Technical Support Needs of Indigenous Civil Society Principal Recipients of Global Fund Grants

7/29/2019 Technical Support Needs of Indigenous Civil Society Principal Recipients of Global Fund Grants

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Copyright ICASO, 2012

until we end aids

Techn ica l Suppor t Needs

of I nd igenous Civ i l Soc ie ty Pr inc ipa l Rec ip ients

of G lobal Fund Grants


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2

Abbreviations 3

1 Introduction and aim 4

2 Methodology 5

3 What it takes to be a Principal Recipient 6

31 Minimum capacity requirements 7

32 Process and role of PR 8

33 Special considerations for CSOs becoming PRs 10

4 CSO needs for technical support 12

41 The decision to seek a CCM's nomination to be a PR 14

42 PR Nomination and proposal development 16

43 During the LFA Assessment andgrant agreement negotiations 1844 Implementation 20

45 Post-grant "exit" strategy 22

5 Who will provide technical support? 24

51 Current and potential sources of TS 24

52 ICASO role 25

6 Conclusions 26

7. Recommendations 28

8. Reections 30

9 Annexes 31

Annex 1 Form of the survey 31

Annex 2 Respondents and interviewed experts 33

Table o f Contents


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3

Abbrev ia t ions

ANCS National Alliance Against AIDS from Senegal

(in French Alliance Nationale Contre le SIDA)

CCM Country Coordinating Mechanism

CSAT Civil Society Action Team

CSO Civil Society Organization

CSS Community Systems Strengthening

DTF Dual Track Financing

ICASO International Council of AIDS Service Organizations

LFA Local Fund Agent

M&E Monitoring and Evaluation

MENAHRA Middle East and North Africa Harm Reduction AssociationOSI Open Society Institute

PLHIV People Living with HIV

PR Principal Recipient (in the Global Funds projects)

PSM Procurement and Supply Management

RAA Romanian Angel Appeal

RBP+ The Burundian Network of PLHIV/AIDS

(in French Rseau Burundais des Personnes Vivant avec le VIH/SIDA)

RHRN Russian Harm Reduction Network (also known as ESVERO)

SAT Southern African AIDS Trust

SOGI Sexual Orientation and Gender Identity policy

SR Sub-recipient (in the Global Funds projects)

SSR Sub-sub-recipient (in the Global Funds projects)

TS Technical Support


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1 . I n t roduct ion and a im

The Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) is among the largest and most

important mechanisms through which developing nations access resources to combat persistent

epidemics of each disease In recent years, civil society organizations (CSOs) have played increasingly

important roles in the context of the Global Fund framework Particularly, the number of CSOs assuming

the role of Principal Recipients (PRs) has grown With this role comes an ethical and legal responsibility

to achieve results Being a PRwhether from civil society, government, or other sectorsrequires great

commitment, strong management systems, programmatic expertise, and the ability to maintain diverse

partnerships Experience shows that while they are often very successful in achieving results, CSO PRs,

particularly from national indigenous groups, have specic needs and challenges, as well as a growing

body of experience that can be usefully shared

This report analyses the technical support needs of indigenous CSOs1 in building their capacity to

be effective PRs It examines the perspectives of recent CSO PRs and collaborating stakeholders on

successes and possible ways to overcome the most common challenges for indigenous CSO PRs with

technical support and capacity building The intended audience of the report includes stakeholders

involved in Global Fund processes, technical support providers, and other partners Additionally, CSOs

which are considering taking on the PR role may nd the report useful.

1 In this report, indigenous civil society groups are understood as groups initiated, established and led by local,

stakeholders CSOs that are branches of global networks and large CSOs are not regarded indigenous CSOs

Note: Research for this report was conducted in 2010

In 2011, the Global Fund announced major changes to its granting mechanism, resulting

in the New Funding Model (NFM). While there are signicant differences between the NFM

and the former, rounds-based funding model, most of the PR role remains intact Therefore,

the insights obtained for this report remain relevant and useful for a variety of stakeholdersHowever, further research will need to be conducted within the context of the NFM, so that

perspectives on new procedures can be gleaned Where appropriate, this report indicates

and comments on policies and procedures associated with the NFM


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2 . Methodo logy

Many of the CSOs taking on the PR role are international organizations or groups afliated with major

international organizations, such as PSI, Care, the International HIV/AIDS Alliance, and World Vision

ICASO narrowed our analysis to the needs of indigenous CSO PRs as they often have less access

to technical assistance. After the review of current PRs identied through the Global Funds online

database, in consultation with the ICASO partners in the CSAT1 initiative team and the Global Fund

Secretariat, a sample of CSOs was identied. Eleven of them agreed to participate in the survey.

These included three that were not yet PRs; one that was undergoing assessment and negotiations

with the Global Fund; one that had submitted a failed regional application in Round 9 but that was to

be resubmitted in Round 10; and one that was nominated as PR but failed to demonstrate sufcient

capacity during the LFA assessment All major geographical regions were covered: Sub-Saharan

Africa (3 CSOs), Middle East and North Africa (1), Eastern Europe and Central Asia (3), Asia (3) andLatin America/Caribbean (1) A standard English questionnaire was used for the survey (see Annex

1) As translation (French and Russian) was arranged only at the request of respondents, language

barriers may have compromised the comprehensiveness or quality of some responses In addition,

ve experts in the eld were intervieweda combination of organizational and technical support

providers and staff of the Global Funds Civil Society Partnership team A full list of individuals and

organizations that were contacted for the report is provided in Annex 2 The interviews and surveys

were conducted in May-July 2010

Since the CSO PR representatives who were interviewed expressed views on experience over the

prior 1-6 years, some recent developments in the Global Funds policies are not reected, such as

the possibility for PRs to use the Global Funds grants for technical support (TS) in preparation for

new projects, the requirement to have costed TS plans in preparation for implementation, or new

recommendations to dedicate 3-5% of requested budgets to management and technical support

in new applications to the Global Fund (starting with Round 10) As noted above, this research was

conducted prior to the development and announcement of the New Funding Model, and therefore

reections on the NFM are not included.

