12 December 2017

Africa: Board Approves Third Batch of Global Fund Grants Valued At $2.83 Billion

Sixty-two grants from 29 countries were approved

On 1 December 2017, the Global Fund Board approved grants worth $2.83 billion from the 2017-2019 allocations. This is the largest amount approved in a single batch since the start of the new funding model.

The Board approved funding for 62 grants emanating from 41 funding requests submitted by 29 countries - plus two multi-country grants for small island states (Western Pacific) and a hybrid grant (RAI2E). The Board was acting on the recommendations of the Technical Review Panel (TRP) and the Grant Approvals Committee (GAC).

This was the third batch of funding approvals in the 2017-2019 funding cycle. The $2.83 billion included eight matching funds requests valued at $48.6 million. Interventions totaling $721.2 million were added to the Unfunded Quality Demand (UQD) Register. Domestic commitments to the programs represented by the approved grants amounted to $3.82 billion.

See Tables 1, 2 and 3 for details. (Because of the high volume of grants, we have split them into three tables - "Africa I: A-K," "Africa II: L-Z" and "Other Regions.")

Table 1: Grants approved from the 2017-2019 allocations - Third batch: Africa I: A-K ($US)

Applicant Comp. Grant name Principal recipient Amount UQD Domestic

commitment

Burkina Faso TB/HIV BFA-C-IPC Init. Privée et Comm. 8,391,291 8,665,319 59,342,228

BFA-SPCNLS SPCNLS 38,149,108 58,888,143

Malaria BFA-M-PADS P. d'Appui au Dev. San. 100,724,448 30,659,843 54,090,598

Cameroon Malaria CMR-M-MOH Ministry of Health 77,897,239 15,579,448

Cape Verde 3 diseases CPV-Z-CCSSIDA Coord. Comm. 4,289,072 1,300,775 9,393,149

Côte d'Ivoire HIV CIV-H-ACI All. Nat. Contre le Sida 22,686,745 117,387,574

CIV-H-MOH Ministry of Health 9,070,896

Malaria CIV-M-MOH Ministry of Health 96,569,403 137,856,506

CIV-M-SCI Save the Children 35,671,076

Eritrea HIV ERI-H-MOH Ministry of Health 21,256,673 10,275,019 14,000,000

TB ERI-T-MOH Ministry of Health 4,366,636 2,153,201 14,000,000

Ethiopia TB/HIV ETH-H-HAPCO H/A Prev. & Control Office 194,160,288 89,298,208 90,239,256

ETH-T-FMOH Ministry of Health 45,599,381 32,645,007

Gambia TB/HIV GMB-C-AA Action Aid Intl. 1,793,360 5,537,909

GMB-C-NAS Nat. AIDS Sect. 77,067,074

Kenya TB/HIV KEN-H-KRCS K. Red Cross Soc. 70,745,412 112,897,732

678,500,000

KEN-H-TNT National Treasury 179,594,995

KEN-T-AMREF AMREF 32,651,550 21,019,778 45,300,000

KEN-T-TNT National Treasury 30,043,120

Malaria KEN-M-AMREF AMREF 13,240,138 43,338,676 19,700,000

KEN-M-TNT National Treasury 54,156,636

Notes:

Amounts shown are upper ceilings.

For countries using euros, the amounts were converted to U.S. dollars at a rate of 1.1901 euros to the dollar.

The domestic commitments shown for Eritrea HIV and TB are being invested in strengthening Eritrea's health systems.

The amounts approved shown in this table include three matching funds requests - one for Burkina Faso malaria $2,120,076; one for Kenya HIV $18,800,000; and one for Kenya TB $6,000,000.

The final amount for the domestic commitment for Cameroon malaria is subject to confirmation.

As is customary, the approved funding is subject to availability of funding and will be committed in annual tranches. Where more than one grant has been approved for a component, the Secretariat has the authority to redistribute the approved amounts among the grants (except that any material change must be validated by the TRP).

Of the 41 country funding requests, 20 were of the program continuation variety; 11 were full review and 10 were tailored. Twenty of the funding requests were from Window 1 (20 March), 20 from Window 2 (23 May) and one from Window 3 (28 August).

Table 2: Grants approved from the 2017-2019 allocations - Third batch: Africa 2: L-Z ($US)

Applicant Comp. Grant name Principal recipient Amount UQD Domestic

commitment

Liberia TB/HIV LBR-C-MOH Ministry of Health 23,480,099 14,604,860 26,418,779

Malaria LBR-MOH Ministry of Health 23,291,765 44,697,227

LBR-M-PII Plan International 12,976,384

Madagascar HIV MDG-H-PSI Pop. Services Intl. 6,321,686 1,541,974

MGD-H-SECNLS Secr. Exéc. CNLS 7,615,103

TB MDG-T-ONN Office Nat. De Nutrition 9,021,000 3,190,137

Mali TB/HIV MLI-H-PLAN Plan International 8,476,315 17,162,298

MLI-T-CRS Catholic Relief Serv. 8,896,876 6,247,263

Mozambique TB/HIV MOZ-C-CCS Centro de Col. Saúde 27,850,971 135,323,122 47,028,011

