1. Concept Note development and modular tools
TBTEAM Annual Meeting, June, 2014

2. Outline Concept note development Elements of the concept note
Programmatic gap analysis
Modular tool
Lessons leaned

3. New funding model cycle
GAC
Concept Note
Grant Making
Board
TRP
Ongoing Country Dialogue
National
Strategic Plan/
Investment Case
Grant Implementation
Let’s begin by looking at the cycle of the new funding model and the overall timings.
It starts with your National Strategic Plan, which underpins the funding request. It is very important that this is as robust as possible, and considers interventions that take into account sub-national epidemiological data and data for key affected populations.
The Secretariat the communicates the funding allocation. After receiving the allocation amount the CCM can start developing the funding proposal, which is called the ‘concept note’.
In the concept note the CCM will be expected to present a funding request that is based on a coasted plan with prioritized interventions flowing from the national strategic plan, with up front risk and capacity assessments. The concept note must be developed using an inclusive ‘country dialogue’ process, with the input of a broad range of stakeholders, including key affected populations and people living with the disease.
The Global Fund Country Team will be engaged with the CCM over the duration of country dialogue, and will present the concept note to the Technical Review Panel, an independent body that assesses the quality of the proposal and recommends what interventions to fund. Once the concept note has been approved by the TRP it is presented at the Grant Approval Committee, which sets the level of approved funding for grant-making.
One of the big changes in the new funding model is that grant-making occurs prior to Board approval. Grant making will be a short window, where the implementation plans that have been agreed at the TRP are finalized with the principal recipient. Once the grant is disbursement-ready it is presented to the Board for approval. The grant life has now been extended to 3 years.
Some key points to highlight:
You can come to the Global Fund when it best suits you, with allocated funds being held in reserve for you until you apply. Funds from the allocation can be used beyond 2016, for a 3 year period after the grant is signed.
Concept notes for different diseases or HSS can be submitted at different times, (although for countries with a high TB/HIV co-infection rates a joint TB/HIV proposal should be submitted.)

4. The concept note
Principal document for TRP and GAC reviews and grant-making purposes
Output from country dialogue, reflective of an inclusive multi-stakeholder process
Encourages robust and ambitious funding request
Funding request based on the national strategic plan
Captures “full expression of demand’’

5. What is the importance of a concept note?
Concept note outlines the reasons for Global Fund investment:
Describes a strategy, supported by technical data that shows why this approach will be effective
Presents a country’s prioritized needs within a broader context, guided by a national health strategy and a NSP
Represents voices of key populations and other stakeholders in the country
Describes how implementation can maximize the impact of the investment
Very important to emphasize that NSP is almost always larger than the CN – so CN is a resource-constrained part of the NSP. The CN should be clear on how this optimal use of constrained resources, given the country context, was arrived at.

6. Overview of the structure of the standard concept note
Section
Country Context 1
Funding landscape, Additionality and Sustainability 2
Core tables
CCM Eligibility & endorsement
Supporting documents +
Funding request to the Global Fund 3
Implementation arrangement and risk assessment 4 .

7. Country context Country Disease, Health and Community Systems context
Section 1
Country context
1.1
Current and evolving epidemiology of the disease, and any significant geographic variations
Define constraints and barriers to an appropriate response
Community system constraints
Health system constraints
Human rights barriers
Key populations with disproportionately low access to services
Country Disease, Health and Community Systems context
1.2
National Disease Strategic Plans
Provide information based on current NSP(s)
Key goals, objectives and priority program areas
Implementation to date, main outcomes and impact achieved
Linkage to national health strategy
Processes for reviewing and revising the response based on outcomes achieved and lessons learned
1.3
Joint programming for TB and HIV
Plan for Joint planning and alignment of TB and HIV Strategies, Policies and Interventions
Barriers that need to be addressed in the alignment process

8. Funding landscape, additionality and sustainability
Section 2
Funding landscape, additionality and sustainability
2.1
Overall Funding Landscape for upcoming implementation period
Describe:
availability of funds for and source of such funding (government and/or donor) for the program.
How the proposed Global Fund investment has leveraged other donor resources
For program areas that have significant gaps, planned actions to address these gaps.
2.2
Complete the Financial Gap Analysis and Counterpart Financing Table
Compliance with counterpart financing requirements and planned actions to reach compliance
Government’s willingness-to-pay commitments and how they will be tracked and reported
assessment of the completeness and reliability of financial data reported including assumptions used and caveats with the figures
Financial gap analysis and counterpart financing
Table 1
Counterpart Financing Requirement

9. Funding request to the Global Fund
Section 3
Funding request to the Global Fund
Programm-
atic Gap
Table 2
3.1
Complete a programmatic gap table detailing the quantifiable priority modules within applicant’s funding.
Detail the request for funding and how the investment is strategically targeted to achieve impact and strengthen health systems.
3.2
Provide strategic overview of funding request including both the proposed investment of the allocation and above allocation amount.
Complete the modular template: link the selected module intervention to goals and objectives, and associated indicators, targets and cost.
Explain the rational for prioritization of modules and interventions
Describe the expected impact and outcomes.
3.3
Modular Template
Table 3
3.4
Focus on key populations and/or highest-impact interventions – LMI and UMIC

10. Concept note will capture the full expression of demand
In the concept note:
Full expression of demand captured at a higher level based on a coasted national strategy
Applicant will determine which program elements of their full expression of demand should be in their request above the allocation
Applicants encouraged to apply for their full expression of demand
Exact amount of existing funds included in a consolidated funding request will depend on the implementation start date.