1 The Civil Society Action Team (CSAT) was a civil society-led global initiative that coordinated, brokered and

advocated for technical support to civil society organizations implementing or seeking grants from the Global Fund to

Fight AIDS, TB and Malaria


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3 . What i t takes to be a Pr inc ipa l Recip ient

the nominated PRs [should] understand what their rolesand responsibilities are. There is a need and a role for

indigenous NGOs as PRs, but they need to be clear aboutthe various pros and cons of the PR role.

To facilitate grant management, the Global Fund requests theCCM to propose one or a few suitable Principal Recipients

(PRs) at the country level to be legally responsible forprogram results and nancial accountability. PRs receive

periodic disbursements of funds directly from the GlobalFund employ these funds towards the implementation ofthe approved proposal, and periodically report on progress

... to the Global Fund and CCM.

Sh

annonKowalski,

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3 . 1 . M in imum capac i ty requ i rementsPRs from all sectors must have certain baseline capacities As many CSOs may not have been

originally built for roles such as Global Fund PR, it is important that these capacities be assessed The

minimum capacity requirements fall into ve categories: Financial Management and Systems, Program

Management, Sub-recipient Management, Pharmaceutical and Health Product Management, and

Monitoring and Evaluation Systems

Selected & Abridged Detail of PR Minimum Capacity Requirements

(a) Financial Management and Systems that:

(i) Accurately and promptly record all transactions, disbursements and balances;

(ii) Disburse funds to SRs, procurement agents and suppliers in a timely and

accountable manner;

(iii) Maintain an adequate internal control system;

(b) Program Management Capacity and Arrangements including:(i) Effective organizational management and transparent decision making and

accountability systems;

(ii) Adequate infrastructure and information systems to support grant implementation,

including the monitoring of performance of SRs and outsourced entities in a timely

and accountable manner

(c) Sub-recipient Management Capacity, including:

(i) Effective systems for undertaking SS capacity assessments and providing TS as

needed, to ensure that any proposed SRs have the required capacities to implement

the program activities;

(ii) Adequate management arrangements that ensure PR oversight of grant

implementation at the SR level facilitating effective and timely program

implementation and resource management by SRs

(d) Pharmaceutical and Health Product Management Systems that:

(i) Procure, store and distribute health products in accordance with

Global Fund PSM policies

(e) Monitoring and Evaluation Systems that:(i) Collect and record programmatic data with appropriate quality control measures;

(ii) Support the preparation of regular reliable programmatic reports; and

(iii) Make data available for the purpose of evaluations and other studies 1

Complete requirements and assessment tools are available

in LFA guidelines for the PR Assessment, March 2011
https://www.google.com/url?q=http://www.theglobalfund.org/documents/lfa/LFA_PRAssessments_Guidelines_en/&sa=U&ei=FRLKUJH4NuSRiQeI14CYBw&ved=0CAkQFjAB&client=internal-uds-cse&usg=AFQjCNEduoMdWIkFwQ9C8exSmR7BsKMlmAhttps://www.google.com/url?q=http://www.theglobalfund.org/documents/lfa/LFA_PRAssessments_Guidelines_en/&sa=U&ei=FRLKUJH4NuSRiQeI14CYBw&ved=0CAkQFjAB&client=internal-uds-cse&usg=AFQjCNEduoMdWIkFwQ9C8exSmR7BsKMlmA


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3 .2 . Process and ro le o f PR

PRs are selected and nominated by Country Coordinating Mechanisms (CCMs) Typically CCMs use a

nominating process through which potential PRs submit expressions of interest However, in the NFM,

a Country Dialogue, led by the CCM, is intended to include various stakeholders, and presumably all

serious potential PRs This Country Dialogue will likely be the process in which potential PRs (and some

SRs) make expressions of interest

The CCM is responsible for submitting the proposal (or Concept Note in the NFM) to the Global Fund

After a successful technical review of the proposal (which may have several iterations), the proposal

is sent to the Global Fund Board for approval Once the Global Funds Board approves a proposal,

nominated PRs undergo assessment of their capacity by the Global Funds Local Fund Agent (LFA)

The LFA provides recommendations on whether nominated PRs have adequate capacity for grantimplementation and how that capacity could be strengthened in a timely and cost-effective manner LFA

recommendations may be incorporated into the Global Fund and PR agreement as a condition of the

grant Based on the LFA assessment results, the Global Fund can decide not to sign the agreement

with the nominated PR and ask the CCM to nominate a new PR

Allocation

Formula

Band

Allocation

NSP

Support

NSPInvestment

Case

TRPREVIEW

BOARDAPPR

OVAL

UNFUNDED

QUALITY

DEMAND

INCENTIVE

FUNDING

INDICATIVE

FUNDING

RANGE

Country

Dialogue

Concept

Note

Grant-

making

Determine/

ApproveAdjusted

Funding

Amount

Figure 1: New Funding Model, Step-by-Step Process1

Adapted fromThe Global Fund Website
http://www.theglobalfund.org/en/activities/fundingmodel/process/http://www.theglobalfund.org/en/activities/fundingmodel/process/


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Once the grant agreement is signed, a PR is responsible for program implementation, thus for achieving

results, disbursing funds and reporting progress The PR reports to the CCM and must secure its

endorsement of all workplans and budgets Also, the PR submits disbursement requests and program

and nancial reports to the GF, and provides access and information to the LFA for the required

program progress verications. It negotiates adjustments to the grant workplan and budget, program

continuation, and has overall responsibility for planning and implementing grant closure Full details are

available inThe Global Funds Operational Guide: The Key To Global Fund Policy and Processes

Figure 2: Funding and reporting mechanisms including role of PRs in the Global Fund1

Adapted from The Global Fund Fiduciary Arrangements for Grant Recipients

The Global FundCCMPrepares and

submits proposals

Selects

principal recipient(s)

