Civil Society Update to GFAN from the 33rd Board Meeting |

Download a PDF of the update

GFAN was invited as a Guest of the Chair to the 33rd Global Fund Board Meeting in Geneva and to observe and participate in the meetings of the Developed Country NGO Delegation. This document provides an overview of the Board Meeting process, key documents and important issues and potential advocacy opportunities for civil society.

The process

For 3 days before the Board Meeting, all 3 civil society (CS) delegations (Developed Country NGO, Developing Country NGO and Communities) held separate and joint preparatory meetings. For those who have never participated in a Board Meeting, the delegations meet – separately first and then jointly – ahead of time to determine what key interventions are needed: sometimes they agree to take those forward jointly, some not. Following that, the CS delegations have a series of meetings together and separately with various officials and other delegations of the Board (like the different country seats or other constituencies of the GF such as Foundations and Private Sector) to raise and solicit support for the steps identified to address or move forward the key issues.

Sometimes, issues can be “resolved” through these series of meetings. Other times they are raised at various points during the Board Meetings.

The documents

The agenda for the Board Meeting can be found here.

There were over 30 documents distributed for the Board Meeting. All are very important and interesting, but what follows is a short list (and links) to documents we think might be of most interest.

Development Continuum Working Group Report

This is a “think-piece” about where global health has been and where it is going and is meant to be for thought and review as the GF Secretariat and Board begin developing the strategy. It discusses 6 aspects of how the development landscape is changing and how those impact health more specifically: health needs; political changes; economic development of countries – and poverty/disease burden in middle income countries; institutional, technical and human resource capacities and accountability; and the key role of civil society. The Working Group is now finished and this paper is for information about important elements of development but is not prescriptive or indicative of what must be considered or followed.

Human Rights and Gender Report

This report addresses activities taken at the Secretariat to advance understanding, engagement of and integration of key populations, community system strengthening, community engagement and gender issues at the level of the Secretariat and in limited cases at the programmatic level. The report shows there is a significant body of work undertaken across the Secretariat to improve collaboration and awareness of these issues internally. It suggests that long-term commitment is needed as change will not happen overnight and some of this work challenges structural and cultural norms that require long-term efforts.

Strategy Development and Partnership Forums Process

This slide deck provides timelines and themes for both the Strategy Development and Partnership Forums (PF) processes. Civil society will be able to input into the strategy development in one of at least three ways: the online e-forum that will be open from April 20th until the end of June; one of the three in-person PFs that will be held between the beginning of May and September; or at a series of consultations that will be held at the same time as other key events (no confirmed details on these yet).

Resource Mobilization and 5th Replenishment

This slide deck provides updates on resource mobilization campaigns on high net-worth individuals (HNWI), domestic resource mobilization and the Innovation Hub. It includes several slides on the key draft messages/focus for the replenishment, the overview of who the GF is targeting and some initial milestones.

Report of the Financial Operational Performance Committee (FOPC)

The FOPC is responsible for general financial oversight of the Global Fund. This report includes some details on a variety of financial topics.

Report of the Strategy Investment and Impact Committee (SIIC)

The SIIC is responsible for what the FOPC is not: the policy and strategy issues of the Global Fund. This committee is where most of the discussions around the upcoming strategy and resource mobilization efforts will occur.

Understanding the issues

What follows below is a table that identifies some of the issues raised by the civil society delegations and some of the movement on and possible advocacy follow-up opportunities. It includes explanations of the reasons the issues were raised, what movement there was (or wasn’t) on them at the BM and whether there are any advocacy opportunities following the BM. These issues were raised in many different sessions and side meetings with constituencies and the GF Secretariat and at the Board Meeting.

Please note: it is impossible to capture the detailed level of rich, complex and nuanced discussions that took place and developed throughout the week. This table and this is from GFAN’s perspective as an observer and guest, not an official or authorized accounting of events and positioning.

