very least, in-country partners must come together regularly to discuss plans, share information and communicate on Global Fund issues. The CCM should engage in substantive discussions and, therefore, its membership should reflect the ability to maintain such a dialogue, with a representative number of members and an active chair. 11. The CCM is an overall guiding body responsible for the use of Global Fund resources. The CCM will need to manage relations with the Global Fund. 12. The CCM is responsible for ensuring that mechanisms are in place to provide the information required for monitoring and evaluation (Please refer to Section VII Monitoring and Evaluation) , or to putting those mechanisms in place if they do not already exist. 13. The CCM should ensure that all relevant actors are involved in the process; and that all views are taken into account. As such, it is responsible for ensuring that information relating to the Global Fund, such as the Call for Proposals is disseminated widely to all interested parties in the country. The CCM is expected to be responsive and supportive of NGOs and other civil society actors wishing to be included in the Country Coordinated Proposal. CCM 14. There should only be ONE CCM per country (except where a sub- Structure national CCM exists: Please refer to Section II. para 27). 15. Applicants should not be obliged to create totally new structures only for the purpose of applying to the Global Fund. Where possible, a CCM should not replace existing, well-functioning, coordinating mechanisms but rather build on them. For instance, in countries where national multi-sectoral bodies to coordinate programmes for specific diseases exist (e.g. National AIDS Council, Roll Back Malaria Commitees and National Steering Committees on TB Control), CCMs may provide a forum on which such national efforts on the three diseases can be collectively coordinated and strengthened. CCM Compo- 16. The CCM should be as inclusive as possible and seek representation of sition the highest possible level from various sectors such as: Guidelines for Proposals 3 of 25
  4. 4. • Government • NGO/Community-Based Organizations • Private Sector • People living with HIV/AIDS, TB and/or Malaria • Religious/Faith Groups • Academic/Educational Sector • United Nations/Multilateral/Bilateral Agencies However, CCMs should remain of a manageable size in order to work and discharge responsibilities effectively. 17. While a CCM is a representative body that reflects the interests and commitments of the various consitutencies, it should also have access to the best available technical expertise in the relevant diseases. Respons- 18. As the Global Fund places great value on local solutions, the members ibilities of of each CCM are left to determine the details of the functioning of their CCM Members CCM and their responsibilities and rights as members of that CCM. However, each CCM should document its organizational structure to ensure transparency. 19. All members of a CCM are expected to be treated as full partners in the CCM, with full rights of participation, expression and involvement in decision making in line with their areas of expertise. 20. All members of CCM are expected to take their membership in the CCM seriously, to actively participate in all aspects of the CCM’s work in line with their resources and areas of expertise. 21. The CCM is expected to be responsive to individual NGOs wishing to scale-up their activities in partnership with national efforts. When requests for information or funding are received from such NGOs, the Global Fund secretariat will refer them to the appropriate CCM. 22. The role of the United Nations agencies, multilateral and bilateral agencies and other development agencies in the CCM should be country partnership-driven and reflect the roles of these partners in AIDS, TB, and malaria programmes in-country. Confirmation 23. The Global Fund Secretariat will serve as the lead advisor to the of CCM Technical Review Panel (TRP) and to the Board on confirming the establishment and functioning of the CCM. Information on CCMs will be collected throughout the year and prior to the proposal reviews by the TRP. Guidelines for Proposals 4 of 25
  5. 5. Regional Applications Co-ordinated 24. If necessary, countries may choose to submit a Coordinated Regional Regional Proposal (CRP) that addresses common issues among a group of Proposals different countries. The planned activities should involve and complement the national plans of each partner country. The principal stakeholders from all countries involved in the proposal should be active participants in the development, oversight and implementation of the programmes. The basic principles of inclusiveness and partnership that apply to a National CCM will apply in this case as well. There should be an explanation on how the coordinated proposal can add value beyond the national level (e.g. by sharing of information and best practices, etc. There are two types of regional proposals that would be considered: Proposals from Multiple Countries and proposals from Small Island States. Multiple 25. Multiple countries may form a Regional CCM to submit a Co-ordinated Countries Regional Proposal (CRP) in order to address cross-border and other multi-country issues, or issues that can be treated more effectively through multi-country co-ordination. In this case, endorsement by the Chair or Vice-Chair of the CCM or, if no national CCM exists, through other relevant national authority of ALL the countries involved will be required. Small Island 26. Countries classified as Small Island States according to the United States Nations definition may form a Regional CCM to submit a proposal. The regional CCM will be expected to include at least one government and one civil society/private sector representative of each country covered. Each constituent country will not be required to form its own CCM. Applications from a Sub-national CCM Sub-national 27. In certain circumstances such as the case of very large countries, a CCM sub-national CCM, based on principles of inclusiveness and partnership, may be formed to submit a proposal. Such a proposal should be consistent with nationally formulated policies, and there should be either evidence of a legal framework stating the autonomy of the sub- national entity or endorsement by the national-level CCM (or, if no national CCM exists, through other relevant national authority) for the application. Non-CCM Applications Individual 28. The Global Fund Board has reconfirmed that non-CCM applications are organizations not eligible unless the proposals satisfactorily explain how they meet the such as NGOs following exceptional circumstances set out in the Framework Document: • Countries without legitimate governments • Countries in conflict or facing natural disasters • Countries that suppress or have not established partnerships with civil society and NGOs 29. Any proposal must demonstrate clearly why it could not be considered under the CCM process at the country level, and the Guidelines for Proposals 5 of 25