Provides governance

during implementation/

oversight of PR

Monitors Impact

Local Fund

Agent

Trustee(World Bank)Sub-recipients

Board

Technical

Review Panel

Secretariat

Principal

Recipients

Academic/Educational

Sector

Government

NGOs/CBOs

PLW Diseases

Private

Sector

Religious/

Faith-BasedOrganizations

Multi-/BilateralDevelopment

Partners

ADVISEGRANT AGREEMENT

REPORTS

PROPOSAL

FUNDS

FUNDSREPORTS

APPROVAL

TECHNICAL REVIEW

SCREENING

INSTRUCTIONTO DISBURSE

ASSESSMENT
http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/documents/core/grants/Core_Fiduciary_Arrangements_en/http://www.theglobalfund.org/documents/core/grants/Core_Fiduciary_Arrangements_en/http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/


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3 .3 . Spec ia l cons idera t ions for CSOs becoming PRs

Most experts agreed that the trend toward having more civil society groups serving as PRs is a positive

development that should be supported Adequate capacity is essential for a CSO in the role of a PR, but

there are other important factors to consider The PR role might be attractive for CSOs, particularly due

to the power and resources it confers, but the decision to pursue this role should be driven by country

needs Becoming a PR can change the nature and size of the organization, and its relationships with

other CSOs and the CCM

Reasons that are often given as to why NGOsconsider becoming PRs are: to increase access to

resources by CSOs and by extension to communities;to build indigenous capacity and promote sustainable

development; and organizational growth. Dangers citedinclude lost of identity and inability to meet both their

original mandate and the new PR mandate.Felicitas(Flanny)

Chiganze

,

SouthernAfr

ican

AIDS

Trus

t

There is traction in getting more CSOs to be PRs. It isgood generally. But a number of NGOs choose that

because of money, not realizing that it will change theirorganization so much. Often they cannot make an

informed decision.LeeAbdelfadil,

I

nternationalHIV/

AIDS

Alliance


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11

Being a PR often requires organizations to step away from their core identities as advocates and direct

implementerswhich they may have spent years developingto take on the primary role of managers

of large projects with multiple implementers This may represent a major shift for organizations that

have focused on advocacy and government accountability: after becoming implementers, its not them

that hold government and others accountable they are accountable to others, one expert noted

Similarly, CSO PRs may experience challenges with other CSOs, as their relationship evolves, particularly

with watchdog organizations and new SRs When CSOs become PRs, their relationships with other

implementing CSOs are substantially dened by legal contracts and a newfound power relative toorganizations that may have been on more equal footing in the past They now have to assume the role

of funders with oversight and TS responsibilities, and may have to decline future funding to SRs if there

are problems with grant deliverables

Government-dominated CCMs may have less understanding of the role of CSOs and often make the

decision to nominate a CSO as a PR because the GF recommends doing so, rather than because they

recognize civil society as a key partner Thus even at early stages when CSOs are being considered as

PRs and indicate their capacity building needs, it is often difcult for them to convince CCMs to include

sufcient technical support for management and other areas. Building CCM understanding of the

importance of civil society leadership can be a long-term process, requiring the participation of numerous

stakeholders, including the Global Fund Secretariat, UN agencies, and other CSOs

Importantly, as one expert pointed out, the question of which organizations should become PRs

should only be posed once there is an understanding of local needs and agreement on how the

response should be shaped It might require consensusamong government, civil society and affected

communitieson how to build health and community systems, ensure their continuity, and build

capacity The Country Dialogue component of the NFM should aid in this process


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Nearly all CSOs need some capacity building assistance in order to be successful PRs CSOs should

have a capacity building plan that encompasses a variety of needs and modes of TS and involves one

main consultant TS provider Such work was successful in Lesotho where the Southern African AIDS

Trust (SAT) provided support to the Lesotho Council of NGOs to prepare for and implement the PR

role. Even CSOs with signicant capacity should make honest assessments of themselves, as thereare most likely areas for capacity enhancement

PRs and experts emphasized that TS and capacity building should start with an assessment and

TS providers should insist on a needs assessment before providing the TSa step that was

identied as a top recommendation to TS providers by surveyed CSOs. TS must be practical and not

generic; knowing the context and local language is important Moreover, the consultants should be

accountable to PRs

4 . CSO needs for techn ica l suppor t

Identication of needs [for technical support] wasbased on the trial and error method.

Lank

aJatikaSarvodaya

Sharm

adanaSangamaya,

SriLanka(currentPR)

Sometimes [it] is difcult to understand the various,creative and committed ways that Ecuadorian NGOs useto sustain their capacities. We dont have public resources

and mainly depend on projects. [] It is necessary toinclude institutional support in grants.

Kimirina,

Ecuador

(currentPR)


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13

Technical support

Typical forms of technical support include:

Short-term consultancies

Workshops and trainings

Interim management and secondments

Personnel mentoring and coaching

1

Adapted from GTZ (2010) Summary of technical support provided by the German BACKUP Initiative for the development of

proposals to the Global Fund

Key points

CSOs interested in the PR role should have a comprehensive capacity building

plan to address various current and anticipated needs for the PR role Planning

should take place proactively and early on, and should acknowledge the need

for external support

Before starting TS, TS providers should (re)assess the CSOs capacity needs

and other demands related to the changing roles of the CSO
http://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdf


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4 . 1 . The dec is ion to seek a CCM's nominat ion t o be a PR

For most CSOs surveyed for this report, the decision to apply for the PR role was made by their boards

and senior management Once the decision was made, the groups often initiate strategic planning

and/or a management assessment The PR role was a natural next step for groups with Global Fundexperience All the experts interviewed for this study pointed out that the decision is not always rooted in

what is best for the national response, but rather in a groups self-interest

Reasons CSOs Seek PR Position

The opportunity to expand actions to tackle high burdens of disease

A lack of management capacity among other local groups

A desire to more effectively channel funding to civil society groups

The need to ll gaps in reaching underserved and marginalized groups

Seen as essential for sustainable development

Pressure from network members

None of the surveyed groups sought specic TS during the decision-making process, but most

used strategic planning as a necessary step after the decision was made The decision, as some

recommended, requires a rm understanding of Global Fund guidelines and requirements. Many

reported that TS for this was needed and that they received it through the Global Funds online

resources, workshops, the GF Secretariat, or existing PRs At the time of this research, there were noclear specialized TS providers for this process, and funding to support potential PRs for their decision-

making was extremely scarce

Deciding and preparing for a PR nomination is the mostimportant stage. People tend to forget its importance.