Additionally, on April 10th representatives of the 3 CS delegations and the ED of the Global Fund, Mark Dybul, attended a GFAN call and the notes from that call can be found here.


Issue Explanation of concern What movement was made on the issues Advocacy follow-up
Partnership Forum (PF) in Addis – Due to Ethiopia’s criminalization laws, the GF is prevented from having Board Meetings in Addis (and other countries) as provided by the Sexual Orientation and Gender Identities (SOGI) strategy. The Communities Delegation – and supported by the other two CS delegations (with some exceptions) – felt that if human rights is a critical pillar of the Fund and given the decision not to hold governance meetings in certain countries, the Partnership Forum should not exclude key and vulnerable populations who might legitimately have security concerns. The CS delegations asked for the Forum to not take place in Addis. – The African constituencies raised points (at pre-meetings and during the BM) in favour of keeping the PF in Addis given there are high level assurances of safety.
– However the CS delegations, the US and some other constituencies felt strongly that the PF should not be in Addis because safety isn’t the same thing as feeling free to express oneself. Information was provided at the BM about the decision-making process at the Secretariat and SIIC; a formal “note verbale” had already been sent to Ethiopia and a positive response received
– The Communities Delegation issued a statement after the BM.
– Your advocacy could include statements of support for the various positions, however it should be noted that as of the time of writing this, the PF in Addis is still planned to go ahead in early May.
Partnership Forum – EE – CS delegations raised the concern that the Eastern European & Central Asia region is being added on to the Latin America & the Caribbean PF. – The GF expressed that the intent was not to have “regional” forums and noted that the Board and SIIC committee provided funding for only 3 meetings, so some compromises needed to be made.
– Staff are reviewing the possibility to attach a meeting to the Stop TB Coordinating Board fall meeting expected in the EECA region, but no decisions have been made.
– Support for holding a Forum or other consultative meeting in the EECA region could be expressed through your GF country representatives to the GF Board.
Ethics Officer – There is a lack of clarity around the actual location of the Ethics Officer and her/his lines of reporting. CS delegations were concerned that no new, separate office was required and that there should be a dual reporting system for the Officer.
– The dual reporting system would permit both a direct line to the Executive Director on operational issues, but also make the Officer responsible to the GF Board.
– The Audit & Ethics Committee clarified the position of the office: it is not a full separate office with large costs, but administratively embedded in the independent Office of the Inspector General.
– However, the issue of lines of reporting remained and thus was raised at the Board Meeting by various constituencies. An amended Decision Point was put forward to have the Ethics Officer housed in the Office of the Inspector General and to have dual reporting to the Board and ED on different issues. A new ToR will be discussed and decided by virtual Board decision in June 2015, then an Ethics Officer could be hired.
– No suggested advocacy on this point.
Human Rights & Gender Report – A Human Rights and Gender report was, for the first time, provided to the Board. This has been the focus of the Community, Rights & Gender (CRG) team constituted towards the end of 2013 at the Secretariat.
– The concern was that there needs to be sufficient resources to do the work described in the report and that the Board needs to be serious about ensuring there are resources to do that work. Additionally, there needs to be monitoring of whether and to what degree the work and capacity building at the Secretariat translates into core programmatic elements in Concept Notes.
– The CS constituencies suggested that this should be an annual report to the Board and that the Key Performance Indicators (KPIs) for these areas be strengthened and included – along with all other KPIs – from the beginning of the new strategy.
– When approached by CS delegations, other constituencies were in agreement as were senior staff of the GFS (including the ED, Mark Dybul). This was brought up at the Board and many constituencies – country blocs and others – spoke in favour of this; in fact, many had reached the same conclusions about needing an annual report, more resources to this work at the Fund and to make sure it translates into HR & Gender programming as core elements of Concept Notes. – There will be an annual report. No follow-up needed.
– Your country representatives at the Global Fund could be asked whether they participated in this discussion, what their position is and whether they agreed with the sentiment that HR & Gender needs to be a core element of the upcoming strategy.
– If yes, ask if they also agree that, in order to accomplish this, the Secretariat will need more resources to effect long-term change at the Secretariat and with implementers at all stages from Concept Note development to programme implementation.
Sub-optimal use of funds – In the various financial documents, a picture comes together that money is only slowly being put to use. Grant expense actuals are lower than forecasted (by 25% or $0.8 billion) and grant disbursements are similarly lower than forecasted (26% or $1 billion). There are some good and some temporary reasons to explain this but the overall picture is one in which the money is being used more slowly than desirable while there is huge unmet demand. The register of Unfunded Quality Demand (UQD), which already sits at $2 billion, is expected to rise and there are few prospects for new funding streams. The main concerns were that this means some combination of fewer or more slowly implemented grants and an excessive availability of cash on the balance sheet as we head into the 5th Replenishment. – The week before the Board meeting, the Developing Country NGO delegation sent a letter detailing and expressing those concerns.
– The issues were raised at most pre meetings and constituency meetings although there was no real, logical place to put this on the agenda.
– The Developed Country NGO delegation (supported by the other CS delegations) urged for the money to be “put to work” at the country level by the end of 2016, in time to show impact towards the next replenishment.
– While there were no formal opportunities for discussion about this, the letter had prompted considerable interest at the Secretariat and by the time of the delegations’ meeting with the ED of the Global Fund, a written response was promised providing a formal process and response to the issues raised.
– Monitor process of written response which will go through the SIIC and FOPC Committees.
– In meetings with Ministers or Ministerial staff (Development, Health, Finance etc) consider raising these points (all the data to back up this concern is contained in the FOPC Report to the Board).
Technical Review Panel (TRP) – The TRP plays an important role, but with the many changes to the process under the new funding model, the question is whether the panel continues to be fit-for-purpose. Delegations proposed a review of the TRP that could address/examine whether the TRP mandate is focused enough, what its lines of communication should be, what information they should provide and what are the parameters for their review or proposals. – All constituencies underscored the important role of the TRP, but many shared the CS concerns. During the BM this was also raised at different times by Point 7, France, the US and the Latin America and Caribbean constituencies in different but complementary ways.
– The head of the SIIC confirmed at the end of the session on Day 2 that a review of the TRP in the context of the NFM would be held and had already been asked for based on the conversations over the previous days.
– Monitor progress of TRP report at the SIIC and Board.
– Responsible for the report and review will be the Technical Evaluation Reference Group (TERG) and it will be reported to the SIIC first, then to the Board.

