1. NY-070626.001/020419VtsimSL001 Portfolio Management Update Fifth Board Meeting Geneva, 5-6 June 2003

2. 5th GFATM Board Meeting: 5-6 June 2003 Slide 1 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 1d Introduction By the 4 th Board Meeting, January 2003  30 grants were signed  US$ 5 million disbursed in 14 countries By the 5th Board Meeting, June 2003  57 grants signed  US$ 32million disbursed in 27 countries  Second disbursements in Ghana and Haiti  2 grants scheduled to be signed at the board meeting and 10 during the week

3. 5th GFATM Board Meeting: 5-6 June 2003 Slide 2 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 2d Progress of Portfolio Management Overview Percent of Components at each Stage

4. 5th GFATM Board Meeting: 5-6 June 2003 Slide 3 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 3d Cumulative Grant Agreements and Disbursements January to June 2003 Grant Agreements signed and Disbursements made, December 2002 – June 2003

5. 5th GFATM Board Meeting: 5-6 June 2003 Slide 4 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 4d Honduras Chile Argentina Panama Haiti Morocco Senegal Ghana Nigeria Zambia S. Africa Zimbabwe Malawi Ethiopia Tanzania Kenya Uganda Rwanda Burundi Mali Benin Madagascar Moldova Ukraine Serbia Tajikistan India China Mongolia Myanmar/Thailand Thailand Laos Cambodia Vietnam Indonesia Sri Lanka North Korea Zanzibar Ethiopia/Zambia As of June 2003 75% of approved Round 1 components have signed Grant Agreements, and disbursements quickly followed Agreement signed Disbursement made In negotiation

6. 5th GFATM Board Meeting: 5-6 June 2003 Slide 5 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 5d Honduras Chile Argentina Panama Haiti Morocco Senegal Ghana Nigeria Zambia S. Africa Zimbabwe Malawi Ethiopia Tanzania Kenya Uganda Rwanda Burundi Mali Madagascar Moldova Ukraine China Mongolia Myanmar/Thailand Thailand Laos Cambodia Vietnam Indonesia Zanzibar Ethiopia/Zambia Grant Agreements are already being signed in Round 2 countries, with money disbursed in Madagascar Botswana Burkina Faso Central African Republic Congo (DR) Eritrea Guinea Lesotho Liberia Mauritania Mozambique Namibia Sierra Leone Somalia Sudan Swaziland Togo Afghanistan Bangladesh Egypt Iran Jordan Myanmar Nepal Pakistan Philippines Yemen Armenia Bulgaria Croatia Ivory Coast Estonia Comoros Georgia Romania Costa Rica Cuba Dominican Republic Ecuador El Salvador Nicaragua Peru East Timor Kazakstan Kyrgyztan Chad Serbia Tajikistan North Korea Benin Ghana Sri Lanka India Mongolia China Agreement signed Disbursement made In negotiation Western Pacific Islands

7. 5th GFATM Board Meeting: 5-6 June 2003 Slide 6 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 6d Average CCM compositions for Round 2 include a range of different national stakeholders *Other includes mainly red cross and red crescent societies **Excluding South Sudan (Sub-CCM) and Somalia, which are not representative due to the particular political situation Government health ministry Government other ministries UN/Multilateral agencies Bilateral agencies NGO/community- based organizations Academic/educational organizations People living with the diseases Private sector Religious/faith-based groups Other* 100% = 91 CCMs** Public sector Non-public sector

8. 5th GFATM Board Meeting: 5-6 June 2003 Slide 7 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 7d Key findings on Governance: Composition and functioning of CCMs is evolving  Broad participation of private sector/civil society/government and donors: Ghana, Malawi, Peru, Senegal, Togo, Zambia  Strong representation of civil society: Haiti, East Timor  CCM becomes a legal entity: Honduras  Engaged private sector in the CCM: Dominican Republic, Panama, Swaziland  Political leadership at high level chairing CCM: Haiti, South Africa  Subcommittees of CCMs: India  Regional CCMs: Western Pacific, Mozambique/South Africa/Swaziland  Strong role in advocating additionality: Uganda  CCMs defining clear roles and responsibilities: Ethiopia, Nigeria

9. 5th GFATM Board Meeting: 5-6 June 2003 Slide 8 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 8d Key Findings: Governance Challenge: Representation of civil society still limited  In Africa, less than 5% of CCM members from private sector  12 of 32 African CCMs have no representation of affected communities  In Eastern Europe, large CCMs with less than 10% civil society representation

