GLOBAL FUND OBSERVER (GFO) Issue 111: 16 November 2009.

[Guest guest]

GLOBAL FUND OBSERVER (GFO), an independent

newsletter about the Global Fund provided by Aidspan to over 8,000 subscribers

in 170 countries.

Issue 111: 16 November 2009. (For

formatted web, Word and PDF versions of this and other issues, see www.aidspan.org/gfo)

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CONTENTS

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1. NEWS: Main

Decisions Made at November Board Meeting

Details are provided regarding all the main decisions

made at the Global Fund’s recent Board meeting.

2. NEWS: Global

Fund To Implement New Funding Architecture

The Global Fund Board has decided to implement a new

funding architecture in order to simplify processes for grant implementers. The

centrepiece is the concept of a " single stream of funding " per PR per

disease.

3. NEWS: Global Fund

Offers Additional Funding for CCMs

The Global Fund has established a new " expanded

funding " window for CCMs. The new window allows a CCM to apply for more

than $50,000 a year in funding providing it submits a two-year workplan with

measurable targets.

4. NEWS: Global Fund Board

Approves Proposals for Phase 1 of the " Affordable Medicines Facility

– Malaria " (AMFm) Funding Stream

The Global Fund Board has approved 10 proposals under

Phase 1 of a small innovative new funding programme called the " Affordable

Medicines Facility – Malaria " (AMFm), which is designed to provide

support for interventions promoting and facilitating the use of artemisinin

combination therapies.

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1. NEWS: Main Decisions

Made at November Board Meeting

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On 9-11 November 2009, the Global Fund Board held its twentieth board

meeting, in Addis Ababa, Ethiopia. GFO was present, with

observer status.

This article summarises the main decisions made at the meeting. The

decisions, in chronological order, were as follows. (For precise wording of

what the Board agreed, see the Decision Points document at www.theglobalfund.org/en/board/meetings/twentieth.

Background documentation will also, in time, be posted by the Fund at the same

location.)

Common platform for joint funding and

programming of HSS: The Global Fund has held

discussions with the World Bank and the GAVI Alliance, with technical support

being provided by the World Health Organization (WHO), regarding a possible

shared approach to the funding of health systems strengthening (HSS). Two main

approaches have been examined. The first is to create a single HSS funding

application form that countries would complete and submit to all three agencies

(Global Fund, World Bank and GAVI). The three agencies would jointly assess the

applications, but different agencies would fund different applications. The

second approach is for the three agencies to jointly assess complete national

health strategies (rather than just assessing proposals submitted via an

application form). The three agencies would jointly decide which ones to fund,

and would jointly provide funding for each endorsed national health strategy.

The Board authorised the Global Fund Secretariat to continue participation in

this assessment work and to broaden the discussions to include additional

options. The Board also asked the Secretariat and the Board’s Policy and

Strategy Committee to propose how a joint HSS platform could be implemented and

funded. [see Decision Point 4.]

Support for the Board’s

implementing constituencies: To enhance the

engagement of constituencies representing implementing countries in Board deliberations

and decision-making, the Board decided to make more money available to support

communications, meeting, travel and staff costs incurred for intra-constituency

functions. The Board approved an annual budget of $800,000 for this purpose.

Each of the seven implementing constituencies may apply for up to $80,000 for

2010, but exceptions to this ceiling may be granted by the Secretariat as long

as the overall budget is not exceeded. [see

Decision Point 7.]

Coping with limited funding

availability: The Board endorsed the

" broad lines of thought " contained in the recommendations of the

Board’s " Working Group To Manage the Tension Between Supply and

Demand in a Resource-Contained Environment. " The Working Group’s

recommendations dealt with how to reduce the costs of funding approved

proposals for Round 9 and the first learning wave of National Strategy

Applications (NSAs); how to delay the provision of some of the funding for

these approved proposals; how to determine the order in which these proposals

should be funded; how to deal with these and related issues in rounds

subsequent to Round 9; and new approaches to raising money for the Fund. The

Board decided that many of the Working Group’s topics and recommendations

require further discussion by the Board. This discussion will take place at a

Board retreat to be held in January or February 2010. [see Decision Points 10 and 30.] The Board

also adopted some of the specific recommendations of the Working Group, such as

an average 10% reduction in the first-two-year budgets of approved Round 9 and

NSA proposals; GFO reported on these decisions in the first article in Issue

110, available at www.aidspan.org/gfo.

