The Global Fund Country Coordinating Mechanism (GFCCM) that was established in 2002 was restructured in 2005 to the present Tanzania National Coordinating Mechanism (TNCM) in order to coordinate other funding sources beyond the Global Fund. The Tanzania Commission for AIDS (TACAIDS) is hosting the TNCM secretariat; all the stakeholders are represented in the TNCM which is under the leadership of the Permanent Secretary of the Prime Minister Office. The Ministry of Health and Social Welfare (MoHSW) is an important actor in the management of the grants (although not the Principal Recipient of all grants) as all the Programme Managers are from the MoHSW. Finally, the Ministry of Finance and Economic Affairs (MoFEA) has been identified as Principle Recipient (PR) for the recent grants. Therefore, four national institutions are strongly related with TNCM and the management of the grants: Prime Ministers' Office (PMO), MoFEA, MoHSW and TACAIDS. In addition, the Local Funding Agent (LFA) in Tanzania is the PricewaterhouseCoopers (PwC).

Tanzania GF Rounds

Round 8 proposal

Global Fund Round 8 proposal development began in November 2007 with the brainstorming meeting that brought together Programme Managers of HIV, TB and Malaria from Mainland and Island Tanzania. The objectives were as follows;

Approved and disbursed funds

Up to December 2007, the Global Fund Board has approved grants amounting to USD 610 million since 2002 for the control of HIV/AIDS, TB and Malaria. To outline important achievements and constraints in the implementation of HIV, TB and Malaria.

• To outline the technical, financial, administrative and programmatic related constraints in program management.
• To review the TORs for the Assessment of previous GF grants.
• To review the TORs for the Assessment of previous GF grants.

The meeting was followed by a general brainstorming meeting in February 2008 to form a Steering Committee that will oversee the process of proposal development, finalize the TORs for the Steering Committee and develop a Road Map for proposal development. The composition of members of the Steering Committee is as follows:

The first meeting of the Steering Committee was conducted 29th February 2008. During that meeting the initial thematic areas for the proposal were agreed as flows;

The teams of writers and peer reviewers were selected composed of members from different organizations (Government, CSOs, Private and Donor Partners Group).

The concluded thematic areas for the proposal were as follows;

1. HIV/AIDS proposal

“Scaling up HIV/AIDS Prevention, Care, Treatment and Support through Health Systems Strengthening. The proposal strategic areas included:

Addressing Commodities Gap:

• Procurement of drugs and laboratory supplies for HIV positive individuals (ARVs, OI medication and prophylaxis, CD4 and chemical analyzers).
• Scaling up of prevention interventions such as PMTCT, Condoms availability and distribution, STI medication scaling up of testing capacity across the country.

Catalytic funding to identify and unlock key systemic bottlenecks

• Human Resources for Health
• Strengthening procurement and logistics functionality at MSD
• M & E functionality within MoHSW
• Operational Research around critical health system issues given scaling up of services Strengthened Coordination
• TNCM Secretariat to be a strong repository of knowledge and technical capacity which is critical to support the TNCM in its decision-making, as well as drive decisions made by the TNCM to action via the relevant entities both within and outside Government
• TACAIDS in its national role as the lead entity in galvanizing a multi-sectoral response to the epidemic
• MoHSW - activities that NACP runs are absorbed into the full ministry and NACP is able to play a technical advisory role.Â

2. Malaria

“Scaling-Up for Impact: Achieving Universal Coverage with Long-lasting Insecticidal Nets for Tanzania. Population coverage with insecticide-treated nets remains insufficient to achieve a community-level impact on malaria transmission in Tanzania. As a strategy rapidly to increase community-level ITN coverage and achieve a significant reduction in transmission of malaria, a one-time universal campaign to distribute long-lasting insecticidal nets (LLINs) to all households will be conducted in 2010. Infrastructure established to distribute LLINs to all children <5 years of age in 2008 will be used to implement this broader campaign to achieve universal coverage. The combination of the Under Five Catch-up Campaign and the proposed Universal Coverage campaign will deliver an average of 2.5 nets to every household in mainland Tanzania and will ensure that all Tanzanians have the opportunity to sleep under an LLIN. The objective is to attain universal net coverage through the distribution of approximately 13 million additional LLINs to 8 million households through a one-time mass campaign (catch-up) on mainland Tanzania in 2010.

The proposal was finalized and submitted to Global Fund headquarters on 1st July 2008.