  6. 6. Board should require validation of these reasons. 30. Criteria for the submitting NGO would include the quality, coverage, and credibility of their services and operations. Regional 31. Regional organizations (intergovernmental organizations and Organizations international NGOs, etc.) may submit a coordinated proposal in order to address cross-border or regional issues. In this case, endorsement by the Chair or Vice-Chair of the CCM (or if no national CCM exists, through other relevant authority) of ALL the countries involved in the proposal will be required. The submitting entity would be the regional organization, and the regional context in which the proposal is submitted should be provided. The same eligibility criteria as for NGOs will apply to such proposals, which will also need to set out a clear case for the added value of a regional approach (Please refer to Para 24.) . Countries in 32. Applications from countries or regions under special circumstances such Complex as in conflict or facing natural disasters, or “complex emergency Emergency situations” will be treated on a case-by-case basis, and specific Situations decisions on eligibility will be made in each case to avoid delays in proposal review. Complex emergencies will be identified by the Global Fund by referring to international declarations such as those of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) III. Conditions for Support Priority The following cases will be considered as priority for Global Fund support: Consideration 33. The highest priority will be given to proposals technically-sound from countries and regions with the greatest need, based on highest burden of disease and the least ability to bring the required additional financial resources to address these health problems. 34. Proposals from countries and regions with a high potential for risk will also be considered, taking into account the opportunity to prevent increases in prevalence and incidence. 35. Proposals from countries with relatively high income-level and relatively low disease burden, but with pockets of poverty or disease, may be considered with lower level of priority. 36. Proposals from countries represented in the OECD’s Development Assistance Committee (DAC) are not eligible for funding by the Global Fund. Guidelines for Proposals 6 of 25
  7. 7. In assessing the conditions for support, the following parameters will be taken into account: Disease 37. Disease burden for HIV/AIDS, TB and/or malaria – based on accepted Burden international standards for assessing disease prevalence, incidence and magnitude. 38. Potential for rapid increase of disease – based on accepted international indicators such as recent disease trends, size of population at risk, prevalence of risk factors, extent of cross-border and internal migration, conflict or natural disaster. Economic 39. Economic and poverty situation - based on relevant indicators such as Situation GNP per capita, UN Human Development Index (HDI), poverty indices, or other information on resource availability. In addition to the above criteria based on epidemiological and socio-economic profile, proposals will also be evaluated on the basis of the following critical dimensions. Political 40. Political commitment by the country submitting the proposal at the Commitment highest possible level. Indicators of such commitment may include: government contribution to the financing of programmes covered in the proposal; per capita health expenditure; existence of supportive national policies and multiyear strategic plans; appropriate legislation; and recent political pronouncements. National 41. Complementarity and additionality to existing programmes by Programmatic demonstrating how the resources sought from the Global Fund would Context complement, add to and be consistent with country level frameworks (such as National Plans, Poverty Reduction Strategies and Sector-wide Approaches, etc.) by building on or scaling up existing efforts and filling existing gaps in national budgets and funding from international donors. The funds from the Global Fund should not replace existing national and international resources. 42. Absorptive capacity by demonstrating how additional resources from the Global Fund could be effectively absorbed and used. Particularly in cases where applicants plan to greatly increase the amount of financial resources, evidence should be provided to show that programme and human resource capacity exists to absorb the additional funding within the given period. Programme 43. Soundness of approach by explaining the mechanisms and work plan it Design will use to achieve its goals. It should clearly explain how the funds requested will be used, justify the amount requested and indicate how those funds will supplement resources from other sources. 44. The proposal should demonstrate a clear logical structure. In particular, each component should have an overall goal. The overall goal should translate into specific objectives. In turn, each specific objective should translate into a set of main activities to achieve these objectives. The expected results for each of these levels of strategy should be clearly formulated. Guidelines for Proposals 7 of 25
  8. 8. 45. For each level of strategy (overall goal, specific objectives, broad activities), indicators must be provided to measure expected results of the proposal and/or broader country programmes to which the proposal is linked. (Please refer to Section VII. Monitoring and Evaluation for details) 46. For each main activity, the proposal should also identify the implementation arrangements including roles and responsibilities of implementing partners. IV. Scope of Proposals – What the Global Fund Will Cover What Will Be 47. The Global Fund promotes comprehensive programmes based on Covered? multi-sectoral approaches and widely-inclusive partnerships with a particular emphasis on scaling up proven approaches. 48. A proposal must address one or more of the three diseases (HIV/AIDS, tuberculosis or malaria) and may also address system-wide/cross- cutting aspects of these diseases in ways that will contribute to strengthening health systems, depending on country realities and readiness. 