LeeAbd

elfadil,

Interna

tional

HIV/A

IDS

Alliance


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15

Key Technical Support Needs at This Stage

Guidance to the key documentation of the GF requirements, guidelines, and

policies that affect PRs specically, including a possible self-assessment.

Peer and other groups advice on advantages and possible implications of the PR

role on the organization, if or how to balance advocacy, direct service provision and

management roles and changing relations with other CSOs and partners as well as

how the PR role could help address local needs

Mentoring through strategic planning that would include honest discussions

about the reasons for becoming PR among other steps and conclude with the

CSOs decision

Help to review the practical steps in the next phases of becoming a PR (once

the decision is made), including communication with the CCM and building capacity

Nonetheless, experts emphasized the need for a comprehensive and honest review of the implications

of becoming a PR within the CSO and externally with other stakeholders This should include a

review of the organizations mission, relationships, and capacities, leading to a decision on the role

the organization believes is most appropriate: manager, implementer, watchdog, or advocateor

combination thereof

However, in order to receive this support from TS providers, a CSO would rst be required to identify

its needs, to trust the TS providers assistance and to be open about its capacities and reasons for

pursuing a PR role Strategic planning before the decision is highly recommended by experts The

Country Dialogue in the NFM may provide a critical venue for the delivery of TS at this stage

Key points

CSO Board and membership, in consultation with management and external

partners including other CSOs, should lead the decision-making process

Preferably, strategic planning should take place before the decision is made

External advice should not be underestimated and should come from TSproviders, current or former PRs, including CSOs, as necessary


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4 .2 . PR Nominat ion and proposa l deve lopment

Once the decision to seek nomination is made by a CSO, most of them start their capacity building

process, as well as work to secure the CCMs nomination, and to develop and defend workplans andbudgets within the countrys proposal Most groups had their capacity assessment at this stage, often

using internal resources But most capacity building processes take place at a later stage, once the

nomination and grant are approved

Surveyed CSOs and experts suggest that PR candidates have their capacity assessed as early as

possible, with external help, to analyze workload and nancial needs for a comprehensive administrative,

management, sub-granting, nance, and M&E review. Consultation with UNAIDS, the Global Fund or

other multilateral organizations, or with other PRs (CSO or otherwise) have been helpful Preparatory

workshops have also helped to build understanding of: new Global Fund guidelines, how to better

address capacities for submitting applications, and other key PR competencies The capacity buildingneeds of CSO PR candidates should be dened and budgeted in proposals to the Global Fund.

CSOs report varying experiences with CCMs regarding nomination and proposal development Medicam

needed to present their candidacy for the PR role at least twice to convince the government to nominate

the organization From its experience, Ecuadorian PR Kimirina noted that the participation of an external

mediator is the key to making good decisions on nominations and work plans since CCMs usually have

members with competing interests ANCS also noted that the involvement of international colleagues in

negotiations and prioritization of civil society interventions was very effective In general there is a need

to prepare arguments that convince government representatives and other partners why a civil societyPR should be nominated (besides that it is recommended by the GF) and why the proposal to invest in

civil society capacity should be approved

Before the proposal writing process [began] many

national stakeholders were involved as TS providers ,[and] specic consultants were hired. Such TS appearedto be extremely helpful while preparing the Global Fund

application for being a PR.All-Ukra

inian

NetworkofPLHIV

(current

PR)


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17


External mediation of proposal development and PR nomination process within CCMs; Guidance on the proposal form (or Concept Note) and related tools;

Guidance on advocacy, budget arbitration and allocations for civil society PRs;

Analyses of needs and gaps in the current health environment

Overall, strong CSOs with leadership roles and true involvement in the CCM are reported to contribute

signicantly to effective discussions around PR nominations and development of country proposals.

Again, it is anticipated that the Country Dialogue and Concept Paper mechanisms in the NFM will

help facilitate this process

Key points

CSOs need to be supported to assess their capacity to become PRs

TS to CCMs that GF and technical partners provide should pay special

attention to building a better understanding of the roles and needs of CSOs

and MARPs, including through documentation and promotion of their

contributions and needs

Dual Track Financing, coupled with the requirement to include a TS plan in

proposals is a positive step

Surveyed organizations often had the capacity to develop project proposals through their past

experience as SRs or PRs but support on issues such as integrating different program components,

developing procurement and supply management plans or budgeting management costs, and planning

and costing of M&E may still be needed


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4 .3 . Dur ing the LFA Assessment and

grant agreement negot ia t i ons

The LFA Assessment is the formal PR capacity assessment, conducted after proposal approval, and

prior to grant signing. All the key elds that are in the Global Funds minimum requirements for PRs (seesection 31) are assessed by LFAs and were mentioned among areas in which CSO PR candidates

needed assistance Additionally, some tools have been more recently developed (eg Global Funds

Guide to Writing PSM Plans) While some groups manage to prepare the documentation needed with

internal resources (eg Medicam and RAA), others require substantial and immediate help The support

needed during this period is resource-intensive and requires diverse expertise in order to help the

organization create plans for multiple technical areas in a short period

LFA Assessment Required Documents

A recent reliable assessment of some other implemented programs

The Procurement and Supply Management Plan

A self-assessment of the national M&E system

A national or grant-specic M&E plan

Audit arrangements

The budget and workplan for Phase 1 of the program

Background information including latest audited nancial statements and annual report

Names of PR-authorized representatives and recipients for notices

A letter containing specimen signatures of people entitled to submit a disbursement request

and conrming the bank account details.1

FromThe Global Funds Operational Guide: The Key To Global Fund Policy and Processes

When a civil society organization is a PR along with anotherentity such as the government, they need enhanced

advocacy and negotiation capacity.

