1. Country Coordinating Mechanisms Evolving CCMs to align with the Global Fund Strategy
Presentation to Board
January 2018

2. Content 1. Status Update of the Evolution project
2. Differentiated CCM Models
3. Options for Implementation

3. Content 1. Status Update of the Evolution project
2. Differentiated CCM Models
3. Options for Implementation

4. What is the ‘CCM Evolution’?
In order to strengthen the Global Fund’s business model, the Global Fund Secretariat has been asked by the Global Fund Board to examine how to evolve the current CCM model to better deliver on the Global Fund strategy This has also been part of the recent “CCM Audit” released by the Office of the Inspector General (OIG).
Overall Objective: to ensure that current CCM practices can inform the exercise (‘learning from the past’), while ensuring the new CCM model would allow CCMs to best deliver on the new strategy (‘setting up the vision’). It also includes how to differentiate CCMs.
The project will lead to a revision of the ‘CCM Guidelines and Requirements’, which will come to the Global Fund Board for approval in May 2018.

5. Where are we with the project: Phases Completed
Phase I
(First semester 2017)
Analyzed CCM functionality and performance to understand current practices.
Phase II
(Second semester 2017)
Undertook extensive stakeholder consultations via 5 regional workshops and electronic feedback from 72 CCMs.
Documented feedback on how to improve CCM functionality, linkages oversight, and engagement.
Phase III
(Nov Jan 15, 2018)
Developed options for improved and differentiated CCM models, based on stakeholder input.
Sent proposal for consultations to 105 CCMs.
Ready for consultations (CCMs, committee members) before Board Committee Meetings. 4 4

6. What are the Next Steps? Phase IV Deployment
(January May 2018)
Draft potential changes to guidance documents (CCM Guidelines)
Present options to the Board Committees
Board level documents to be approved in May 2018
Prepare deployment plan
Prepare monitoring tools (updates to EPA for different types of CCMs)
Deployment
(Second semester 2018 and onwards)
Publish and communicate new “CCM Guidelines”
Update and deploy training packages
Coordinate Change Management
Conduct regional dissemination workshops
Start measuring compliance levels
Align CCM Funding Policy 5 5

7. Content 1. Status Update of the Evolution project
2. Differentiated CCM Models
3. Options for Implementation

8. What are the different CCM Models?
We are proposing 3 different groups for differentiation for CCMs and the evolution of the current Regional Coordination mechanism (RCM)– based on both the analysis of CCM functionalities and feedback from the CCM regional consultations (conducted in August and September 2017):
1. Pivotal CCMs
(~ 25 countries)
2. “Transitioning Countries”
(~ 60 countries)
3. “CCMs in Challenging Contexts”
(~ 23 countries)
Regional Coordination Mechanism (RCM):
The RCM model is also evolving in line with the overall evolution.

9. What are the different CCM Models?
1. Pivotal CCMs
1. Countries that have at least one disease that is “severe” or “extreme” and where Global Fund pays for a large share of the national response* (about 25 countries)
2. “Transitioning Countries”
2. Countries that are preparing to transition from Global Fund financing, either higher income countries or where there is a relatively “low” disease burden, and often where the Global Fund investments are low compared to national government funding (Global Fund relevance). Some of these countries are currently receiving or are projected to receive transition funding in less than two allocation periods. This group is composed of two sub-groups:
a) Transitioning Now: 3 components receiving transition funding, or are not eligible. (about 10 countries)
b) Preparing for Transition: All Upper Middle Income countries, regardless of disease burden, and lower middle income countries with a disease component that is low or moderate disease burden (about 50 countries)
2. “Transitioning Countries”
3. “CCMs in Challenging Contexts”
3. This group is composed of three sub-groups (about 23 countries):
a) Challenging Standard: CCMs in countries that are under “Additional Safeguard Policy” or categorized as “Challenging Operating Environment” which are neither “Chronic Instability” nor “Acute Emergency”
b) Chronic Instability: CCMs in countries with precarious security situation relating to periodic political strife, governance change or weak leadership or localized conflicts as defined in the “Challenging Operating Environment” OPN
c) Acute Emergency: CCMs in countries with humanitarian crises due to armed conflict, emerging disease threats or outbreaks or natural disasters as defined in the “Challenging Operating Environment” OPN (currently no country, but allows for cases like Ebola crisis, civil war outbreak or natural disaster)
* These are countries with High Disease Burden and Global Fund Relevance. The GF relevance is calculated based on “GF investments” compared to what the national government is funding.