49. System-wide/cross-cutting aspects may include system development activities that benefit the fight against at least two of the three epidemics such as human capacity development, infrastructure development, etc. It is not limited to health sector-related activities and may also target other sectors such as education, the workplace, social services, etc. A particular focus should be given to demonstrate how the programme will ensure adequate human resources are made available and developed, based on an analysis of the appropriate numbers of professional staff and the appropriate mix of skills and capabilities necessary for sustainable programme implementation. Target 50. The application should be a single proposal targeting one or more of the Diseases three diseases, each described as a separate component as appropriate to the country context. In cases where two or more components are linked in such a way, which would not be realistic or feasible to separate, they may be considered as an integrated proposal. Applicants should specify whether they would like their proposal to be reviewed as an integrated proposal or as separate, stand-alone components. Where relevant, intervention strategies for the three different diseases should be integrated to maximize available resources. Diseases targeted in the proposal will depend on the situation and existing needs of countries, and a country should not feel obliged to apply for resources for every disease. Balance of 51. The most appropriate balance of interventions will differ according to Interventions country contexts. A proposal does not need to cover every intervention. If a particular intervention is not appropriate in the country context or is available through other arrangements it is not necessary that this intervention be part of the proposal. Guidelines for Proposals 8 of 25
  9. 9. 52. The Global Fund will only support proposals that promote technically sound and cost-effective interventions that stimulate and are integral to country partnerships involving the government, civil society, and the private sector. Proposed interventions should be based upon a high quality, recent country situation analysis. Social and 53. Proposals should actively take into account interventions that address Gender issues social rights and gender inequalities, as well as behavioral practices that fuel the spread of the three diseases. A specific focus should be given to the modalities for mainstreaming gender equality through gender analysis and planning, the recognition of the equal sexual and reproductive health needs of women and men and strategies that target men as well as women for activities related to safe sexual practices. Examples of 54. Resources from the Global Fund may be used to support activities which Activities include the following: Supported • Prevention, treatment, care and support of those directly affected • Increased access to health services; recruitment and training of personnel and community health workers; • Behaviour change and outreach; and community-based programmes, including care for the sick and orphans; • Provision of critical health products (including drugs) to prevent and treat the three diseases, and for the strengthening of comprehensive commodity management systems at country level; and • Operational research in the context of programme implementation: Basic research will not be covered by the Global Fund grants. 55. For activities involving the use of essential drugs, there should be a description of the products and treatment protocols as well as resources (human and systems, etc.) in place to ensure rational use and maximizing adherence and monitoring of resistance. V. Budget Requirements Duration of 56. The Global Fund will provide funding for proposals of different duration, Funding and multi-year (up to five years) proposals can be approved. Funds will be allocated for the initial two year period with funding for the third and subsequent years depending on a performance assessment and the Global Fund’s available resources. Funding 57. The Global Fund has not set specific limits on the amount of Ranges funding available for single applications as of yet but may for subsequent rounds for proposals. However, each proposal will be judged in relation to its feasibility, country ability to absorb funds, level of funds requested relative to current fund flows and national political commitment for tackling the target disease(s). Guidelines for Proposals 9 of 25
  10. 10. Budget 58. Budget summaries should be provided in US dollars within the following Require- categories: ments • Human Resources: Consultants, recruitment, salaries, etc. • Infrastructure/Equipment: Building infrastructure, cars, microscopes, etc. • Training/Planning: Training, workshops, meetings, etc. • Commodities/Products: Bednets, condoms, syringes, educational material, etc. • Drugs: ARVs, drugs for opportunistic infections, TB drugs, anti- malaria drugs, etc. • Monitoring & Evaluation: Data collection, analysis, reporting, etc. • Administrative: Overhead, programme management, etc. 59. Proposals should also include detailed budgets as attachments, which should reflect the above-mentioned categories as well as the broad categories. 60. It should be noted that proposals may allocate a certain portion of the funds to strengthen or develop financial and programmatic management mechanisms. 61. Because monitoring and evaluation is vitally important to future funding decisions the CCM should allocate an appropriate proportion of the budget to strengthening the existing information systems or to activate the necessary systems (Please refer to Section VII. Monitoring and Evaluation). Identifica- 62. As the resources provided by the Global Fund should be additional tion of Existing relative to other sources of funding, the resources already available Resources and planned for subsequent years (domestic as well as external donor funding) should be explicitly stated. Budget 63. Overall budget allocation to implementing partners should be made Allocation to transparent. The following country or regionally based entities will be Partners eligible to receive funds: • Government agencies; • Civil society organizations (including NGOs, community-based organizations, associations); • Faith-based organizations • Private sector institutions; • Universities and other academic institutions requested by the CCM to play a key role in programme implementation and assessment of programme effectiveness. VI. Financial and Programmatic Management 64. The financial and programmatic management system needs to be described clearly. Management arrangements refer to systems to be used to ensure that programme activities are implemented and monitored in an efficient and coordinated manner particularly where a wide variety of implementers are expected to participate. They need to identify who the implementers are, what their specific roles will be and how they will relate to each other. Management arrangements must also Guidelines for Proposals 10 of 25
