Operational Research in the context of HIV/AIDS, TB and Malaria control efforts from the perspective and experience of the Global Fund Serge Xueref John Puvimanasinghe Jean-Paul Moatti Edward Addai Monitoring, Evaluation & Learning Unit The Global Fund, Geneva

I.The Global Fund: mandate & portfolio review II.Operational Research in GF grants: status & the way ahead III.Conclusion: m e OR

The Global Fund (GF) has a mandate to raise and disburse substantial new funds in a transparent manner to achieve sustained impact on HIV/AIDS, TB, and malaria Raise it Spend it Prove it Financing instrument -Country Ownership -Performance-based funding Introduction

$6.6 billion disbursed, 562 grants in 136 countries 58% of total funds approved (by TRP) are for grants in sub-Saharan Africa 61% for AIDS; 14% for TB; 25% for Malaria GF Portfolio overview: As of 31st October, 2008

35% of approved financing is for key health systems components Innovative cross-cutting HSS funding: –$186 million approved in Round 7 –$ 290 million recommended by TRP in Round 8 (health workforce, information systems, supply chain management, community service delivery) Global Fund supports workforce capacity: 96% of grants have a training component GF Portfolio overview (2): Health systems strengthening

GF-supported programs: Acceleration of scale up

OR in GF grants Scaling up programs to fight AIDS, TB & malaria offers a unique opportunity to experiment alternative ways of delivering key health care services and prevention interventions

I.The Global Fund: mandate & portfolio review II.Operational Research in GF grants: status & the way ahead III.Conclusion: mORe

OR in GF Grants The Global Fund encourages the inclusion of OR in the control programs it supports. Programs are encouraged to spend 5-10% of their grant budget on monitoring and evaluation (M&E), which could include spending on relevant OR.

OR in the GF Grants Definition* of OR: Any research that produces practically-usable knowledge (evidence, findings, information, etc) which can improve program implementation (effectiveness, efficiency, quality, access, scale-up, sustainability) regardless of the type of research (design, methodology, approach) falls within the boundaries of OR. * from the Framework for OR/IR in health and disease control programs (TDR/WHO/USAID/UNAIDS/WB/TGF)

Overview of OR in Global Fund Grants Global Fund Round Number of Approved Proposals (At date of Analysis) Number and Percentage of Grants with OR Component Average budget for OR (per proposal) / Percentage of Total Proposed Budget Round (19%)400,000 USD 2.6% Round (52%)434,000 USD 4.4% Round (58%)360,000 USD 2.5%

Words from the GF Exec. Director With a few exceptions, operational research that really guides and informs implementation is still under-represented at this conference. Too often, investments worth many millions of dollars are being made in the absence of good data, and too often we fail to learn from and share all our experience in scaling up AIDS programs. The AIDS field has always been innovative, unafraid to criticize and challenge. It now needs to be much more creative in fostering collaboration between science and implementation, so that research becomes an integral part of all programs. Similarly, we must also do more to link science and policy. Prof. Michel Kazatchkine, Mexico AIDS Conference, August 2008

GF goal and objectives Goal: scale-up of OR in GF grants Driving Principles: –Respect Country Ownership –Foster Partnerships –Reach Consensus, being not GF specific –Transparently share data Objectives: –To develop and implement a joint OR Framework –To facilitate the building of local capacity in OR –To develop a GF OR information system

I.The Global Fund: mandate & portfolio review II.Operational research in GF grants: status & the way ahead III.Conclusion: mORe

mORe - OR embedded into Programs to improve quality and/or quantity of services - Part of the M&E funds (5-10% of total grant) Monitoring Learning Evaluating Conclusion

Role of Countries/Partners Countries to include OR in GF grants –GF supports/encourages OR –Develop and submit OR proposals within GF applications and/or reallocate within existing grants (collaboration with the FPM) Partners to support countries in OR –Partners to support OR (protocol writing, capacity building…) GF to facilitate scaling-up of high quality OR

Merci Thank you