REPORT ON GLOBAL FUND CONSULTATIVE MEETING HELD IN MAPUTO 30TH SEPTEMBER TO 1ST OCTOBER 2008.

1.0 INTRODUCTION
The meeting was organised by the Global fund to fight AIDS, Tuberculosis and Malaria in collaboration with UNAIDS to discuss recommendation of the 5 years evaluation study of Global Fund partnership environment (Study Area 2) and build consensus on recommendations from the study.

MEETING OBJECTIVES
1.To obtain feedback from partners on the findings of study area 2 of the Global Fund's Five Year Evaluation
2.To identify specific actions that can be taken by the Global Fund and partner organisations in response to the findings of Study Area 2

Participants were informed that the fund needed new thinking on how it does its bussiness as per evaluation findings and therefore a more effective partnership is required to deliver best services. These consultation are important as they are expected to provide inputs to the Global Fund board retreat which will take place in mid october 2008.

2.0 PROCEEDINDGS
The meeting started by 2 presentations presented in plenary as detailed below:

2.1 NEW DEVELOPMENT AND ROUND 8 UPDATES
A presentation on the new developments in the Global Fund and round 8 updates was made. It was explained that the portiforlio has kept on expanding and by August 2008;
501 grants signed in 136 countries with a total value of US$ 8.7 billion
US$ 5.7 billion disbursed
US$ 10.7 billion in approved proposals
Just under 60% of funding to sub-Saharan Africa

The GFATM secretariat is undergoing major restructuring to cope with the growing demands. New clusters have been formed to accommodate partnerships and grater CSO engagement.

Global Fund Round 8 Updates
An update of Round 8 application was provided, members were informed that;
Application reached unprecedented scale about US$ 6.1 billion was requested
54% overall (recommended) success rate - highest ever rate of recommended proposals
68% success rate for malaria proposals
49% success rate for HIV proposals
51% success rate for TB proposals
A total of US$ 3.15* billion recommended funding (combined two-year value)
The increase is equal to 190% over Round 7

This corresponds to a total of 94 proposals worth US$ 3.15, the distribution by disease components proposals and amount is shown below.
Malaria 30% -28 proposal worth 1.62bn (51%)
HIV and AIDS 40%- 37proposals worth 1.2bn (39%)
Tuberculosis 30% -29 proposals worth 326m (10%)
Total 100% 94 proposals worth US$ 3.15bn (100%)
The meeting was also briefed on the new initiatives that GFATM is currently undertaking to improve the grants performance. The new initiatives included in round 9 will be Architecture Review for streamlining processes and encouraging National Strategy Applications. Other initiatives that were put in place in round 8 like Dual track financing and Health Systems Strengthening will continue.

2.2 REVIEW OF STUDY AREA 2 AND RECOMMENDATIONS
Brief overview of Study Area 2 was given; A study was designed to evaluates the Global Fund partner environment at global and country levels and in relation to grant performance and health systems effects. The key study questions were;
1.How effective and efficient is the Global Fund's partnership system in supporting HIV, TB and malaria programs at the global, regional and country level?
2.What are the wider effects of the Global Fund partnership on country systems?
The study conducted Country Partnership Assessment in 16 countries including interviews with over 60 partners and stakeholders in each country and review of 95 grants and their performance in countries

The study found that;
Global Fund achievement marks a major advancement of a partnership approach to development aid and a new model for global public-private partnership for health
Global Fund is a key component of a complex development architecture which is changing the paradigm of development assistance
The model of the Global Fund is a work in progress and the Partnership presents a mixed picture
Better delineations of an international division of labor is required, which cannot be accomplished by the Global Fund alone. More integrated institutional approaches be established, with systematic institutional guidance (e.g., TA, HSS, grant oversight, global partnership, development architecture)

Recommendations
The study made 17 recommendations to the Board, Secretariat, Development and Technical Partners and Partnership clusters. For detailed review of the recommendations please refer to the study area two executive summary attached for reference.

3.0 CONSULTATIVE BREAK OUT SESSIONS ON RECOMMENDATIONS
After the completion of the morning sessions the participants were split into four groups based on the broad themes prepared by the secretariat. The thematic groups for the beak out sessions were;
1.Technical Assistance
2.Grant Oversight
3.Health System Strengthening
4.Global Fund Partnership

Participation into any of the groups was voluntary according to member's areas of interest; attendance into multiple sessions was encouraged. The groups with the help of facilitators reviewed the recommendations of study area 2 and made presentations of their work in plenary the following day, where members from other groups had an opportunity to make their comments.

Issues from the Breakout Sessions
The Technical Assistance Group
Report should focus on strategic recommendations that are aligned with current GF trend to finance NSAs (programmes vs. projects).
Coordination and Management of TA needs to be build upon existing mechanisms at the country level and should not be the primary responsibility of the GF (R14 f, R15 a, b).
TA support planning and implementation should be monitored as one the indicators for performance.
Use regional meetings (UNAIDS, WHO, GF) to allow for exchange of experiences around provision of TA.
Partners should take steps to build capacity to manage TAs in countries
Provision of TA should learn from successful experiences in Malaria and TB.

The Grant oversight Group
Want to see clear voice for funding for the National Strategies (NSA).
Clarification of the role of CCM from Grant oversight to NSA oversight
Need to build capacity of PR in Sub Recipients Oversight
More emphasis on the use of existing common accountability mechanisms and structures including common performance frameworks.
Provision of clear process for transition from proposal development to NSA funding
Reporting should be aligned with the country planning cycles

Health System Strengthening Group
Country should use WHOs-HSS building blocks for proposal development
There is a need for the division of labor among partners at Global Level
Countries should develop costed HSS strategic plans and GF should buy in.
There is a need to work with IHP to support effective strategies and plans for HSS development
TAs to build capacity for HSS should be organized through WHO and regional bodies like SADCC, COMESA, ECSA and EAC.
Partners should support strengthening of the existing National strategies
GF need to make long term commitment to support HSS
Need to share Good practice.

Partnership Group
Need for clear definition of partnership and accountability of partnership
More engagement between the Fund Portfolio Managers (FPMs) and country partners
Governing board to Governing board discussion should be in the IHP context
CCMs should be strengthened based on the country architecture.
More clarity should be provided on the private sector engagement in terms of level and scope of engagement.
More specific capacity building for CSOs should be undertaken
There is a need for documenting how ownership works at country level
Need for review of partnership strategies for both good and bad partnerships.

4.0 CONCLUSION
Plenary Discussion on Architecture of the Global Fund
The last part of the plenary discussions was used to discuss issues of the architecture of the GFATM. Members provided the following recommendations
GFATM should remain a financing entity although it can tap on the policy discussions from the policy organs and technical bodies like WHO, UNAIDS and WB.
It should create partnerships and sustain the partnerships at Global and Country level.
The ongoing dialogue on architecture of GFATM is important also at local level
The upcoming partnership strategy should have incentive for partnership and bring more interaction with countries even without country presence of GFATM.