  11. 11. indicate how communications, supervision and capacity building among implementers will take place. Both programmatic and financial management issues should be taken into account in management arrangements. Local 65. In order to ensure the appropriate management of the Global Fund Fiduciary grants, local fiduciary arrangements at recipient level will need to be Arrangements ensured through the suggestion in each proposal or component of one or more Principal Recipients (PR) responsible for overall programme implementation and accountable to the Global Fund. Principal 66. A Principal Recipient (PR) is a legal entity that receives and manages Recipient(s) the funds from the Global Fund, on behalf of the CCM, and should be (PR)(s) part of the CCM. The overall role of the Principal Recipient(s) is to be responsible for financial management as well as implementation of the programme, including the following: receiving and disbursing funds to sub-recipients; overseeing and carrying out procurement; ensuring monitoring and regular reporting on progress; and submitting regular financial and programmatic progress reports. 67. The PR(s) will act under the general guidance of the CCM. All sub- recipients will receive the funds allocated to them through the PR(s). The PR(s) will be an institution with its own legal status and transparent financial systems and capacity in place to enable them to carry out the above activities. The PR(s) may need to draw upon the expertise of other institutions in discharging its functions. The Grant Agreement will be entered into between the PR(s) for the CCM and the Secretariat for the Global Fund. In the process leading to the Grant Agreement, the Global Fund may request more detailed information on topics such as financial management, budgets and implementing partners. 68. The Global Fund’s system of accountability will be based on the following principles: • The funds were used for the intended purposes; • They were used cost-effectively for these purposes; • They produced the expected result/impact; • All fiduciary arrangements, including audits should be fully transparent to stakeholders and others interested in the activities of the Global Fund; • The system should be designed to minimize transaction costs for all parties, especially the recipients. 69. Proposals will be expected to include provision for independent audits. The Principal Recipient(s) has/have the responsibility for ensuring the necessary data will be made available. 70. Grants from the Global Fund can only be awarded subject to the condition that sound fiduciary arrangements are in place at recipient level. Sound fiduciary arrangements would include the following: • Good programme management capacity; • Systems for financial controls • Capacity and systems for disbursement and accounting of funds; • Mechanisms for procurement in accordance with international agreements and law; • Systems to provide assurance that funds were properly used and reached the intended beneficiaries; • Systems that insure transparency, and accessibility for the Guidelines for Proposals 11 of 25
  12. 12. implementing partners and the Global Fund and its agents, and that ensure sound reporting capacity. 71. The Global Fund places great importance on the timely release of funds to recipients, and adherence to internationally recognised accounting standards and ensuring full transparency for all parties. Fiduciary, programme management, and programme monitoring systems at the recipient level should be developed with this in mind and should be responsive to beneficiary needs. Trustee 72. A Trustee Agreement has been concluded with the World Bank. Under Agreement this agreement the World Bank agrees to receive funds from donors, to hold and invest these funds, and to disburse them at the instruction of the Global Fund. Under this agreement the World Bank does not assume responsibility for financial oversight, subsequent disbursement of funds or use of funds at country level. Disbursement 73. Funds from the Global Fund will be transferred to the approved of Funds applicants only after the Grant Agreemtent has been signed. The Grant Agreement is signed after a PR has met the requirements for good programme management, financial control, disbursement mechanisms to implementing agencies and procurement agencies. Once the Grant Agreement is signed, an initial disbursement, not exceeding one-third of the annual budget, will be made to the PR’s special account. Replenishment of the account during programme implementation will be based on Statements of Expenses (SOEs), which will indicate that funds have been spent for the intended purposes. Detailed guidelines for fiduciary arrangements will be provided to the applicants whose proposals have been approved. VII. Monitoring and Evaluation Principles for 74. Monitoring of Global Fund grants will focus on programmatic Monitoring accountability, assessing the programmatic progress and public and health impact of activities supported by the Global Fund. Evaluation 75. A Country Coordinated Proposal (CCP) should include an explicit Monitoring and Evaluation Plan which measures performance against baseline data in specific programme areas, targets, and timelines for achieving them. 76. To the degree possible, the monitoring plan included in the CCP should make use of existing monitoring and evaluation structures and information systems, including independent mechanisms, and build on existing country indicators. Indicators 77. A CCP should be results focused, linking resources to real, achievable results. Clear and measurable sets of indicators for specific programme activities should be an integral part of the proposal. The indicators should be given in absolute numbers (if possible) and percentages. The following types of indicators should be an inherent component of all CCPs: • Process/output indicators: Immediate products of activities meant to Guidelines for Proposals 12 of 25