[see Decision Point 9.]

Approval of Round 9 and NSA grants: The Board approved 85 Round 9 grants that will cost

$1.99 billion over two years, and five " first learning wave "

National Strategy Applications that will cost $0.39 billion over two years. GFO

provided details of these decisions in Issue 110, available at www.aidspan.org/gfo. [see Decision Point 11.] [Note: Up-to-date information regarding approved

Round 9 and NSA grants, together with information on all earlier grants, is

available on a country-by-country basis at www.aidspan.org/grants.]

CCM Guidelines: The Global Fund is planning revisions to the CCM Guidelines. The

Board delegated to its Portfolio and Implementation Committee (PIC) the

authority to make the changes, except that if the PIC wants there to be any

changes to the six CCM minimum requirements, these will have to approved by the

Board. [see Decision Point 12.]

Quality Assurance Policy for

Pharmaceutical Products: The Fund’s

Quality Assurance Policy requires that Finished Pharmaceutical Products (FPPs)

can only be purchased using Global Fund money if the FPPs are WHO-prequalified,

or have been authorised by a Stringent Regulatory Authority, or have been

approved by the Fund’s Expert Review Panel (ERP). The Board agreed to

expand the eligibility criteria for products to be reviewed by the ERP, because

grant implementers have sometimes found it difficult to find suppliers for

qualifying malaria and first-line TB FPPs, leading to the risk of treatment

disruptions. The Board also decided that because it will take some time to

organise submissions and reviews for products newly eligible as a result of

this change, certain additional exceptions to the current policy will be

allowed until 31 December 2010. [see

Decision Point 13.]

2010 operating expense budget: The Board approved a 2010 operating budget for the Secretariat of

$274 million. The size of the Secretariat, at 597 staff, will remain roughly

the same as it is in 2009. [see Decision

Point 14.]

In-kind non-health product donations: The Board approved, on a trial basis in a limited number of

countries, the idea of accepting non-health products as donations to the Global

Fund. The trial will last about two years. [see

Decision Point 16.]

Expansion of Debt2Health: The Board decided to make Debt2Health a permanent part of the

Global Fund’s fundraising effort. (Under this initiative, wealthy

countries that have lent money to developing countries choose to forgo

repayment of a portion of their loans on the condition that the borrowing

country invests an agreed-upon amount in health in their own country through

Global Fund-approved programmes. The amount generally equals the payments the

country was making to service the debt.) The pilot phase has been completed,

with two agreements signed and a third signature pending. These agreements

cover debt with a face value of $140 million, which has raised $80 million,

after discounts, for the Global Fund. In addition, a further three agreements

are being negotiated with a face value of $93 million, with the potential to

generate additional funding of $46 million. [see

Decision Point 17.]

Affordable Medicine Facility –

Malaria (AMFm): The Board approved 10

proposals in a small new funding stream, the AMFm, at a net cost to the Fund of

$18 million after some grant restructuring. The funds are for interventions to

support the increased use of artemisinin combination therapies (ACT) for the

treatment of Malaria. The proposals were part of a pilot phase in a limited

number of countries, which is expected to last about two years. The Board said

that it will consider a global scale-up of the AMFm funding stream if an

independent evaluation reveals that the initiative is achieving its objectives.

[see Decision Points 24 and 25. See also

separate article on AMFm, below.]

Partnership Strategy: The Board approved a new Partnership Strategy designed to enhance

the Global Fund’s partnerships. The Strategy includes an accountability

framework (the Partnerships Performance Framework) to enable the Fund and its

partners to assess the effectiveness of the partnership. The Secretariat will

develop an implementation plan for the Partnership Strategy by March 2010. [see Decision Point 27.]

