Synthesis of the Information-Sharing Meeting on the
Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)

Organized by the World Health Organization, South East Asia Regional Office (WHO/SEARO)

(Dhaka, Bangladesh, 21-24 July 2002)

The following report consists of an overview of the submission process in the Region and contains useful tips and recommendations.

Goal

To achieve the highest possible success rate for the second round of applications by South East Asian Region (SEAR) countries to the GFATM.

Profile of Expected Second-Round Applications by Components by SEAR Countries

SEAR	1st round, categories 1&2	Second-round applications
		HIV/AIDS	TB	Malaria	Regional proposal
1. Bangladesh		Yes	Yes	Yes	AIDS, TB and Malaria: India/Nepal/ Bhutan/ Bangladesh
2. Bhutan		Yes	No	Yes
3. Indonesia	TB, HIV, Malaria	Yes	No	Yes
4. India	TB	Yes	No	Yes
5. DPR Korea	TB	No		Yes
6. Maldives		Yes	No	No
7. Myanmar		Yes	Yes	Yes
8. Nepal		Yes	No	Yes
9. Sri Lanka	TB/Malaria	Add care-supports to resubmission	No	No
10. Thailand	TB, HIV	Yes	No	Yes	AIDS, TB and Malaria: Thailand-Cambodia
Total	9	9	2	8	2
Grand total		21

Our target: a minimum of 70% success rate = 15 components.

Action Points by WHO and UNAIDS

1. In order to prepare quality proposals, WHO and UNAIDS will actively provide technical support to member states and also mobilize resources outside WHO and UNAIDS e.g. bilaterals and multilaterals who are active in the three diseases.
2. WHO/SEARO will hold an "internal peer-review process" for the draft proposals before submission to the Global Fund (GF), three weeks prior to the closing date, to allow time for final revision. This process includes inviting experts in the three diseases to review the proposals, and cross-cutting expertise to review the final draft proposal (submitted by members on a voluntary basis). This would mean that draft proposals are sent to identified peer reviewers; member countries do not need to be physically present for the review. The peer reviewers will provide written comments back to the CCMs (which the CCMs are free to use or not, as they wish).
3. WHO/SEARO may expand the mandate and terms of reference of the existing Regional Task Force on HIV/AIDS to include malaria and TB. This Task Force will provide relevant technical support to countries upon request in both the upstream and downstream processes of the GF.
4. The first meeting of the GFATM Procurement Task Force will be held in Washington, DC on 8 August 2002. WHO/SEARO and theGFATM Board member from SEAR will solicit recommendations from members on the procurement of commodity, drug, supplies, diagnostics inputs and stance for this meeting. Key concerns for this meeting will be the following: lowest possible price; quality; pre-qualification; transparency; adequate and regularity of supplies; generic products; long-term programmatic sustainability; economy of scale; administrative cost of procurement; country-led process; existing procurement mechanisms, e.g. the global drug facility for TB, TRIP and DOHA (declaration, free trade and health). This process should be finished by 1 August 2002.
5. WHO/SEARO will compile and distribute information regarding the status of pre-qualification of drugs, supplies and other commodities relevant to AIDS, TB and malaria.