ANCS,

Senegal

(currentP

R)
http://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/en/procurement/guide/?lang=en


19/36

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The conclusions of the LFA Assessment help to identify further needs for capacity building before

assuming the PR role, frequently related to management, M&E or PSM Those further needs often

require help from external consultants and are relatively costly, costing up to US$400,000 for short-term

technical support and coaching for M&E and PSM planning1 Generally, experts note that with the Dual

Track Financing (DTF) policy in place, access to technical support for the LFA assessment is improving

with time; funding or direct assistance can often be received from UNAIDS, WHO, GIZ or others

All but two CSOs surveyed indicated that they did not need assistance in grant negotiations to nalizethe performance framework which contains the country-dened indicators, targets and time frame.

1 Amounts are based on data provided by All-Ukrainian Network of PLHIV, information from OSF about their support to

two groups preparing for the PR role, and Novibs published report of their support to one PR

Key points

UNAIDS, WHO, TB Technical Assistance Team and Roll Back Malaria, theInternational HIV/AIDS Alliance, other TS providers, should support the

formation of special TS teams to be available during the LFA Assessment and

grant negotiation period for the nominated CSO PRs, particularly rst-time

PRs

The LFA Assessment process will prepare PRs for grant negotiation, as many

of the same documents and assurances are required for grant agreement

signing

The ndings of the LFA Assessment can be of immense value to the CSO on

their ownthe GF Secretariat is responsible for communicating the ndings tothe nominated PR


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4 .4 . Implementat ion

At this stage it is particularly important to learn how to provide documentation to and communicate withthe Global Funds Secretariat, the CCM, and LFA Capacity building and mentoring are most needed

in the start-up period leading up to the rst project fund disbursement and the rst report and second

disbursement request to the Global Fund CSOs that received technical support in the previous stage

found it effective to continue collaboration with the same TS provider, as in the case of the Romanian PR

ARAS assistance to Serbian CSO PR Youth of Jazas

We have already passed through all the processas a PR. But we need continuous capacitybuilding in all indicated areas [in minimum

requirements for PRs].

EthiopianInterfaith

Forum

for

Developm

ent,

Dialogue

and

Action(currentPR)

Identity incongruity of the Network required TS fordevelopment of organization capacity as a projectimplementing unit maintaining the function of acommunity-based grassroots network of PLHIV.

All-Ukrainian

NetworkofPLH

IV

(currentPR)


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21


1. M&E: Developing a system with information support and reporting formats, training staff

in the PR and SRs, and mentoring on Global Fund requirements;

2. Financial management: Introducing and adapting software for tracking the status of

sub-granted contracts, developing policy manuals, solidifying contract monitoring and

fund transfer systems;

3. Human resource management: Possible restructuring, reviewing personnel policies,

staff expansion and recruitment;

4. PSM: Nearly all CSOs need TS for PSM Includes developing sound practices in

tendering, inventory management, and supply chain management, and establishing

partnerships with external providers of PSM support

5. Programmatic capacity: Community system strengthening (CSS) knowledge is vital

for PRs PRs will need some level of competency with issues and policies affecting all

programs they manage, even if being delivered by specialist SRs

6. SR management: Most needs and requests for assistance are linked with SRmanagement SR management includes:

Building and operating grants management system inside the PR

Selection and oversight of Sub-recipients

TS for nancial management and M&E, and general organizational development

7. Management of the change in relationships with other groups and within the

organization: A common challenge for indigenous CSOs, particularly important at this

stage. Conicts of interest are apt to arise among SRs with oversight roles or which are

members of networks managed by the PR

Key points

First-time PRs should seek mentoring to learn to develop documentation for

and to communicate with the Global Fund, their CCM, and the LFA

The Global Fund should support and promote horizontal cooperation among

PRs

Current CSO PRs should have comprehensive, budgeted technical support

plans with the grant as the main source of funding and work proactively with

the UNAIDS family, WHO and others to identify TS providers and engage

international and local resources


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4 .5 . Post -grant "ex i t " s t ra tegy

It is crucial for us to increase our capacities to generateour own resources. We work for that in research

proposals , we do consultancies with fees forpeople who can afford them. Donors demand

sustainability as though it was an automatic process.

K

imirina,Ecuador

(currentPR)

Our exit strategy will be to advocate with thegovernment to accept the existence of the NGOsand other similar organizations who could also be

partners in disease control and prevention.LankaJatik

a

Sarvodaya

Sharmadan

a

Sangamaya,

SriLanka

(currentPR

)


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Two levels of exit of Global Fund grants were assessed: sustaining services after funding is over, and

management of changes in organizations once they conclude their role as PRs

All the surveyed organizations foresaw their long-term involvement in large project management and

planned to continue their PR role if their countries remain eligible It is not logical to apply just for one

round to be a PR given the big investment in management, the Cambodian group commented But

a few groups acknowledged too that there would be a need for support if they were to conclude their

role as PRs in order to manage the changes in their organization in terms of their size, nature, services,and income Two groups, Kimirina and RAA, had already started consultancy work to generate

alternative income but acknowledged that it was challenging

In general, very little TS experience exists in the eld of phasing out grants for management of CSO

changes, building program funding sustainability and policy change With more CSOs phasing out

their grants and more CSOs starting their PR role there will be increasing need for a particular type of

TS for CSOs with grants that are ending Part of this support is to do strategic planning for the CSO