MOZ-H-FDC Fund. Desenv. De Comm. 27,875,236 42,000,428

MOZ-H-MOH Ministry of Health 249,416,867

MOZ-T-MOH Ministry of Health 41,858,657 5,027,583

Niger Malaria NER-M-CRS Catholic Relief Serv. 53,040,170 15,434,801

S.T. & Principe Integrated STP-Z-UNDP UNDP 7,008,381 673,186 8,080,986

Somalia HIV SOM-H-UNICEF UNICEF 22,776,275 13,121,960 Exempt

TB SOM-T-WV World Vision 22,110,931 8,816,077 34,813,896

Sudan Malaria SDN-M-MOH Ministry of Health 100,783,761 152,072,790

Tanzania Malaria TAZ-M-MOFP Min. of Fin. & Plan. 145,258,808 19,429,759 20,275,996

Zambia TB/HIV ZMB-C-CHAZ Church Health Assoc. 63,401,344 94,165,870 207,000,000

ZMB-C-MOH Ministry of Health 137,984,476

Malaria ZMB-M-CHAZ Church Health Assoc. 17,725,490 11,586,696 100,000,000

ZMB-M-MOH Ministry of Health 51,274,510

Notes:

Amounts shown are upper ceilings.

For countries using euros, the amounts were converted to U.S. dollars at a rate of 1.1901 euros to the dollar.

Although the table shows a domestic commitment amount for Somalia TB, Somalia is exempt from the domestic co-financing requirements.

The amounts approved shown in this table include three matching funds requests - two for Mozambique TB/HIV $6,000,000 (for MOZ-C-CCS) and $5,990,631 (for MOX-H-FDC and MOZ-H-MOH); and one for Zambia TB/HIV $6,999,818.

The GAC said that the grants approved by the Board were found to be disbursement-ready by the Secretariat after a thorough review process and in consultation with partners. During grant-making, the GAC said, each applicant refined the grant documents, addressed issues raised by the TRP and GAC, and sought efficiencies where possible. The GAC endorsed the reinvestment of efficiencies in one of the following: (a) the same grant, in areas recommended by the TRP; (b) other disease components of the same applicant - where the TRP did not recommend reinvesting in the same grant; or (c) the general funding pool.

Table 3: Grants approved from the 2017-2019 allocations - Third batch: Other regions ($US)

Applicant Comp. Grant name Principal recipient Amount UQD Domestic

commitment

Afghanistan HIV AFG-H-UNDP UNDP 8,861,891 2,468,030 1,800,000

TB AGF-T-MOPH Ministry of Health 9,522,516 4,337,999 1,400,000

AFG-T-UNDP UNDP 13,429,462

Malaria AFG-M-UNDP UNDP 20,804,866 7,281,169 588,018

Cambodia TB/HIV KHM-C-MEF Min. of Econ. & Fin. 55,410,198 9,802,669 42,525,575

Haiti TB/HIV HTI-C-PSI Pop. Services Intl. 84,112,929 13,387,738

Malaria HTI-M- PSI Pop. Services Intl. 21,600,000 1,228,691

Honduras Malaria HND-M-CHF Coop. Housing Found. 5,376,572 5,806,485

Kazakhstan HIV KAZ-H-RAC R. Center Prev. & Control 4,500,000 140,800,000

Lao HIV LAO-H-GFMOH Ministry of Health 6,931,650 2,515,711 7,849,233

Multi-Country W. Pacific TB/HIV QUA-C-UNDP UNDP 11,368,713 N/A

Malaria QUA-M-UNDP UNDP 1,566,350 N/A

Nicaragua HIV NIC-H-INSS Inst. N. de Seg. Soc. 8,429,981 48,058,631

RAI2E Malaria QSE-M-UNOPS UNOPS 243,690,850 30,945,477 321,600,000

Solomon Is. HIV SLB-C-MOH Ministry of Health 1,512,241 2,170,427

Malaria SLB-M-MHMS Ministry of Health 4,394,587 5,446,657

Timor-Leste Malaria TLS-M-MOH Ministry of Health 7,951,919 1,019,243 2,025,773

Thailand TB/HIV THA-C-DDC Dept. Dis. Control MOH 18,033,492 11,346,422 901,025,475

THA-C-RTF Raks Thai Found. 19,631,167

Ukraine TB/HIV UKR-C-AUA Alliance for Public Health 35,817,918 34,108,097 242,770,168

UKR-AUN All-U. Ntwk. PLHIV 39,365,910

UKR-C-PHC Public Health Centre MOH 44,298,703

Notes

Amounts shown are upper ceilings.