Translation and interpretation: The Board approved funding some increased translation and

interpretation for Board and committee meetings and documents (or portions of

documents). Decisions concerning whether and what to translate and interpret

will be left to chairs and vice-chairs. The Board said that this new policy

would be implemented incrementally. For example, initially, translation and

interpretation (from English) would be limited to two languages. [see Decision Point 28.]

Round 3 Russia HIV grant: The Board approved

" on an extraordinary basis " an extension of a Round 3 HIV grant to

Russia, for which the PR is the Open Health Institute, and which was due to

expire on 31 August 2009. The extension is until 31 December 2011. The cost of

the extension is $24 million. The OHI grant, as it is known, includes the

provision of ARVs as well as the provision of lifesaving prevention services to

vulnerable populations. The Board was responding to the fact that under the

current income eligibility policies of the Global Fund, Russia is no longer eligible for

HIV funding, and so cannot apply for funding to enable these activities to be

continued. In its decision, the Board noted that the Fund’s income

eligibility policies are under review, and that this review should be completed

by late 2010. The Board also urged Russia to expand its investments in

services to vulnerable populations. [see

Decision Point 29.]

Launch of Round 10: As reported in GFO 110, the Board decided that subject to

confirmation at its next board meeting in April 2010, the Fund will issue the

Round 10 call for proposals on or about 1 May 2010. Proposals must be submitted

by 1 August 2010, and the board will decide which ones to approve between

November 2010 and January 2011. [see Decision Point 30.]

Architecture review: The Board approved a number of measures to simplify processes for

grant implementers by introducing a single stream of funding per PR per

disease. (The Board had approved this basic concept at its meeting one year

ago.) The single stream of funding means that, in future, when there are

multiple grants for the same PR for the same disease, they will be rolled into

one. The transition to the single stream of funding will occur gradually over

the next two years. There will continue to be rounds of funding, similar to the

current rounds-based channel, as well as national strategy applications (NSAs).

However, as reported in GFO 110, the rolling continuation channel (RCC) will be

discontinued. By the start of Round 11, each new proposal submitted to the

Global Fund will have to be in the form of a consolidated request for funding,

incorporating all then-current Global Fund support to the country for that

disease. [see Decision Point 31. See also

separate article on the architecture review, below.]

Youth leadership: The Board asked the Secretariat, in consultation with the

constituencies represented on the Board, to consider how they can better

include young people and facilitate youth-led action at global and national

levels; and how to ensure that the ideas and perspectives of youth are better

reflected in the work of the Global Fund and the Board – and to report

back to the Board on this within two years. [see

Decision Point 32]

Other Decisions: Several appointments were made to the Technical Evaluation Reference

Group (TERG) to replace people whose terms had expired [Decision Point 5]; the Board approved a

new memorandum of understanding between the Global Fund and Roll Back Malaria [Decision Point 6]; the

Board decided that a representative of the Partners Constituency on the Board,

a non-voting position established at the 19th Board meeting, would

have a seat on both the Policy and Strategy Committee and the Portfolio and

Implementation Committee [Decision Point 8];

the OIG (Office of the Inspector General) Charter and Disclosure Policy were

amended to clarify working relationships between the OIG and the Secretariat

and to enable the OIG to collaborate more closely with partner organisations [Decision Points 21-23]; the Board adopted

a Risk Management Framework [Decision Point

15]; and the Board authorised the Secretariat to engage in further

negotiations for the construction of a building to be leased by the Secretariat

for use as office space, leading to reduced rental costs [Decision Point 19].

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2. NEWS: Global Fund To

Implement New Funding Architecture

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The Global Fund Board has decided to

implement a new funding architecture in order to simplify processes for grant

implementers. The centrepiece is the concept of a " single stream of

funding " per PR per disease.

This article explains how the new funding architecture will work. It is

based on Aidspan’s understanding of the decisions taken at the recent

Board meeting in Addis Ababa,

and of information contained in documents submitted to the Board for that

meeting. The Global Fund Secretariat will be providing more information on the

single stream of funding in the near future.