PR The other parts are: intense work with government and other structures for the sustainability

of the programs, and ensuring that grants do build community systems that can be sustained with

comparatively low funding

Key points

CCMs and CSO PRs, particularly from upper-income countries, together with

in-country partners and international networks, should build in an advocacy

and policy dialogue plan for sustaining the services in community and health

systems in Global Fund grants

Because most PRs aspire to a long-term PR role, there is a dearth of post-

grant planning, and consequently the relevant TS

ICASO should initiate dialogue with key TS providers on developing TS for

(CSO) PRs exiting GF grants, including strategic planning and diversifying

donors


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5 . 1 . Current and potent i a l sources o f TS

Standard sources of technical support and capacity building include UN agencies, WHO, USAID-

funded Grant Management Solutions, GIZ, the Clinton Foundation, and specialized consulting

groups and experts Their support (and funding for their work) is mostly available to CSOs only once

they have received the PR nomination. However, a desire for more exibility and access to local

experts has been expressed by CSOs

The Global Fund Secretariat, though not a TS provider, could be helpful: it informs countries and

TS providers about Global Fund requirements, provides guidelines and tools and can link relevant

groups to help them get additional support The GF Secretariat might also facilitate horizontal TS

relationships CSO PRs

5 . Who wi l l prov ide techn ica l suppor t?

We were disappointed in how some of the technicalassistances were provided because they were more oriented

toward favoring some NGOs to the detriment of others; completely ignoring the RBP+ which was ofcially designated

by the Burundi CCM .RBP+,Burundi

Indigenous NGOs are relatively poorly resourcedcompared to their international counterparts. Byextension, their organizational capacities are alsolimited. Any Global Fund grants to indigenous

NGOs should ordinarily include an allocation forcapacity development (both short and long term).

Felicitas(Flanny)

Chiganze,

SouthernAfrican

AIDS

Trust
http://www.gmsproject.org/http://www.giz.de/Themen/en/4356.htmhttp://www.giz.de/Themen/en/4356.htmhttp://www.gmsproject.org/


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Nonlocal PR responsibility to build national capacity

[] a multilateral organization or an international nongovernmental organization may be nominated as

Principal Recipient In the interests of country ownership and long-term sustainability, this arrangement

should be temporary and, thus, the non-local PR should develop an action plan and budget which aims

to enable a national entity to take over the role within an agreed time frame1

From Section I33 inThe Global Funds Operational Guide The Key To Global Fund Policy and Processes, August 2010

5 .2 . ICASO ro le

A set of tools, as well as expertise and capacity is available from existing CSO TS providers, like the

International HIV/AIDS Alliance, regional groups like the Southern Africa AIDS Trust (SAT), HIVOS, and

global and regional networks

In many cases, experts and PRs see current and former PRs as having substantial technical expertise

that can be used to help other groups interested in the PR role There are examples of such support

already ANCS from Senegal has hosted a number of study visits from interested organizations around

Africa RAA from Romania helped the Serbian CSO PR The All-Ukrainian Network of PLHIV providedconsultant support to possible PRs in the TB response in Ukraine, and assists with capacity building

and advice to PLHIV groups in Eastern Europe and Central Asia, who typically play the role of SRs or

SSRs Horizontal cooperation is additionally supported through the PR working group, an informal global

network of CSO PRs Current PRs could also provide mentoring and other TS in areas such as making

the decision to seek the PR role, applying and negotiating for a CCM nomination, and participating in the

resource-intense process of the LFA assessment

Multilaterals and international organizations that are currently PRs could be very helpful in providing

support for national groups to become PRs and even for handing over their PR role to indigenous CSOs

To date this has met with challenges Although GF grant agreements encourage multilaterals to build

local capacity, experts suggest that such international organizations would need incentives, relevant

resources, and tangible support

Experts and PRs do see a specic role for ICASO in relation to the CSO PRs. ICASO should advocate

for building political and technical capacities of civil society, including people living with the diseases and

key populations, for participation in national strategy planning, solutions for program sustainability and

further promote the DTF policy Principally, ICASO has a role in global advocacy for effective civil society

participation in national strategy planning supported through the Global Fund, as well as continued

participation of CSOs within the new grant architecture, nding better strategies for phasing out grants in

middle income countries and better access to funding for TS to CSOs
http://www.theglobalfund.org/documents/Operational_Guide_en.pdfhttp://www.aidsalliance.org/http://www.satregional.org/http://www.hivos.net/http://www.hivos.net/http://www.satregional.org/http://www.aidsalliance.org/http://www.theglobalfund.org/documents/Operational_Guide_en.pdf


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6 . Conclus ions

The increasing involvement of CSOs as PRs and SRs requires a concomitant commitment from donors

and partners to fund and organize technical support and capacity building While indigenous CSOs are

often limited in terms of the internal management capacity that is the necessary foundation for becoming

an effective PR, they offer much in terms of local credibility and community expertise that governments

and multinationals cannot

Key areas of technical support needed

CSO management in all core areas for PRs Understanding of Global Fund guidelines, policies and processes and how

to use them to meet local needs, particularly as the new funding model is

implemented

Management of change in CSO structures and relationships with other

organizations as groups evolve into and conclude the PR role

Advocacy and political and technical expertise to negotiate and promote policy

dialogue with CCMs and other ofcial bodies.

The greatest need and lowest availability of support is often found among smaller indigenous

CSOs Such groups may require additional mentoring and linking to technical support and

networks of peer organizations


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Capacity assessment

CSOs often do capacity assessments themselves; additional external support to crystallize thinking

about needs and unrealized gaps is often valuable and can help formulate requests for technical support

throughout the life of a project

Techn ica l suppor t needs in d i f fe rent s tagesThe poor availability of TS and capacity building for CSOs at the initial and end-point stages of Global

Fund projects was identied as a challenge by several surveyed groups. During the other stages, TSis generally more available but stil l comes with challenges TS is frequently needed during the LFA

Assessment and at the start of implementation. Before Global Fund grants nish and/or middle-income

countries become ineligible, much more support is necessary for CSOs to nd alternative solutions for

generating income from other sources, or MARPs may be signicantly and negatively impacted.