  13. 13. enable interventions, such as infrastructure build-up and human resources training. • Coverage/outcome indicators: Interventions delivered, including number and quality of services and distribution across affected populations. • Impact indicators: Change in epidemiological profile of disease burden across given populations, measuring incidence, prevalence, morbidity, mortality. 78. Annex II (Illustrative Country Level Indicators) includes current best practice country level indicators which applicants are encouraged to make use of when identifying appropriate indicators for their application. For additional indicators, please refer to the following and other M&E manuals: • UNAIDS “National AIDS Programmes: A guide to monitoring and evaluation” • “An expanded DOTS framework for effective tuberculosis control, WHO publication WHO/CDS/TB/2002.297,” “Millenium Development Goals” (cited in Bull WHO 80:439), and “Guidelines for comprehensive monitoring of DOTS programs”(DRAFT available through WHO/Stop TB) • “Framework for monitoring progress & evaluating outcomes and impact”, World Health Organization, Geneva 2000, WHO/CDS/RBM/2000.25 79. Although ideally indicators measurable with already available data should be selected, there may be situations in which the measurement of outcomes and impact of programmes may require more time or strengthened capacities. In such cases, a CCP should adopt or construct “proxy-indicators” (e.g. simple measurable indicators of expanded service provision, improved coverage of target population, etc., that can capture general progress in relation to the resources provided by the Global Fund) to track progress over the short-term until more suitable indicators and systems for data collection are in place. Baseline Data 80. Baseline data against which these indicators will be measured should be provided in the proposals. Existing data from population and health- based surveys could be used as baseline information for CCPs if the following three conditions are met: (i) the surveys are recent (ii) the geographical scope of the surveys corresponds to the area in which the CCP will be implemented; and (iii) the methods used for data collection and analysis are adequate. If baseline data is unavailable for certain components, a plan for how to obtain these data should be indicated and the information collected from the first year of implementation should be used as baseline data for the following years of implementation. Targets 81. Clear targets should be indicated in the proposals. Strengthen- 82. Recognizing that countries may not currently have sufficient capacity to ing M&E establish and maintain systems to define the most appropriate indicators Capacities and to produce baseline data, CCPs should have plans for strengthening M&E capacities (partners, activities, schedule and resource requirements and source). Progress 83. The Principal Recipient(s) would submit routine progress reports which Reports contain information on the state of the process and the results of agreed Guidelines for Proposals 13 of 25
  14. 14. indicators. First year reports will be expected to focus mainly on establishing baselines and indicating progress against process indicators. Second year reports will be expected to begin to measure progress on outcome/coverage indicators. VIII. Procurement and Supply Management Procure- 84. With respect to products such as essential medicines, the Global Fund ment and will support proposals which are consistent with international law and Supply agreements respecting intellectual property rights and which encourage Management the maximum possible quality of and access to these products. 85. The Global Fund has not to date set specific policies or guidelines on product procurement and supply management, e.g. which products or suppliers are eligible or whether cost recovery or duties levied on products procured with Global Fund resources will be supported. More formal guidelines will be approved by the Fund’s Board in the future, in which case all grant agreements negotiated following the approval of these guidelines will be crafted in manner consistent with them. Similar arrangments may be made in the future for services, for which fairness, transparency and maximum impact for costs would be important considerations. 86. For each disease component, proposals should specify existing arrangements for procurement and supply management for relevant products, such as condoms and Insecticide-Treated Nets (ITNs) as well as all pharmaceutical products, to ensure safe and effective application of products to proposed interventions. The information should specify which systems and/or activities are in place or planned relative to the critical steps of procurement and supply management, thereby answering the following ”minimum” questions: • How have/will suppliers for all products be selected, including pre- qualification process(es) and assuring sustainable supply? • What procurement procedures will be used for all products, and how will these ensure open and competiteve tenders, expedited product availability, and consistency with applicable national and international intellectual property laws/guidelines? • What quality assurance mechanisms are or will be in place to ensure that all products procured and used are safe and effective? • How will distribution be conducted to minimize product diversion and to maximize broad and non-interrupted supply? 87. Additionally, proposals should specify management and coordination arrangements for procurement and supply chain systems, including existing mechanisms and scale-up plans for product information/tracking systems, warehouse management, staff training activities, etc. 88. Applicants should provide information on all product donation programmes to which countries have applied or from which they are receiving support. The name of the programme, a contact person at the programme (with phone number and email address), the resources requested/granted, the timeframe over which these resources will be available, and the manner in which Global Fund resources will be additional and complementary to this existing support should be outlined. Guidelines for Proposals 14 of 25
  15. 15. Examples of product donation programmes include the Global TB Drug Facility, and drug donation programmes by pharmaceutical companies. 89. In addition to the information included in proposals, approved applicants may be subject to an assessment of their procurement and supply management systems prior to the signing of grant agreements, at the discretion of the Global Fund. 90. Applicants should ensure that specific procurement and supply management indicators are included in their overall monitoring and evaluation programmes. Examples of indicators may include: stock out rates; percent of products received centrally that are received at points of care; and degrees of adherence. Core procurement and supply management indicators are available from WHO and other technical partners of the Global Fund. IX. The Proposals Review Process How to Apply 91. Signed proposals must be submitted in hard copy to the Global Fund Secretariat by the deadline; exact replicas in electronic versions (by e-mail or diskette) would also be appreciated. Deadline and 92. Applications can be submitted at any time after the call for proposals; in Mailing order to be considered in this second round of proposals, proposals must Address be received at the Global Fund Secretariat no later than the set deadline, which is to be found on the Global Fund website. If you do not have access to the website, contact the local UNAIDS/WHO offices The Proposals should be submitted to the following: Global Fund to Fight AIDS, TB and Malaria International Conference Center Geneva 9 – 11 Rue de Varembe (mezzanine) CH 1202 Geneva Switzerland FAX: 41 22 791 94 62 E-MAIL: proposals@theglobalfund.org Language for submission 93. Proposals in any of the six UN languages (Arabic, Chinese, English, French, Russian, Spanish) will be accepted and will be treated equally regardless of the language of submission. The Secretariat will have all proposals translated into English. However, to facilitate the work of the Secretariat and the Technical Review Panel (TRP) in reviewing applications (the review will be conducted in English), countries are Number of encouraged to submit English translations. Proposals That Can Be 94. An applicant may submit one proposal (Coordinated country Submitted Proposal: CCP) per round. A proposal submitted in one round by a CCM does not preclude an applicant from applying again to the Global Fund for additional resources in another round provided that the needs Guidelines for Proposals 15 of 25