Under the " single stream of funding " concept, where there

currently are multiple grants for the same PR for the same disease, the grants

will be consolidated into a single grant. And, in future, if additional funding

is approved for that PR and disease, that funding will be rolled into the same

grant.

If a CCM submits a proposal and nominates a new PR (i.e., a PR that is

not already implementing Global Fund grants for the same disease), and if the

proposal is approved for funding, a new grant will be signed with that PR

– but thereafter, any additional funding approved for that PR and disease

will become part of that same grant.

There will continue to be rounds of funding, similar to the current

rounds-based channel, and there will continue to be national strategy

applications (NSAs), though the rolling continuation channel (RCC) is being

discontinued. Thus, any approved proposal will lead either to a new grant (in

the case of a new PR/disease combination), or to an expansion and/or extension

of an existing grant.

The transition to the single stream of funding will occur gradually

over the next two years. During that time, there will be opportunities for

countries to consolidate several grants into one. These opportunities include

when new funding proposals are submitted in Round 10 (expected to be launched

on 1 May 2010), and when Round 9 grant agreements are signed, and when amended

grant agreements are signed as part of Phase 2 Renewal.

The Board first approved the concept of a single stream of funding at

its eighteenth meeting in November 2008. At its twentieth meeting in Addis Ababa on 9-11

November, the Board approved the implementation of the single stream of

funding, as well as a number of changes to Board policies that are required to

make it happen.

The expected benefits of the new architecture include the following:

Grant implementation and management

will be simplified, both for implementers and for the Secretariat.

Transaction

costs related to reporting and disbursements will be reduced.

The need for

formalities involved in grant closures will be removed, except when the

funding relationship with a PR comes to an end.

Support for

national programmes will be enhanced.

Performance-based

funding will be enhanced as a result of having a more transparent and holistic

view of Global Fund-financed activities in each country.

Other features of the single stream of funding include the following:

The

independent TRP process will be maintained.

Where there

are multiple PRs for the same disease, a single stream of funding will be

created for each PR.

The single

stream of funding will be closed when the Global Fund discontinues its

funding relationship with a PR.

Starting with Round 11, all proposals submitted to the Global Fund will

have to be based on a consolidated request for funding, incorporating existing

grants for the same PR and disease – or, where there is more than one PR,

a consolidated request for funding for each PR.

Each time grants are consolidated, a Single Stream Grant Agreement will

be signed by the Global Fund and the PR. These Grant Agreements will be subject

to a fixed three-year review and commitment cycle, a new feature of the single

stream of funding. What this means is that the Global Fund will make an initial

commitment for three years. Towards the end of the three years, the grant will

be subject to an in-depth performance review, similar to what is done now for

Phase 2 Renewals. If the performance review indicates that the grant should

continue, funds will be committed for another three years.

Normally, when funds are committed for another three years, the level

of funding will be similar to what it was for the previous three years. An

as-yet unpublished background paper " Architecture

Review – Progress Update " states that if the grant has

demonstrated strong performance, the CCM may apply for an increase in funding

in order to allow for scale-up of the grant’s activities. In these

instances, the CCM can ask for additional funding of up to 20 percent of the

funds allocated for the previous three years.

It will also be possible for a CCM to submit a new proposal for the

same PR and disease – i.e., if the CCM wishes to add new programmes or

activities. This would increase funding for the existing grant with that PR.

The fixed three-year review and commitment cycle is unaffected by the

introduction of new funds, which can take place during intermediate years.

Thus, if the CCM submits a new proposal for the same PR, as outlined above, and

if the proposal is approved, new funding will be committed only up to the next

scheduled three-yearly review. This enables the PR to get onto a standard

three-year cycle for all its Global Fund-related activities within a disease.