RAI2E = Regional Artemisinin-resistance Initiative Phase 2 (Elimination). The countries included in RAI2E are Cambodia, Lao, Myanmar, Thailand and Viet Nam. This is a hybrid initiative. Of the $245,690,850 total funding, $120,297,271 comes from the catalytic investment pool ($119,000,000 from multi-country approaches and $1,297,271 from RSSH matching funds for Myanmar); the balance ($123,393,579) comes from country allocations. The other multi-country grants shown here (Multi-Country Western Pacific) are funded entirely from the country allocations. (Yes, it does get confusing!)

The amounts approved shown in this table include two matching funds requests - one for Afghanistan TB $1,432,340; and one for RAI2E Malaria $1,297,271.

Judging by the end dates shown in the GAC report, more than three-quarters of the approved grants have a proposed start date of 1 January 2018. We reported in earlier articles that in the 2014-2016 funding cycle, it took, on average, about two months from Board approval to first disbursement. However, the Secretariat is confident that grants from this batch that need to be signed by 1 January 2018 - because current grants have 31 December 2017 end dates - will, in fact, be signed by then, and that few existing grants will need to be extended. If the Secretariat is right, that would mean that the time from Board approval to first disbursement will have been reduced to about one month.

More to come

There were 143 grants reviewed in the first three batches. The GAC met on 21-22 November, where it was slated to review 22 grants; a decision on these grants is expected on 13 December. The GAC was scheduled to meet one more time in 2017, on 6-7 December, where it was expected to review 14 grants; a decision on these grants is expected on 12 January 2018.

The grants that will have been reviewed at these meetings are from Windows 1, 2 and 3. Three more windows have been scheduled for 2018, as follows (with the TRP meeting dates shown in parentheses):

Window 4 -- 7 February (TRP: 19-29 March)

Window 5 -- 30 April (TRP: 3-11 June)

Window 6 -- 6 August (TRP: 9-21 September)

Grant extension approved

The Board approved a no-cost extension of the Multi-Country South Asia HIV grant to September 2018 from 31 December 2017. This grant aims to support the development and strengthening of civil society and community-based organizations to reduce vulnerability to HIV and to reduce the impact of HIV on men who have sex with men (MSM) and transgender communities in seven South Asian countries: Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka. In three of the seven countries - Afghanistan, Pakistan and Sri Lanka - program implementation was completed and transition to the National HIV programs has been achieved. In the other four countries, efforts are still ongoing, the GAC said. An extension of nine months was required to complete planned programmatic activities and achieve the intended results. This was not the first extension given to this grant: The total cumulative extension of the grant has reached 33 months.

During the extension period, the PR will focus on fully transitioning the program to the national HIV programs and completing unfinished work, including advocacy efforts and sensitization of health workers and law enforcement agencies. The budget for the period of the extension will be completely financed from savings found in the grant in the amount of $1,677,524. The budget includes costs associated with close-out of the program in Afghanistan, Pakistan and Sri Lanka in Quarter 1 of 2018 and for the overall closure of the grant activities in Quarter 3 of the same year.

The GAC noted that a number of multi-country grants will not be eligible for additional investments from the 2017-2019 allocation period because the focus of their grants is not aligned with the priorities for multi-country approaches under catalytic investments.

Change of PR for multi-country grant

Via the GAC report, the Global Fund Secretariat formally notified the Board of a change in implementation arrangements for the Multi-Country Key Population Research and Advocacy (KPRA) grant. The PR, the Asia-Pacific Network of People Living with HIV/AIDS (APN+) has been replaced by Save the Children Federation (SCF).

In December 2016, from the 2014-2016 allocations, the Board conditionally approved this regional grant with an upper ceiling of $3,576,375, contingent on APN+ fulfilling three specific requirements which were intended to address management capacity weaknesses. The conditions included the hiring of new program management; completion of the grant budget; and addressing all TRP clarifications. According to the GAC, APN+ had not addressed any of the requirements by the specified deadlines. Because of the technical soundness, potential for impact and strategic value of the proposed program in the region, the GAC supported continuing the grant-making process with a new PR, SCF.

The goal of the KPRA regional (or multi-country) grant is to strengthen community capacity to improve access to quality HIV prevention, testing, treatment, care and support services among key populations in Bangladesh, Cambodia, Indonesia, Nepal, Thailand, Myanmar and Vietnam. The proposed strategies include (a) building evidence and engaging in strategic advocacy for the purposes of improving the quality of HIV prevention and care services for people who inject drugs, sex workers and transgender people; and (b) improving understanding of existing community-based HIV testing services, and advocating for community-centered models to meet the UNAIDS strategy and the 90-90-90 targets on testing, treatment and viral load suppression.

SCF was able to complete grant-making to the satisfaction of the Secretariat.

Aidspan reported on the approval of the first batch of grants for 2017-2019 here; and on the second batch of grants here.

Most of the information for this article was taken from Board Document GF-B38-ER02, Report of the Secretariat's Grant Approvals Committee. This document is not available on the Global Fund website.

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