What are the ways the Global Fund can strengthen the effectiveness of its country-level partnerships to improve outcomes and impact for the three diseases?
The Global Fund to Fight AIDS, Tuberculosis and Malaria was created as a global partnership that has an operational architecture based on a series of assumptions that included the following:
- The Global Fund would not need a country presence as partners (mainly multilateral United Nations organizations and bilateral agencies) would represent the Global Fund partnership at the country level;
- The Global Fund would not need to provide a global or regional mechanism for technical assistance to countries, as other resources would be available for this support; and
- Providing long-term comprehensive support for country HIV, tuberculosis and malaria responses would remain key priorities for all of the partners involved. As part of this landscape of national and global stakeholders, the Global Fund had a very exclusive and clear mandate – the mobilization of significant additional and sustainable resources to address the three diseases. At the country level, the model was for the Global Fund to rely on its partnership model to make the funding work.
In the 10 years since its creation, there has been a growing diversity of the challenges in health, and also the number of state and non-state actors involved. Against this changing landscape, the goal of a fully complementary partnership architecture remains – in line with the 2005 Paris Declaration on Aid Effectiveness, and the 2008 Accra Agenda for Action. At the global level - this sense of shared responsibility has increased and memoranda of understanding are regularly signed to ensure clarity in global level partnership arrangements.
However – at the implementer level - countries report that they experience overlapping and sometimes conflicting messages regarding:
- The mechanisms through which sustainable, predictable funding can be accessed on a timely basis;
- Ways in which to integrate the funding priorities of partners into national planning cycles; and
- Where and how to source management and technical support.
Specific to the Global Fund, there are a small number of instances where operational agreements are currently being developed with partners at the country or regional level. These are being explored as a potential mechanism to complement the overarching collaboration frameworks that are being set in global level memoranda of understanding.
Whether it is through an expanded number of these operational country-level agreements, or some other mechanisms or approach, there appear to be a number of opportunities to strengthen the Global Fund’s partnerships and engagement model.
Without limiting the range or focus of potential strengthening measures, some of the areas of focus may include ways to:
i. Increase the level of participation and representation of implementers in Global Fund governance mechanisms – directly, or via increased engagement with other partnerships – to more effectively engage countries in a dialogue on implementation issues that adversely affect program outcomes, and the necessary Global Fund policies and strategies to address challenges arising;
ii. Improve the routine provision of coordinated management and technical assistance for implementers – with a focus on ways to stimulate the more routine inclusion of implementation support in national strategies and underlying implementation plans, and also address potential under-spending when management and technical assistance support is included in program budgets;
iii. Build or further strengthen the managerial and planning capacity of implementers through increased engagement of partnerships with proven capacity. Examples may include a strengthened engagement model with the private sector at the country level; and
iv. More clearly define the roles and responsibilities of partners, and the Global Fund’s engagement with them, both at the country and regional levels.
Further reading on this topic
Briefing Note on the role of the Global Partnership on Country Systems
Paris Declaration on Aid Effectiveness
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