The above-mentioned background paper states that along with the single

stream of funding, the Global Fund plans to introduce some changes with respect

to information that CCMs have to provide. The Fund will create an online

applicant profile, designed to reduce the amount of information the CCM has to

provide with each application. And, beginning in Round 10, only those CCM

requirements pertaining to proposal development and PR nomination will be

reviewed at the time of proposal submission. Requirements relating to CCM

membership, as well as program oversight and governance, will be reviewed on a

regular basis and on a separate timeline by the Secretariat (in some cases

through the LFA).

The background paper adds that as of Round 10, the TRP will be able to

" select out " parts of proposals that are not technically sound while

recommending the remainder for funding.

The Board has authorised the Secretariat to negotiate revisions to

existing grant agreements that may be required to consolidate the grants into a

single stream of funding. The Board has also authorised the Secretariat, on an

as-needed basis and without Board input, to commit additional funds for a

Single Stream Grant Agreement, equivalent to up to 12 months of approved but as

yet uncommitted funding in existing grants (e.g., for Phase 2 of a rounds-based

grant that has not commenced yet).

In the event that a CCM elects to consolidate an approved Round 8,

Round 9 or NSA grant for which a grant agreement has not yet been signed, the

Board has approved exceptions to existing Board policies to allow for the

Single Stream Grant Agreement to be signed up to 18 months after the Board

approved the proposal, and to allow the start date for the Grant Agreement to

be up to 24 months after Board approval of the proposal. Current policies

require grant agreements to be signed within 12 months of Board approval, and

for the grant start dates to be no later than 18 months after Board approval.

The Global Fund says that it will produce a comprehensive

communications plan to explain the changes, together with very clear

application and guidance materials that will be developed and disseminated with

ample time before submission deadlines.

The Board decision outlining the

changes to Board policies required to implement the single stream of funding is

available at www.theglobalfund.org/en/board/meetings/twentieth

(see Decision Point 31). Other features of the new architecture are described

in " Architecture Review – Progress Update, " a paper prepared

for the Policy and Strategy Committee (GF/PSC/11/02) and referred to in the

Committee’s Report to the Board (Document GF/B20/4)

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3. NEWS: Global Fund

Offers Additional Funding for CCMs

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The Global Fund has established a new " expanded funding "

window for CCMs. The new window allows a CCM to apply for more than $50,000 a

year in funding providing it submits a two-year workplan with measurable

targets. (All references in this article to CCMs apply also to Sub-CCMs and

Regional Coordinating Mechanisms.)

The current " basic funding " window for CCMs has been

retained, but the annual ceiling for basic funding has been raised from $43,000

to $50,000.

Thus, CCMs can choose to apply either under the basic funding window

(which carries a $50,000 ceiling, and for which the requirements are fairly

minimal), or under the new expanded funding window, which provides in excess of

$50,000, and for which the requirements are more extensive.

A CCM that is currently being funded under the old funding policy

(ceiling: $43,000 a year) may submit a request to terminate the funding

agreement before its end date, and may reapply for basic or expanded funding.

If the request is approved by the Secretariat, unspent funds from the

terminated agreement will be transferred to the new funding agreement.

The new policy is in response to concerns that CCMs are under-funded,

particularly with respect to areas that are often neglected, such as grant

oversight and constituency engagement. According to the Global Fund, the

expanded funding window will promote stronger and more transparent performance

among CCMs.

Under the expanded funding window, funding requests may be submitted

once every two years. All CCMs members must sign the request. There is no upper

ceiling with respect to how much funding can be requested. However, if a CCM is

applying for funding in excess of $100,000 per year, it must demonstrate that

it has obtained 20 percent of the amount exceeding $100,000 from sources other

than the Global Fund.

As part of a request for expanded funding, the CCM must submit a

detailed two-year budget broken out by cost category and by functional area,

and a two-year workplan that includes activities and performance targets. All

CCM members are expected to be involved in the preparation of the budget and

workplan.

For funding obtained through the expanded funding window, the CCM is

required, at the end of both the 10th and 22nd months of

funding, to submit a report on expenditures and performance.

Under either the expanded or basic funding window, CCMs can apply for

funds to support the following types of expenditure:

Salary of CCM secretariat staff.