Action Points by the Global Fund Board and Secretariat

1. The GF will bear in mind that the appointment of the local funding agency (LFA) should be a "country-led process" and should not be "imposed". In fact, the name "local funding agency" should be recast to read as “local support agency” (LSA). During the deliberations in this four-day meeting, it was stated that an attempt will be made to finalize the appointment of LFA/LSA within the next 15 days. The SEAR countries have drawn attention to the need for capacity-building of local/national institutions of world repute, who can most feasibly be entrusted with the role of LFA/LSA. Besides, the SEAR countries are unanimous that for the health sector—particularly for issues like burden of disease, disease surveillance and prevention, care, support and treatment of diseases—funds be entrusted to the Global Fund to Fight HIV/AIDS, TB and Malaria. The WHO would be the most appropriate LFA/LSA. The final say regarding LFA/LSA should be a joint decision by both the countries concerned along with the GF secretariat, and not of the GF secretariat alone. Besides, the precise role and responsibility of the LFA/LSA needs to be clearly articulated in consultation with the country concerned.
2. Ensure that the resource allocation from the Global Fund reaches the most needy countries and vulnerable populations. There must be some assurance that principles of equity will be observed while making the resource allocation, such that the needs of the country—as well as the burden of disease and vulnerability of population—not be overlooked. Additionally, equity in regional share must be kept in mind.
3. Among these needy countries, the GFBoard will create a special mechanism to actively support these country to come up with a quality proposal and strengthen these three programmes. This special mechanism should consist of an inter-active TRP, interacting with the country whose candidate proposal is under consideration. At present, the TRP appears to be a one-time review mechanism that does not permit revisions and re-submissions. SEAR countries need assurances that the TRP will provide sufficient opportunity to the country concerned for interaction as well as revision of the candidate proposal during the process of TRP review, prior to placement of the candidate proposal before the Board of the Global Fund.
4. Ensure the quality and comprehensiveness of general comments, specific comments, strengths, weakness and recommendations made by the TRP members to individual proposals according to international standard of peer reviews.
5. Board members from the SEAR constituency ensures that Board and related Working Group meeting dates and agendas will be transmitted to all members in SEAR for active participation in the deliberation in the Board by SEAR members. During the deliberations, a view prevailed that there must be broader participation by SEAR countries in the next Board meeting, in particular by those countries that have so far not received any share of the allocation, as well as those countries that have received a very minimum allocation. Accordingly, the view prevailed that Nepal, Myanmar and Maldives, Bangladesh, Bhutan and India must participate in the next Board meeting.
6. Candidate proposals with respect of HIV/AIDS, TB and Malaria typically comprise 5-6 activities. SEAR countries urge that, if one single activity is found not technically sound or in some manner not feasible, then the remainder activities should be approved if these are found to be feasible and technically sound. The entire proposal should not be rejected out of hand.
7. SEAR countries observed that, although the GF gave an extremely limited time for finalization and submission of first-round proposals, now that the first round is over the GF itself is not in a position to implement its own initial approvals with respect of successful proposals. Since many countries from this Region have not succeeded in this first round, and furthermore since a great deal of regional and technical peer-review needs to precede the final submission of proposals for the second round, it is urged that some provision be made for late submission of candidate proposals provided reasonable and adequate justification is given. Candidate proposals submitted by the currently stipulated deadline of 27 September 2002 should, however, by placed in the review process.
8. SEAR countries urge that, with regard to procurement systems, pre-existing internationally accepted systems may be utilized wherever these are in place. It would be more appropriate to use these existing systems and make processes simpler rather than more complicated, and not reinvent the wheel.
9. SEAR countries urge that mechanisms be put in place by the GF to directly provide regular information to the CCMs, instead of exclusively depending upon the Board representative from the SEA Region.
10. Finally, the SEAR countries urge that the Global Fund make regular and frequent use of the internet. All successful proposals may be placed on the internet.

Action Points by Countries

1. Prepare a strong and quality proposal (with several components) according to the guidelines and revised form; take into account the national programmatic framework and that of the GF. The most difficult parts are Sections 26 and 27.
2. Ensure that section 2 of the application form on CCM is completed, as it will be scanned and screened by the Secretariat before transmission to the TRP. Bear in mind that the size and composition of the CCM membership should be broadly representative but manageable.
3. Make sure to get the signatures of all CCM members.
4. Ensure that the final draft proposal arrive at WHO/SEARO for the internal peer review process (if so desired) at least 3 weeks prior the closing date of 27 September 2002.
5. Countries with approval from the first round: Decisions on LFA and the PR in consultation with the GF secretariat and the Trustee should be made as soon as possible.
6. Active participation in the Board meeting, through e-mail communication before the Board meeting and physical presence.

Action Points by Other Development Partners (multi- and bilateral)

1. To actively participate in the CCM at the country level.
2. To become involved in the support of proposal preparation.

Timelines

1. At regional level: 21-24 July 2002: Information-Sharing Meeting, Dhaka, Bangladesh.
2. At country level: Series of working sessions, meetings for the preparation of applications, active participation by CCM, soliciting signature by CCM members.
3. Internal peer-review process
• Final draft proposals arrive on a voluntary basis to SEARO:Friday 6 September 2002.
• Let say one component be seen by two internal peers (within SEAR) with thorough written comments (act as if they are the TRP), work through e-mail. A format for comments will be provided.
• Internal peer-review process with face-to-face discussion: Wed to Fri 11-13 September 2002.
• Compilation of all feedback to proposers by Monday 16 September 2002 via e-mail. Ensure Jai has all e-mail addresses!
4. Countries should feel free to agree or disagree with comments made by SEAR internal review processes.
5. Closing dates for proposals to GF Secretariat: 27 September 2002.

Other Related Timelines

1. 8 August 2002: 1st meeting of Procurement Task Force meeting Washington DC.
2. 4 September 2002: meeting of Working Group on Proposal, Geneva (work procedure of TRP, participation by WHO/UNAIDS in the review process).

Tips Arising From the Meeting

1. Read the guidelines and the form thoroughly. Ask for advice when needed.
2. Answer all the questions.
3. Regional proposals are much more difficult, with more efforts being made— especially when having several regional proposals.
4. Integrated proposal versus stand-alone components in a single proposal: risk of "all or none" for integrated proposal.
5. Technical—not just purely academic—expertise, is needed to understand the programmatic issues of the three diseases.
6. Strike a balance with budget items (reasonable proportion of administrative costs).
7. Allocations of resources to other implementing partners (Table 33).
8. Issues for TRP: if some objectives and program activities under one disease component are found to be unsatisfactory, what should the TRP recommend?