  16. 16. for funding are well justified. 95. The following types of proposals described above can be submitted in addition to the national-level CCM proposals: • Coordinated Regional proposals • Sub-national proposals • Individual organizations (such as NGOs and Civil Society) and regional organizations Secretariat screening 96. The Global Fund Secretariat will receive and assess all proposals, to determine whether applications are complete and fulfill the basic eligibility criteria for the Global Fund. The Secretariat will advise applicants accordingly and forward applications to the Technical Review Panel (TRP), for review on a specific date. Technical Review 97. Review by the Technical Review Panel (TRP) will take place at preset dates, generally two to three rounds annually. 98. The TRP is an independent, impartial team of experts appointed to guarantee the integrity and consistency of an open and transparent proposal review process. The TRP comprises experts for the three diseases as well as broader cross-cutting expertise. The names of the TRP members are posted on the Global Fund website. 99. The TRP will review applications submitted to the Global Fund for support in each round of proposals, and make recommendations to the Board for final decision. The review will be conducted in English. 100. Where proposals are not approved for funding by the Board, the Secretariat will make available to the applicants clear indications of the reasons why and under which terms, the Board would encourage resubmission. 101. In all cases, the TRP’s recommendation to the Board will include a written summary of its rationale. General Character 102. Successful proposals should in general demonstrate the following istics of a characteristics described in Annex I General Characteristics of a Successful Successful Porposal: Proposal (Annex I) • Soundness of approach; • Feasibility with respect to implementation plan and management; • Potential for programmatic sustainability; and • Evaluation and analysis. Disclosure of 103. Applicants should be aware of the following information disclosure policy Information of the Global Fund when submitting a proposal: • The Global Fund will share general information related to the review process with different stakeholders, however proposal-specific deliberations remain confidential. Guidelines for Proposals 16 of 25
  17. 17. • The Global Fund will only share information on the reasoning behind the different decisions taken on proposals with their authors, other groups that are part of the proposal (e.g. all members of a CCM listed on the CCM certification sheet), and Board Members and their representatives. • All others making inquiries about specific proposals would be informed of these guidelines and directed to make their inquiries directly to those with whom the Secretariat may share this information. 104. Basic information on the approved proposals will be posted on the Global Fund web site with permission of applicants. (http://www.globalfundatm.org) Guidelines for Proposals 17 of 25
  18. 18. Annex I GUIDELINES FOR PROPOSALS GENERAL CHARACTERISTICS OF A SUCCESSFUL PROPOSAL These characteristics will serve as a basis for the Technical Review Pannel to establish criteria for review of the proposals. I. Soundness of approach, with proposals demonstrating that they: 1. Are consistent with internationally accepted best practices exhibiting scientific soundness; 2. Give due priority to the identifiable groups and communities most affected and/or at most risk within countries; 3. Enables the development, strengthening and expansion of government/private/NGO partnerships; 4. Contribute to the elimination of stigmatisation of and discrimination against those infected and affected by HIV/AIDS, especially for women, children and vulnerable groups; 5. Are consistent with international law and agreements, respect intellectual property rights, such as TRIPS, including Declaration on the TRIPS agreement and Public Health at Doha, and encourage efforts to make quality drugs and products available at the lowest possible prices for those in need; 6. Improve service coverage and demonstrate a potential to achieve measurable impact. II. Feasibility with respect to its proposed implementation plan and management, with proposals demonstrating that they: 1. Are technically and programmatically feasible and relevant in the specific country context; 2. Have in place strong and transparent arrangements for financial management and control. 3. Support substantially increased quality and coverage of proven and effective interventions, which strengthen systems for working: within the health and other relevant sectors; across multiple sectors; and with communities; 4. Build on, complement, and co-ordinate with existing regional and national programmes1 in support of national policies, priorities, strategies and 1 Including governments, public/private partnerships, NGOs, and civil society initiatives Guidelines for Proposals 18 of 25