10. The objective for the different CCM models
Transitioning CCMs:
Focus on ensuring linkages with the national response, including representation of key populations, and that the government is planning to take over
Evolved Transitioning CCMs Model:
Addition of transition-specific activities, at two levels of intensity, depending on how soon Global Fund financing ends
Pivotal CCMs:
(High Disease Burden & Global Fund Relevance)
Focus on optimal internal functioning, robust program oversight and CCM integration
CCMs in Challenging Contexts:
Focus on adapting to coordinating activities (e.g. humanitarian) needed in their context, and preserving stability
Current CCM Model
Evolved Pivotal CCMs Model:
Evolved CCMs in Challenging Contexts Model:
More emphasis on building a highly engaged, and strategic body that stimulates strong performance of GF programs, and the wider health landscape, to progressively encourage governments to fund them
Given flexibility in adhering to Global Fund requirements

11. 2. Context-based validation
Country assignment to CCM models
Countries could be assigned to one of the 5 different categories using a ‘Two-Step’ methodology:
Revising Assignments
1. Data Analysis
2. Context-based validation
Data Analysis
Revising Assignments
Context-based validation
The countries that will be accessing Transitioning funding in 6 years or less are mapped as “Transitioning”.
Then, countries that are either “Challenging Operating Environment” (COE) or under “Additional Safeguard Policy” (ASP) are automatically mapped in “Chronic Instability” or “Challenging Standard”.
The other CCMs are mapped in “High Burden/High GF Relevance” model.
Country Team, following input received from CCMs, agree on the “data analysis” categorization (to endorse or adjust it). Only minor adjustments are expected. In case of disagreement, a panel composed of CCM experts and chaired by the CCM Hub will take the final decision.
In principle, countries would be assigned into their CCM model every 3 years. Revisions can be made on an exceptional basis within the 3 year period, for example for acute emergencies, at the request of CTs and/or CCMs

12. Content 1. Status Update of the Evolution project
2. Differentiated CCM Models
3. Options for Implementation

13. Level of Ambition: 3 Options for Implementation Choice from 3 Scenarios
As the budget to implement the “CCM Evolution” is uncertain, the Global Fund Secretariat will propose to the Board and its committees 3 different options to choose from:
Options
Description
Option 1: “Basic”
Includes the optimal package of activities to maximize the impact while staying within a very limited increase. Choosing to invest in this option will result in least impact for all target models, estimated at 30 %.
Option 2: “Intermediate”
Includes the most cost efficient activities. Choosing to invest in this option will require trade-off decisions of prioritizing certain activities over others, resulting in about 80% of estimated impact.
Option 3: “Full implementation”
Includes activities that are needed to achieve the desired change. Choosing to invest in the full implementation option will result in maximum impact for each target model.

14. ‘Full implementation’
Level of Ambition: 3 Options for Implementation Comparing potential options
Options
What could be included in this option (incremental to current budget) *
‘Basic’
+ CCMs are differentiated based on their context (5 typologies).
+ Most of the CCM ‘Good practices’ (in all areas) are being systematized.
+ Limited “Code of Conduct” implementation
+ Limited CCM Performance management (‘self-assessed’ only)
‘Intermediate’
+ Code of conduct is fully implemented**
+ 6 Regional workshops for CCM members, to disseminate changes
+ Civil society providers to deliver trainings to key and vulnerable populations to strengthen their leadership and to enable them to play their roles as CCM members, (20 CCMs/year) (most of it from CRG Strategic Initiative).
+ Budget support to CCMs for preparing transition
+ Professionalize the Oversight function*** (for 40 CCMs)
+ CCM Performance Management is assessed by neutral parties (40 CCMs/year), verified by CCM Hub**.
+ All CCM members are being oriented at the beginning of their mandate (40 CCMs/year).
‘Full implementation’
+ CCM Performance Management is assessed by neutral parties (all CCMs), verified by CCM Hub**
+ Dedicated program to build CCM Secretariat’s capacities (40 CCMs/year) **
+ CCMs Secretariat are equipped with an ‘Oversight Officer’**
+ Support to CCMs to evaluate what their best institutional anchorage should be
+ CCM Executive Secretaries’ profiles are elevated to a higher level – beyond Admin
* Individual items can be moved from one option to the other ones.
** Implementation for CCMs “High Burden / High GF relevance”, “Challenging standard” and “Chronic Instability” only.
*** When expertise is not available through CCM members, the CCM may decide to engage professionals as oversight committee members (5 working days/month).

15. Thank you!