– As internal discussions have begun, the delegations spent some time identifying what their key issues should be for the strategy. Although there was no real entry point at the Board Meeting for a full discussion on this, at every opportunity the delegations did raise these issues in side meetings, constituency meetings and at the Board Meeting. The key initial priorities as identified:

  • Focus first and foremost on accelerating progress in order to end the three diseases by 2030. All strategic objectives should emanate from this primary goal.
  • Focus on people most in need – the poorest and the most vulnerable people and communities.
  • Prioritize investments that protect, promote and defend human rights and gender equity.
  • The sustainability of epidemic control should always be more important than financial sustainability – treatment is the number 1 priority.
  • Deliver accelerated access to scientific innovation – lessen the time between when new, proven methods, tools and treatments are developed and put into the field.
  • Tackling the unfinished business of the health-related SDGs.
  • Proactively working to achieve scale-up of community service delivery approaches (including community systems strengthening, meaning communities own the response to the epidemics).
  • Adjust the allocation formula to learn from the first 3 years of implementation of the new funding model and emphasize full expression of demand by countries.
– The strategy will be approved in November. Therefore, discussions and decisions around what will be in the Global Fund strategy will be happening in the short term.
– Ask for a meeting with your government’s Global Fund team and/or CCM to present what elements should be included in the strategy.
Participate in the e-forum that will be open from April 20th until June 30th to provide direct feedback.