Consultancy work – e.g., technical support for core CCM

functions such as civil society participation, programme oversight and

alignment with other national bodies. (Costs for hiring consultants to

write proposals to the Global Fund are not eligible.)

Office management, including

rent, equipment and supplies, but excluding vehicle purchase or long term

lease.

CCM meetings, including travel

costs for members (and non-members invited by the CCM) to attend CCM

meetings or participate in grant oversight visits.

Communication and information dissemination – e.g., call for proposals, minutes of meetings, maintaining a

website or newsletter, translation of key information.

Organisation and facilitation of meetings and workshops on CCM capacity building, or topics related to

CCM core functions.

The Global Fund expects that, under the new policy, the costs of

providing funding for all CCMs combined may double (to about $12 million in

2011, from about $6 million in 2009). This includes staff in the Global Fund

Secretariat required to administer the policy.

The funding for CCMs comes from a separate

pool of funds maintained by the Global Fund. Grant funds had been used for this

purpose, but that practice ceased in late 2007.

The text of the new " Country Coordinating Mechanism (CCM) Funding Policy " is available in Annex 2 of the " Report

of the Portfolio and Implementation Committee, " Board Document GF/B20/5, which will shortly be available on the Global

Fund website under " Board documents " at www.theglobalfund.org/en/board/meetings/twentieth.

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4. NEWS: Global Fund Board

Approves Proposals for Phase 1 of the " Affordable Medicines Facility

– Malaria " (AMFm) Funding Stream

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At its recent meeting in Addis Ababa, the Global Fund Board approved 10

proposals under Phase 1 of a small innovative new funding programme called the

" Affordable Medicines Facility – Malaria " (AMFm), which is

designed to provide support for interventions promoting and facilitating the

use of artemisinin combination therapies (ACT).

The total budget of the approved proposals is $127 million. Of this

amount, the Global Fund estimates that $98 million will be generated through

savings in the approved countries’ existing Global Fund malaria grants,

and that a further $11 million will be provided from other sources (i.e., other

Global Fund grants, other donor funds and domestic resources). Thus, the total

incremental cost to the Global Fund of the approved proposals is $18 million.

All proposals cover a two-year period. Twelve applications were

submitted. Of the 10 approved proposals, five were rated by the Global

Fund’s Technical Review Panel (TRP) as Category 1 (no issues, or minor

issues to be dealt with during negotiations), and another five were rated

Category 2 (some clarifications required). The TRP rated two proposals Category

3 (not recommended for funding).

Applications for Phase 1 were on an invitation-only basis. Invitations

were extended to 12 CCMs. The countries were selected based on criteria such as

having a moderate to high mortality rate, and having previous experience with

large scale ACT programmes.

The following table provides more details

on the results of the Phase 1 funding process.

Country

Budget ($)

Incremental cost to the Global Fund

($)1

CATEGORY 1

Cambodia

10,965,277

9,602,617

Madagascar

2,052,437

1,190,992

Niger

2,113,024

1,701,532

Tanzania

(mainland)

12,801,955

NIL

Zanzibar

1,015,469

782,968

Total Category 1

28,948,163

13,278,109

CATEGORY 2

Ghana

22,079,553

NIL

Kenya

16,571,492

NIL

Nigeria

43,740,110

NIL

Rwanda

2

2,857,752

NIL

Uganda

12,484,998

4,270,305

Total Category 2

97,733,905

4,270,305

Total Recommended for Funding

(Categories 1 and 2)

126,682,068

17,548,414

CATEGORY 3 (Not

approved)

Benin

4,917,809

3,218,107

Senegal

3,871,837

2,355,821

1 After re-structuring of

existing malaria grants, and savings from other sources.

2 Rwanda submitted a total budget of

US$9,796,263. The TRP recommended reducing this to $2,857,752.

AMFm is an innovative financing mechanism designed to expand access to

affordable ACT drugs for malaria. ACT is currently the most effective treatment

for malaria, but ACT drugs account for only one in five malaria treatments

taken and are provided almost entirely by the public sector. Yet over 60

percent of patients access anti-malarial treatment through the private sector,

where ACT drugs make up only five percent of treatments provided. The reason

that ACT drugs are not more widely used is that they are more expensive than

other treatments.