Techn ica l suppor t prov iders and donorsDonors and TS providers have limited resources and competing requests for support They have some

areas of specialization and coverage of TS but there are gaps in certain stages and technical areas

Horizontal exchange and more structured, longer-term TS, capacity building and mentoring could be a

role for current and former PRs Their experience and knowledge of local contexts and the Global Funds

work has proven to be useful in negotiations with CCMs and the Global Fund, to help build management

capacity during the LFA Assessment and project planning


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7 . Recommendations

UN agencies and TS providers should:1 Invest in long-term comprehensive capacity building of CSOs that can potentially become or

are already major implementers Where feasible, one capacity building facilitator (consultant

should work with a CSO throughout the process

2 Review how to promote greater access, support and investment for indigenous and rst-time

PRs and CSOs seeking nomination

The Global Fund and its partners should:1 Document the contribution and needs of indigenous and other CSOs in Global Fund grant

implementation and communicate this to CCMs

2 Promote horizontal cooperation among PRs and CSOs interested in the PR role, peer-to-peer

exchanges, and involve current and former PRs in technical support and mentoring

3 Regularly review how current non-indigenous PRs, such as UN and international organizations,

invest in building national capacity including indigenous CSOs

4 Review eligibility criteria to enable addressing the needs of poor and marginalized populations

in middle-income countries, rene strategies for improving post-grant sustainability, and seek toensure relevant support to CSOs and other PRs and CCMs

5 Evaluate whether the DTF policy has been successful in its objective to reach underserved,

vulnerable and key populations, and how achieving this objective could be further improved

including through community system strengthening


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CSOs seeking or in the PR role should:

1 Conduct strategic planning and request advice about the PR role before the decision to seek a

nomination as a PR

2 Plan and seek technical support and capacity building actively and early on, and openly

acknowledge the need for external help when relevant

Other civil society groups, CSO TS providers and ICASO and its partners should:

1 Continue to provide strategic information about the Global Fund, thus increasing the capacity

of CSOs to understand about how changes in the grant management affects thereby providing

more opportunities for CSO in-country and global engagement

2 Be vocal about the benets and challenges of being a PR, walk interested groups through

the stages of becoming a PR, and link them with former and current PRs, technical support

providers and donors when possible

3 Promote civil societys role as an independent actor in its participation on CCMs andcommunicate with donors in their capacity as watchdogs


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8 . Ref lect ions

The recent announcement of the New Funding Model (NFM) has raised many questions Per the Global

Fund, the NFM is intended to achieve greater impact, improve grant efciency, and promote greater

in-country dialogue and ownership While the basic framework has been articulated by the Global Fund,

many of the details are yet to be fully dened.

Within the NFM framework, there are some clear opportunities for increased civil society participation

most notably, the Country Dialogue The structure of the Country Dialogue has not been established,

and may ultimately manifest differently in different countries and regions But the outcome of all the

Country Dialogues will be the Concept Notethe equivalent of the proposal in the NFM The Concept

Note will outline the country prole, the total demand (need), and the proposed interventions. The

Concept Note is submitted by the CCM and should include the nominated PRs and some potential SRs

Whereas the proposal development process was almost entirely driven by the CCM in the past, the

Country Dialogue in the NFM is intended to involve a range of stakeholders, including civil society,

government, affected populations, and the Global Fund Secretariat, in an iterative and supportive

discourse As was highlighted in this report, the greatest gaps in available or accessible TS for

CSOs exist in the earliest and latest stages of a grant cycle. As the Country Dialogue is the rst

step for in-country stakeholders, there is an unprecedented opportunity to provide TS around the

potential PR assessment and decision to seek nominationthereby producing stronger PRs for grant

implementation The modest literature available on the Country Dialogues indicates that the Global Fund

Secretariats role is principally to aid in these assessments, provide guidance on minimum requirement of

PRs, and generally to work with the CCM to produce a strong, successful Concept Note, with all of the

right stakeholders involved

While there is an obvious opportunity in the lack of an established structure for the Country Dialogues,

there is also an inherent threat If CSOs, their advocates (such as ICASO and its partners), and

watchdogs are not proactive in shaping the Dialogues, country-by-country, and establishing a strong

civil society presence from the outset, they risk a diminished role not only in the Dialogue, but in the

Concept Note and the implementation of the grant Therefore it is critical that CSOs and their allies fully

understand the NFMand in particular the Country Dialogueand are prepared to come to the tableas soon as it is set Given the Global Funds professed desire to improve civil society participation and

country ownership, the future of CSO leadership in the response to HIV/AIDS is promising However, the

present opportunity must be seized


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9 . Annexes

Annex 1 . Form of the survey

1 Respondent and contacts

11 Name

12 Position in the organization

13 Organization name

14 Direct phone number and/or Skype

2 Decision to become a PR and TS before becoming a PR

(for the rst time if you are a PR for more than one grant)

21 How was the decision made? Did you undertake strategic planning or another process?

22 What did you have to do and change in the organization to become a PR?

23 What support have you received? From whom? Who provided funding?

24 What support was needed/would have been useful for that stage in addition to what you

received? For which areas of work? Did you identify your needs or did you have support to

identify your needs?

3 Preparation of the proposal(if you participated in more than one process, describe either the most recent process or all of them)

31 What technical support (TS) did you need? In which work areas? What type of TS?

How did you identify your needs (if you did)?

32 What TS did you receive? For which areas? Who provided the support, and who funded it?

33 Was the TS you received effective? How did you measure its quality?

34 What tools/information were important for you at the proposal preparation stage?


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32

4 Grant negotiation

41 What technical support (TS) did you need? What type of TS?

How did you identify your needs (if you did)?

42 What TS did you receive? For which areas? Who provided the support, and who funded it?

43 Who could provide such technical support, besides the group that provided it to you?

5 Implementation of the grant-supported project

51 Which were the key work areas where you needed TS (M&E, building capacity of sub-recipients,

nancial management, advocacy/policy/government relationships, human resource management,

procurement & supply management, innovative service related, other)? Please explain and provide

examples

52 How did you identify your priority needs? Did you use TS, tools or internal assessments, or

recommendations from related agencies?

