1 Collective Efficiencies Development Finance Architecture Workshop Prerna Banati - July

2 Global Fund principles & practice  The Global Fund is a unique financing mechanism with a mandate to raise and disburse substantial new funds in a transparent manner to achieve sustained impact on HIV/AIDS, TB, and malaria. Since 2001, the Global Fund has grant agreements of over USD $ 4 billion in 127 low and middle income countries.  The Global Fund was founded on a set of guiding principles  Operate as a financial instrument, not an implementing entity.  Make available and leverage additional financial resources.  Support programs that reflect national ownership.  Operate in a balanced manner in terms of different regions, diseases and interventions.  Pursue an integrated and balanced approach to prevention and treatment.  Evaluate proposals through independent review processes.  Establish a simplified, rapid and innovative grant-making process and operate transparently, with accountability.  The Global Fund is an example of upstream harmonisation pooling financing from a large number of donors  The Global Fund works with our partners to promote collective efficiency  There have been many successes. But challenges remain to overcoming historic harmonisation problems in country.

3 Global Fund and the Paris Declaration WITH STRONG COMMITTMENT TO THE PARIS PRINCIPLES, THE GLOBAL FUND PLAYS A LEADING ROLE IN THE PARTICIPATION OF GLOBAL INITIATIVES IN THE PARIS PROCESS. The Global Fund has worked to ensure that Global Initiatives are actively participating in the Paris Process. In particular, the Global Fund has been delegated responsibility, on behalf of health, education and environment Global Initiatives in the measurement of progress in countries. As part of this exercise, the Global Fund raised the interests of Global Initiatives, and participated in field studies to operationalize measurement of the Paris Declaration.

4 PROACTIVELY PROMOTING COLLABORATION WITH OTHER GLOBAL INITIATIVES TO IMPLEMENT THE PARIS DECLARATION Global Fund & GAVI –The Global Fund and the Global Alliance for Vaccines and Immunization (GAVI) held a retreat in 2006 with a series of country and global partners to analyze strengths, weaknesses and ways to improve harmonization. –The Global Fund has been working closely with GAVI on health systems strengthening (HSS) in Ethiopia. A clear workplan is being developed which will broadly highlight the contributions of the different partners to HSS Efforts are underway: Collaboration in implementation

5 CAPITALISING ON THE FLEXIBILITY OF THE GLOBAL FUND MODEL IN APPLYING THE PRINCIPLES OF HARMONISATION TO IMPLEMENTATION ARRANGEMENTS Global Fund & PEPFAR, World Bank –The Global Fund coordinates with the President’s Emergency Plan for AIDS Relief (PEPFAR) in their fifteen focus countries and the World Bank in several countries, including India and Rwanda. –This has been formalized with joint implementation meetings with partners each year. A prime example has been implementation efforts in Ethiopia, where PEPFAR and the national government have agreed on joint implementation arrangements with the Global Fund, as stated in a Memorandum of Understanding (MoU). –The Global Fund has shown flexibility and ability to work in varied implementation situations such as in fragile states, with bilaterals, with the World Bank, other Global Initiatives such as GAVI and PEPFAR Efforts are underway: Capitalising on flexibility

6 Efforts are underway: Monitoring and Evaluation BUILDING COMMON MONITORING AND EVALUATION SYSTEMS –The Global Fund is leading collective approaches to monitoring and reporting, including agreeing standard indicators among nine international partners for the three diseases, and coordinating financial and other investment in M&E systems. –A series of stakeholder M&E strengthening tools have been developed in collaboration with many partners. These are applied through stakeholder country workshops to coordinate investments in M&E among partners according to national priorities and gaps, in line with the “Three Ones” principles.

7 Maximizing collective efficiencies To support progress towards the MDGs, more attention needs to be focused on: –Strengthening health systems and financial accountability, supply chain and information systems –Strengthening wider structures to ensure quality and accreditation of scale up of services, training and health systems –Increasing country and community ownership, participation and involvement in governance and implementation The Global Fund can benefit from: –Making more of country flexibility given a limited country presence –Continued strengthening of upstream harmonisation to promote predictability