In November 2008, the Global Fund Board approved the first phase of

AMFm, among a small group of countries, to enable lessons to be learned before

a global roll-out of the AMFm.

AMFm tries to increase the provision of affordable ACTs in two ways:

(1) by reducing the cost of ACT drugs; and (2) by ensuring that additional

activities (called " supporting interventions " ) are carried out to

assist safe and effective implementation of the AMFm. The proposals that were

just approved by the Board consist of these supporting interventions.

With respect to reducing the cost of ACT drugs, the Global Fund has

reached agreement with all eligible

manufacturers to reduce their ACT sales prices to first-line private sector

buyers to the same level as for public sector buyers. This is the first in a

two-step process. The second step is an AMFm co-payment to further lower

the prices to first-line buyers in all sectors, which will happen when those

buyers place orders. First-line buyers include international,

regional and national buyers from the public, not-for-profit and private

sectors that purchase ACTs directly from the manufacturer, or procurement

agents buying on their behalf.

The supporting interventions must include, at a minimum, public

awareness campaigns, training and supportive supervision for ACT providers,

policy and regulatory measures, pharmocovigilance planning, and programmes to

reach poor people and children. Countries are encouraged to add other

supporting interventions. For example, the majority of applications to AMFm

Phase 1 proposed the introduction or expansion of rapid diagnostic tests to

support scale-up, including undertaking operational research where needed to

inform scale-up in the private sector. The TRP welcomed this as a sound

approach to malaria case management.

The AMFm is hosted by the Global Fund, with some financial support

provided by other agencies, including UNITAID, the U.K. Department for

International Development (DfID), and the Bill and Melinda Gates Foundation.

The Roll Back Malaria Partnership (RBM) provides technical support

It is expected that once the co-payment has been applied, first-line

buyers in all sectors will be able to buy ACTs from manufacturers at an average

price of about five cents per treatment course. In the private sector,

first-line buyers are expected to pass on a high proportion of any savings, so

that patients are able to buy ACTs at a price that is competitive with other

malaria drugs such as the increasingly ineffective chloroquine, and the

undesirable oral artemisinin monotherapies. The idea, therefore, is to increase

access to ACT drugs and to displace inappropriate treatments from the market.

The AMFm will not result in separate grant agreements being signed.

Rather, funds provided for supporting interventions will be channelled through

existing malaria grants. (This will require that the relevant Grant Agreements

be amended.)

Invitations to apply for Phase 1 of the AMFm were sent on 20 March 2009.

(The invited countries are those listed in the table above.) Applicants were

provided with a proposal form and were given a deadline of 1 July 2009. The

proposals were reviewed by the TRP in a process that was separate from, but

similar to, the review process for proposals under the rounds-based channel.

Phase 1 lasts for two years. It will be independently evaluated before

the end of the two-year period. The Global Fund Board has said that the AMFm

will be expanded to a full roll-out unless significant failures are observed

during Phase 1.

More information on the results of

the Phase 1 funding process can be found in the " Report Of The Technical

Review Panel And The Secretariat On Applications To The First Phase Of The

Affordable Medicines Facility – Malaria (AMFm Phase 1), " Board

Document GF/B20/10, which will shortly be available on the Global Fund website

under " Board documents " at www.theglobalfund.org/en/board/meetings/twentieth.

The Board decision points on the AMFm proposals and Phase 1 of the AMFm can

also be found on that site (Decision Points 24 and 25).

General information on the AMFm can

be found on the Global Fund website at www.theglobalfund.org/en/amfm. Among the documents

available there are " Affordable Medicine Facility – Malaria:

FAQs, " and the proposal forms and guidelines used for Phase 1.

" Reproduced

from the Global Fund Observer Newsletter (www.aidspan.org/gfo), a service of

Aidspan. "

Forwarded

by:

---------------------------

Yours in Global Concern,

A.SANKAR

Executive

Director- EMPOWER

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