5.3. Where do you search for TS in those work areas, or where would you suggest others nd TS?

54 How do you measure the quality of TS? Please provide examples

6 Post-grant strategy

61 Do you have an organizational strategy for what you will do after the Global Funds grant term?

If yes, what is it? If not, what possible exit strategies would you consider for your organization?

62 What kind of support do you think you will need to prepare for an exit strategy for after the

grant term?

7. Your involvement in technical support (TS)

7.1. Do you provide TS yourself? To whom? Sub-recipients (SRs) and SSRs? In what TS areas?

7.2. Have you provided formal or informal support to PRs, or to groups interested in becoming PRs, o

to groups interested in becoming SRs? Please provide examples

8. Recommendations

8.1. What would be 3 things that you would do differently if you were a major donor in the HIV /TB

Malaria eld, for better TS to NGOs that are PRs?

8.2. If you could make one recommendation to TS providers regarding how they could better

address NGO/PR needs, what would it be?8.3. Final comments


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Organization Country Round, working with other PRs,amount of grant agreement with the

organization

Contactperson

The Burundian

Network of PLHIV/

AIDS (RBP+)

Burundi Round 8 HIV (with governmental PR, US$

13,904,412)

Benjamin

Nicayenzi

Medicam Cambodia Round 9 HIV (with governmental PR)

negotiated

Dr Sin

Somuny

Corporacin Kimirina Ecuador Round 8 Malaria (with governmental PR,

which however has signicantly smaller

budget, US$ 4,442,653)

Round 9 HIV (with governmental PR) -

negotiated

Amira

Herdoiza

Ethiopian Interfaith

Forum For

Development,

Dialogue and Action

Ethiopia Round 7 for HIV (with one governmental PR

and one CSO PR; US$ 13,802,195)

Jihad keno

Abagero

TISI Sangam of Fiji Fiji Round 8 for TB (with one governmental PR)

- nominated by CCM but did not pass LFA

assessment due to insufcient capacity

Dorsami

Naidu

Annex 2 . Respondents and in terv iewed exper ts

CSOs that participated in the survey (Sorted alphabetically by country)

Table continued on page 34


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34

Middle East &

North Africa

Harm Reduction

Association

(MENAHRA)

Lebanon

(regional)

Prepares application for Round 10, based

on unsuccessful application for Round 9 that

had UNODC as aPR

Elie Aaraj

Romanian Angel

Appeal Foundation

(RAA)

Romania Round 6 for HIV (single PR, US$

11,370,707)

Round 6 for TB (single PR, US$ 10,413,467)

Sylvia Asandi

Russian HealthCare

Foundation

Russia Round 4 HIV (single PR - US$ 119,873,915)

Round 4 TB (single PR, USD 88,165,448)

Dmitry

Goliaev

National AllianceAgainst AIDS (ANCS) Senegal Round 1 HIV (with governmental PR, US$2,906,326)

Round 6 HIV (with governmental PR, US$

9,547,543)

MagatteMbodj and

Massogui

Thiandoume

All-Ukrainian Network

of PLWH

Ukraine Round 6 HIV (with other CSO, US$

52,314,214)

Now preparing for R10

Hanna

Shevchenko

Lanka Jatika

SarvodayaSharmadana

Sangamaya

Sri Lanka Round 1 TB (with government PR, US$

475,020; now inactive)Round 1 Malaria (with government PR, US$

5,176,412)

Round 4 Malaria (with government PR, US$

1,347,200)

Round 6 TB (with government PR; US$

957,593);

Round 8 Malaria (with government PR)

Dr LP

Chandradasa

Table continued from page 33


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Name Affiliation Experience / e-xpertise

Felicitas

(Flanny)

Chiganze

Deputy Executive

Director, SAT

SAT is a technical support provider in Southern Africa The

organization has conducted assessments of PR and SR needs

for the Lesotho Council of NGOs in their quest for PRship and

SAT Zambia for SRship

Katja Roll Senior Civil Society

Ofcer, Africa Unit,

The Global Fund

to Fight AIDS,

Tuberculosis and

Malaria

The Global Funds Civil Society team supports civil society groups

through direct involvement, raising awareness and access to the

Global Funds policies and guidelines and are in touch with CSO

PRs among other CSO groups They work closely with the Global

Funds Portfolio Managers and CCM teams to address civil

society needs

Dr LeeAbdelfadil

Senior Advisor andGF and Programme

Lead on Health and

Community System

Strengthening,

International HIV/

AIDS Alliance

To expand technical support and further strengthen civil societycapacity, the Alliance has established seven Regional Technical

Support Hubs, operating in Africa, Latin America and the

Caribbean, South Asia and Eastern Europe These Hubs have

been established to meet the demand from Alliance linking

organizations as well as other local NGOs and CBOs, for

technical assistance that matches what local people need, and

support that enables them to learn from and inuence their peers.

The Alliance organizes a number of international workshops

and technical support tools A number of the Alliance linking

organizations are also PRs for the Global Fund grants

Matthew

Greenall

HIV/AIDS and

Development

Consultant, Program

Advisor to CSAT

He has developed many proposals for the Global Fund and is co-

author of several Aidspan guides

Shannon

Kowalski

Senior Global

Fund Ofcer, Open

Society Foundations(OSF), also member

of Private Donor

Delegation to the

Global Funds Board

OSF is an implementing donor which supports public health

initiatives that reach marginalized groups in several regions

It particularly focuses on civil society groups It paid for andassisted with planning technical assistance to several CSO

PRs and proposal development processes (the Russian Harm

Reduction Network, Globus in Russia, a PR-to-be in Zambia,

etc) She is actively engaged in developing and monitoring

Global Fund policies and keeping civil society groups informed

about them

Experts Interviewed (Sorted alphabetically by name)


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