  19. 19. partnerships, including Poverty Reduction Strategies and sector-wide approaches; 5. Are utilizing appropriate and equitable supply and distribution systems, when they include significant commodity and drug procurement components. III. Potential for sustainability, with proposals demonstrating that they: 1. Strengthen and reflect high-level, sustained political involvement and commitment with respect to the allocation of national resources; 2. Have identified available resources, resource gaps and a strategy for ensuring that Global Fund investments will be additive and catalytic, and will not replace existing funding; 3. Have been approved by a Country Coordination Mechanism (CCM) that seeks to strengthen the participation of communities and people, particularly those infected and directly affected by the three diseases, in the development of proposals;2 IV. Evaluation and Analysis, with proposals demonstrating that they: 1. Are results focused, linking resources to the achievement of a clear and measurable set of indicators for specific programme activities; 2. Include an explicit monitoring and evaluation mechanism, or a plan for developing one, which measures performance against baseline indicators in specific programme areas and are based upon a high quality, recent situation analysis. Annex IIA: Illustrative Country Level Indicators for HIV/AIDS3 2 This criterion is relevant where the proposal comes from a CCM. For individual organizations that submit proposals directly under extraordinary circumstances, they must demonstrate clearly why it could not be considered under the CCM process at the country level, and the Board should require validation of these reasons 3 The highlighted section includes Best Practice indicators extracted from UNAIDS “National AIDS Programmes A guide to monitoring and evaluation”, UNGASS list of indicators and the MDG related to HIV, that countries are encouraged to use. For Guidelines for Proposals 19 of 25
  20. 20. Process/outputs4 Coverage/Outcomes Impacts Immediate products of activities Interventions delivered, including Change in epidemiological profile of meant to enable interventions, such number and quality of services and disease burden across given as infrastructure build-up and human distribution across populations populations, measuring incidence, resources training. prevalence, morbidity, mortality. •No. of HIV/AIDS prevention brochures/ booklets developed and •Percent of target groups (specify which target audience) reporting •Percent of pregnant women aged distributed utilization of services (specify which 15-24 who are HIV infected •No. of media HIV/AIDS radio or TV services) •Percent of infants born to HIV programs produced and no. of hours infected mother who are HIV aired •Percent of patients with STI at infected •No. of condoms sold or distributed health facilities who are •Percent of defined sub-populations appropriately diagnosed, treated, at higher risk (MSMs, CSWs, IDUs, •No. of staff trained in HIV and counselled etc.) who are HIV infected prevention/reproductive health/life 33. •Percent of adult men aged 15-49 skills who are HIV infected •No. of staff trained in HIV diagnosis, •Percent of young people aged 15-24 care, support, and treatment who both correctly identify ways of •Percent of sub- •Percent of health facilities with preventing the sexual transmission •populations with specific STIs drugs in stock to treat Sexually of HIV and reject major Transmitted Infections misconceptions about HIV (STI)/Opportunistic Infections (OI) transmission •Percent of blood units transfused in •Median age at first sex among the last 12 months adequately young people aged 15-24 screened for HIV according to national or WHO guidelines • Percent of young people aged 15-24 reporting the use of a condom •Percent of districts with VCT during sexual intercourse with a services non-regular sex partner •Percent of schools with teachers 34. trained in life-skills based HIV •Percent of CSWs reporting using a education and who taught it during condom with most recent client the last curriculum year • Percent of IDUs active in the last •Percent of large enterprises/ month reporting sharing injecting companies which have HIV/AIDS equipment the last time they injected prevention and care policies and drugs programmes •Percent of IDUs who used a condom the last time they had sex •No. of PLWHA support groups and 36. no. of enrolees •No. of community orphan support •Percent of people expressing projects and no./estimated percent accepting attitudes towards people •Impact indicators on care, of orphan children enrolled with HIV treatment, and support are under 1. development •Percent of households that received 52. •Percent of young people exposed to external support for orphans and reproductive health training (school vulnerable children in the last year settings/peer education) 37. 11. •Percent of people from high risk •Ratio of current school attendance groups (MSM, CSWs, mobile among orphans to that among non- populations) exposed to peer orphans in the age range 10-14 education/outreach programs years 13. 43. •Percent of IDUs exposed to needle exchange programs •Percent of HIV+ pregnant women receiving a complete course of ARV prophylaxis to prevent MTCT •Percent of people with advanced HIV infection receiving ARV combination therapy 32. IIB: Illustrative Country Indicators for Tuberculosis additional indicators, please refer to existing M&E manuals (UNAIDS, WHO, USAID, FHI, NAC Operational M&E manual). Whenever relevant, data should be disaggregated by age and gender. 4 This is an illustrative list of process/output indicators. Additional/other indicators may be identified by country programmes depending on their intervention strategies. Guidelines for Proposals 20 of 25
  21. 21. Best Practi ce indicators for country programmes* Process/outputs Coverage/outcomes Impacts Immediate products of Interventions delivered, Change in epidemiological activities meant to enable including number and quality profile of disease burden interventions, such as of services and distribution across given populations, infrastructure build-up and across populations measuring incidence, human resources training prevalence, morbidity, mortality • Existence of DOTS • Proportion of smear- • Number of smear- expansion plan and positive TB cases positive cases per budget in accordance registered under DOTS 100,000 population with international successfully treated* guidelines • Number of deaths from • Proportion of all TB (all forms) per • Proportion of total estimated new smear- 100,000 population per financial requirements for positive TB cases year DOTS detected under DOTS* implementation/expansio • n available • Proportion of all treatment units implementing DOTS • Average percentage of in line with standard** time that unexpired criteria for effective standard drug regimens implementation* are available in MOH storage and treatment • facilities • Average percentage of time that diagnostic units are adequately equipped and supplied • Proportion of all cases receiving DOT as described in national policy guidelines • Proportion of planned activities for training, supervision and monitoring that were actually conducted • Proportion of units submitting accurate, complete and timely reports • * Programs should report on ALL THREE of these indicators; especially, reporting only on the proportion of DOTS units would be insufficient ** For detailed descriptions, and a list of additional indicators, please refer to ‘An expanded DOTS framework for effective tuberculosis control, WHO publication WHO/CDS/TB/2002.297, ‘Millennium Develoment Goals’ (cited in Bull WHO 80:439), and ‘Guidelines for comprehensive monitoring of DOTS programs’, DRAFT available through WHO/STB Guidelines for Proposals 21 of 25