10. 5th GFATM Board Meeting: 5-6 June 2003 Slide 9 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 9d Key Findings on Governance Opportunities:  Participation in regional consultations leading to exchange of experience in operationalizing CCMs  Interest in multi-country and regional proposals to address cross-border issues  Democratic processes used to select PRs and sub-recipients e.g. Argentina, Chile, Ecuador, Nicaragua and Nigeria using public tenders

11. 5th GFATM Board Meeting: 5-6 June 2003 Slide 10 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 10d Key findings: PR arrangements Challenges:  Diversification of PRs continues to be a challenge - Ministry of Health remains most typical PR  Absence of clear, democratic process of nomination of PRs Opportunities: Evolving PR nominations in Round 2  Private sector foundation PRs emerging in a few instances (e.g. Chile, Haiti, Philippines and Serbia)  Regional, intergovernmental organization as PR (e.g. Secretariat of Pacific Communities, Mozambique, South Africa and Swaziland)  Multiple PRs in some e.g. Sri Lanka: Government and NGO; Zambia : PRs from government, NGO, and FBO sectors

12. 5th GFATM Board Meeting: 5-6 June 2003 Slide 11 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 11d Key findings: harmonization at country level For example:  Evidence of harmonization with existing efforts in countries (e.g., with World Bank MAP in Ghana, Malawi, and Senegal, basket fund in Zambia)  Expansion/scale-up of World Bank/ DfID TB projects (e.g., China and India)

13. 5th GFATM Board Meeting: 5-6 June 2003 Slide 12 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 12d Key findings: growing evidence of additionality Increasing commitments at the country level:  In Madagascar, Global Fund financing has catalyzed increased investments from other partners in malaria control  Global Fund ensured that its financing would supplement rather than replace existing funding in Uganda  Thailand’s health budget for ARVs will almost triple between 2001 and 2006

14. 5th GFATM Board Meeting: 5-6 June 2003 Slide 13 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 13d Key findings: Catalyzing effects - countries helping each other Examples from Latin America and the Caribbean  Cuba: Cuban doctors catalyzing ARV scale-up plan in Honduras  Peru: Offers access to one of the best DOTS implementation experiences in the world: leadership in MDR-TB  Argentina: sent consultants to Bolivia and Paraguay to help prepare proposals for Round 3  Honduras: sharing its work plans and administration mechanisms with the rest of the region

15. 5th GFATM Board Meeting: 5-6 June 2003 Slide 14 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 14d Lessons learned: Adjusting standards to realities and expectations GoalReality Grants to be signed and money is disbursed rapidly Countries’ willingness and preparedness to proceed is uneven Country-driven processes Countries requesting more guidelines, templates and samples PRs to develop procedures governing sub recipient relationships Countries requesting guidance Promote public-private partnerships Decisions taken by CCMs do not always encourage public-private partnerships

16. 5th GFATM Board Meeting: 5-6 June 2003 Slide 15 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 15d Lessons learned: Making improvements to accelerate grant signing and disbursements for approved grants  Avoid undue delays caused by TRP clarifications process  Improve communication of Global Fund minimum requirements before grants can be signed to assist CCMs and PRs to prepare adequately e.g.  Nominations of PRs by CCMs  Minimum capacities of PRs  Increase speed of LFA contracting - competitive process underway to establish a “menu” of suitable and available LFAs  Ensure suitable alternatives for procurement and supply management if PR capacities are weak – list of accredited procurement agents

17. 5th GFATM Board Meeting: 5-6 June 2003 Slide 16 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 16d Lessons learned: Use existing systems and leverage work of partners  Avoid duplication of PR assessments through improved access to previous work by partners; focus on areas where no previous track record or a need to validate certain capacities  Actively encourage PRs to make use of their existing systems and, if necessary, work with development partners to strengthen capacities  Ensure that reporting systems are flexible and adaptable to different country circumstances and existing systems

18. 5th GFATM Board Meeting: 5-6 June 2003 Slide 17 of 17Portfolio Management Update NY-070626.001/020419VtsimSL001 17d Areas where improvements are being seen:  LFA assessments accelerating due to accumulated experiences  Use of existing systems and leveraging work of partners  Fund portfolio management processes and policy guidelines are increasingly being streamlined and clarified, accelerating grant negotiations and disbursements