11. Implementation arrangement and risk assessment
Section 4
Implementation arrangement and risk assessment
Overview of implementation arrangements
Include dual-track financing
Describe coordination among implementers
Identify any anticipated challenges 1
Information on the implementation capacity of PRs and risk mitigation measures to program delivery
Include an implementation arrangement diagram (not required at concept note submission) 2
For each PR, complete the ‘minimum standards for implementers’ assessment 3
Describe current or anticipated risks to program delivery and/or PR performance, including the proposed mitigation measures 4

12. Core tables & templates in a standard concept note
Financial Gap
Analysis & Counterpart Financing Table*
Programmatic Gap Table(s)
CCM Eligibility Requirements** 1 2
Modular Template
List of Abbreviations and Annexes
CCM Endorsement
of Concept Note** 3 4
* Not applicable to stand-alone HSS or applications from Regional Organizations, Regional Coordinating Mechanisms and Non-CCMs
** Not applicable to applications from Regional Organizations and Non-CCMs

13. Financial Gap Analysis & Counterpart Financing Table

14. Programmatic gap analysis
Programmatic gap table provides a comprehensive picture of the key gaps which form the basis of prioritization of the funding request
Include programmatic gap analysis for three to six priority modules within the applicant’s funding request
Coverage levels for the priority modules selected should be consistent with the coverage targets in section D of the modular template

15. Programmatic gap table - example
Programmatic Gap Table (Per Priority Intervention) - (create 3-6 programmatic gap tables as needed)
Priority Module
 TB care and prevention
Selected coverage indicator
Number of notified cases of all forms of TB
Current National Coverage
6000
Year 1
Year 2
Year 3
Comments/ Assumptions
Insert year of latest results
60%
2015
2016
2017
Current Estimated Country Need
A. Total estimated population in need/ at risk #
 10000
10000
 WHO estimate
B. Country targets (from National Strategic Plan)
 7000
8000
9000 %
70  80
90 
Country need already covered
C. Country need planned to be covered by domestic & other sources
 4000
5000
7000
 domestic contribution increases annually
 40 50 70
D. Country need already covered by existing Global Fund grants
 1000
 10
Programmatic Gap
E. Expected annual gap in meeting the need: A - (C+D)
 5000
3000
 50 30
F. Targets to be financed by indicative funding
 2000
2000
 20 20
G. Coverage from indicative, existing Global Fund and other resources: F+(C+D)
 8000
 9000
 70 90
H. Targets to be financed by above indicative funding
1000 10
I. Total coverage (indicative+ above indicative+ existing GF grants+ other resources)
 90
100

16. The modular approach
The modular approach is a framework used to structure the information that defines a grant
It runs throughout a grant's lifecycle, providing consistency at each stage
During the concept note stage, a funding request is defined by selecting a set of interventions per module to align with national strategy
During the grant making stage, each approved intervention is further defined by identifying and describing the required sets of activities
During grant implementation, progress of each intervention is monitored as laid out in the prior stages
Program level
Module
Intervention
Activity and cost

17. Example: TB modules and interventions
Impact/outcome indicators
Coverage/output indicators
Work-plan tracking measures
Disease/HSS
Modules
Interventions
Activities (not standardized)
Cost Inputs TB
TB Care and Prevention
Case detection and diagnosis
Smear microcopy
Product cost
Treatment
Training of health workers
Transportation
HIV
MDR-TB
Prevention
Baseline clinical assessment
Storage
TB/HIV
TB/HIV
Engaging all care providers
....
Procurement agent fee
Malaria
Program Management
Procurement of FLD, microscopes
Quality assurance
Community TB care delivery
HSS
M&E
Key Populations 17

18. Measurement framework

19. Modular tool – should be submitted online

20. Lessons and suggestions
Start the NFM process as early as possible
Several of the process that inform CN could be done concurrently and with CN development
Most of the tools are new – but instructions are available and worth reading before completing them
Ensure that figures are consistent – NSP, programmatic gap table, modular tool, narratives
“tell the story” – process and contents, quality
Make a strong and evidence-based case for funding – allocation and above allocation
Experience so far in developing single CN and joint programming for TB and HIV is promising