  22. 22. Annex IIC: Illustrative Country Level Indicators for Malaria Global Indicators Process/outputs Coverage/outcomes Impacts Immediate products of Interventions delivered, including Change in epidemiological activities meant to enable number and quality of services and profile of disease burden interventions, such as distribution across populations across given populations, infrastructure build-up and measuring incidence, human resources training prevalence, morbidity, mortality 53. % of health personnel 58. Proportion of households 68. Malaria death rate involved in patient care having at least one treated (probable and confirmed trained in malaria case bednet. cases) among target management and IMCI groups (under-five and (Integrated 59. Percentage of patients with other target groups). Management of uncomplicated malaria getting Childhood Illnesses) correct treatment at health 69. Number of cases of severe facility and community levels, malaria (probable and 54. % of antenatal clinic according to national confirmed) among target staff trained in guidelines, within 24 hours of groups (under-five and preventive intermittent onset of symptoms other target groups). antimalarial treatment for pregnant women. 60. Percentage of health facilities 70. Number of cases of reporting no disruption of stock uncomplicated (probable 55. % of of antimalarial drugs (as and confirmed) among villages/communities specified in national drug target groups (under-five with at least one policy) for more than one week and other target groups). Community Health during the previous three Worker (CHW) trained months. 71. Crude death rate among in management of target group. fever and recognition of 61. % of patients hospitalised with a diagnosis of severe malaria 72. % of probable and sever febrile illness. and receiving correct confirmed malaria deaths 56. % of service providers antimalarial and supportive among patients with (health personnel, treatment according to national severe malaria admitted to CHWs, etc.) trained in guidelines. a health facility techniques of treatment 62. % of health facilities able to 73. Annual parasite incidence of nets and/or indoor confirm malaria diagnoses (API) among target groups spraying according to according to national policy (by region/according to the the national policy. (microscopy, rapid tests, etc.). epidemiological situation) 57. 63. % of pregnant women who 75. have taken chemoprophylaxis or intermittent drug treatment, according to national guidelines. 64. % of malaria epidemic detected within two weeks of onset and properly controlled 65. % of mothers/caretakers able to recognise signs and symptoms of danger of a febrile Guidelines for Proposals 22 of 25
  23. 23. disease in a child < 5 years. 67. * For additional information on these and other indicators, please see "Framework for Monitoring Progress & Evaluating Outcomes and Impact", World Health Organization, Geneva, 2000, WHO/CDS/RBM/2000.25; “Roll Back Malaria initiative in the African Region, Monitoring and Evaluation Guidelines; WORLD HEALTH ORGANIZATION, REGIONAL OFFICE FOR AFRICA, HARARE, 2000; DRAFT (Reviewed –31/01/2001) (contact: afarie@whoafr.org; fellerdansokho@who.int) *These indicators are currently under development and will be updated. Annex III: Sample Illustrating Each Level of Indicators • Goal and expected impact (Describe overall goal of component and what impact, if applicable, is expected on the targeted populations, the burden of disease, etc.), (1–2 paragraphs): [Narrative on goal and impact] Goal: To reduce HIV prevalence among young people aged 10-18 from 10% to 8% by 2010 Impact indicators Baseline Target (Refer to Annex II) Year: 2001 Year: 2005 (end of grant period) Percent of young people aged 10-18 10% (50,000) 9% who are HIV infected • Objectives and expected results (Describe the specific objectives and expected outcomes), (1 paragraph per specific objective): (1 of 2) [Narrative on objective 1 and results] Objective 1: To improve reproductive health knowledge among young people aged 10-18 in school settings from 30% to 50% by 2005 Outcome/coverage indicators Baseline Targets (Refer to Annex II) Year: Year 2: Year 3: Year 4: Year 5: 2000 2003 2004 2005 Percent of young people in school aged 30% 40% 45% 50% 10-18 who both correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission o Main activities related to specific objective and expected output (Describe the main activities to be undertaken, such as specific interventions, to achieve the stated objectives): [Narrative on activities related to objective 1] Objective To improve reproductive health knowledge among young people aged 10-18 in school settings from 30% to 1: 50% by 2005 Broad activities Process/Output Baseline Targets Responsible/Implementing indicators (indicate Year: Year 1 Year 2 agency or agencies one per activity) (Refer 2001 to Annex II) Curriculum Number of primary and 0 10 20 Health Ministry development secondary schools that incorporated RH into curriculum Guidelines for Proposals 23 of 25
  24. 24. Teacher training Number of teachers 20 30 30 NGO xxx trained in reproductive health contents Peer educator training Number of peer 10 20 40 NGO yyy educators trained • Objectives and expected results (Describe the specific objectives and expected outcomes), (1 paragraph per specific objective): (2 of 2) [Narrative on objective 2 and results] Objective 2: To improve reproductive health knowledge among young people aged 10-18 outside of schools from 20% to 40% by 2005 Outcome/coverage indicators Baseline Targets (Refer to Annex II) Year: Year 2: Year 3: Year 4: Year 5: 2000 2003 2004 2005 Percent of young people outside 20% 30% 45% 50% school aged 10-18 who both correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission o Main activities related to specific objective and expected output (Describe the main activities to be undertaken, such as specific interventions, to achieve the stated objectives): [Narrative on activities related to objective 2] Objective To improve reproductive health knowledge among young people aged 10-18 outside of schools 2: from 20% to 40% by 2005 Broad activities Process/Output Baseline Targets Responsible/Implementing indicators (indicate Year: Year 1 Year 2 agency or agencies one per activity) (Refer 2001 to Annex II) Training Number of peer 10 40 40 NGO yyy; Ministry of educators trained Education Outreach activities Number of outreach 0 20 20 NGO xxx activities conducted Cultural performance Number of youth 0 20 20 NGO zzz; Company aaa theaters/musicals performance with RH content Guidelines for Proposals 24 of 25
  25. 25. Guidelines for Proposals 25 of 25