1. The Global Fund December 2005

2. 2000JulyG8 endorse new AIDS, TB and malaria targets in Okinawa 2001April June July African leaders commit to greater response in Abuja Endorsement of the need for a global fund at UNGASS Over US$ 1.5 billion in pledges made by G8 in Genoa 2002January April July November Global Fund created at first Board meeting Round 1 proposals approved at second Board meeting Executive Director assumes role Initial disbursements of grants commence 2003January June October Round 2 proposals approved at fourth Board meeting Additional funding pledges made by G8 in Evian Round 3 proposals approved at sixth Board meeting 2004JuneRound 4 proposals approved at eighth Board meeting Global Fund: History and key milestones B&P/300704/9 2005FebruaryFirst 24 grants undergo Phase 2 Review

3. Unique structure and operations Additional resources for the three diseases –US$ 8.8 billion has been pledged to the Global Fund through 2009-10. –Non-traditional sources include private foundations and corporations – resource mobilization efforts on-going. –Funding from donors and for recipient countries is expected to be additional to existing contributions and health budgets. Broadened public / private / civil society partnerships –At country level, public sector, NGOs, development partners and private sector participate in a country-led coordination mechanism for proposal design and implementation. –The Global Fund itself is governed by a Board with representation from donor and recipient governments, NGOs, communities, foundations and private sector. Performance-based funding aligned with harmonization efforts –Grant recipients to focus on results rather than on inputs. –Building on existing systems and common/harmonized donor arrangements. B&P/300704/11

4. Unique structure and operations Lean organizational structure –The Global Fund has no field offices and does not implement programs; its small Secretariat is based in Geneva. –Local Fund Agents are contracted to conduct program, budget & report assessments and to monitor activities. –An independent Technical Review Panel of disease & development specialists meets to review grant proposals and to make funding recommendations to the Board. Transparency, openness, flexibility, responsiveness –Transparency as a key operating principle means all approved proposals, program details, contact information and up-to-date financial data are available on the website at www.theglobalfund.org www.theglobalfund.org –A Partnership Forum is held every two years – the first took place in July 2004 in Bangkok, second in Durban in 2006 – to invite the input and recommendations of all stakeholders, particularly those without a direct voice on the Board. –Commitment to changing in response to lessons learned and valid criticisms. B&P/300704/12

5. Model for grant accountability aims to find the right balance between key priorities Sustainability/ Ownership Speed Rely on local stakeholders at the country level to implement programs and manage grant proceeds Encourage the use of existing standards and processes Monitor and evaluate programs and make decisions on future funding based on performance and accountability Promote rapid release of funds to support target populations Accountability ARCH/300704/9

6. The Global Fund grant process ARCH/300704/2

7. China Mongolia Countries with grants from multiple rounds are assigned the round in which they received their first grant. Countries with Global Fund grants With Round 5, the Global Fund has approved Over 350 components in over 125 countries 2-year budget: US$ 3.5 billion 5-year budget: US$ 8.8 billion B&P/300704/14

8. Distribution of Global Fund commitments Two year budgets Expenditure by disease Expenditure by region PRS/300704/3

9. Grant portfolio details Components by sector of recipients Round 2-4 only. Data not available for Round 1. Components by expenditure category Round 1-4 PRS/300704/5

10. Building the measurement framework Operational performance Grant performance System effects Impact Sample Measurements e.g. declining mortality from HIV, TB and malaria e.g. additionality, sustainability and partnerships e.g. coverage, people reached by services e.g. actual against target disbursements Indicators and measurement tools have been developed with relevant partners for all levels

11. Proposal Management & Grant Negotiation Proposal Management Proposal Success Rates Building the measurement framework Operational performance Grant performance System effects Impact Secretariat Cost Base Key Highlights Core Indicators Resource Mobilisation Resources vs. Need n= Disbursement & Grant Support n= Initial focus on operational performance: the Executive Dashboard Proposal Managem ent Performance- Based Funding & Grant Support Business Services Grant Negotiatio n Resource Mobilisation

12. Building the measurement framework Operational performance Grant performance System effects Impact A suite of tools has been developed to support grant performance management and track grant progress GSC Month: 012161820 Grant Performance Report

13. Implementing the grant performance system Performance data in real time Grant Proposal Form CCM Request for continued funding Annual Review Grant Scorecard Grant Agreement Attachment 1 Annex A Grant Performance Report Disbursement Request/ Progress Update

14. Performance rating system Decision categoryGrant Performance rating Contextual considerations “Go” Phase 2 grant committed for the remaining proposal period (years 3-5) A expected or exceeding expectations and No or minor contextual issues “Conditional go” Phase 2 grant committed conditional upon time- bound actions to be taken by the PR/CCM (maximum 1 year) B1 Adequate and/or Major contextual issues that can be addressed by the PR/CCM “Revised go” CCM/PR reprogramming (targets and Budget substantially revised for Phase 2) subject to Global Fund approval B2 inadequate but potential demonstrated and/or Major recent improvements in program supporting environment “No go”* Phase 2 grant not committed *requires Board Decision C unacceptable or Critical contextual risks beyond PR and/or CCM control M&E/300704/9

15. Performance based funding works Grants are split into four categories based on performance. Grants that under- perform have only received 45 percent of the scheduled disbursements.

16. Share for the Global Fund Using conservative approaches, estimates suggest: For malaria, the Global Fund contributed 45% of all international funding in 2004. This will greatly increase in 2005 For tuberculosis, the Global Fund provides 66% of all international funding in 2005 For HIV/AIDS, the Global Fund contributes 20% of all international funding in 2004

17. Conclusion A great experiment Passed its first tests A tool for national efforts to fight disease A flexible instrument for change Ownership: stakeholders has the freedom and responsibility to develop the Global Fund so it remains useful A Public-private partnership opportunity