16 th RBM Partnership Board meeting 14-15 May 2009 Decision points and next steps Ramada Park Hotel

16th RBM Partnership Board meeting14-15 May 2009

Decision points and next steps

Ramada Park Hotel

Adoption of Board Meeting Agenda

• 16th RBM Board Meeting agenda was adopted with proviso that sufficient time is given to the election of a new Board Chair.

Adoption of 15th Board Meeting Minutes

• Minutes of the 15th RBM Board meeting were adopted with an amendment to page 9 withdrawing the mention of a Financiers' Forum concept paper to be presented to the Board.

• Draft Board Meeting minutes to be circulated within 10 days after the end of the Board sessions.

Adoption of Financial Report

• The Board provisionally adopts the unaudited Financial Statement for the RBM Partnership Secretariat and SRNs – 2008 (Table 1) (certified by the WHO Chief Accountant);

• Took note of the income projected for 2009 (table 3) and the actual income for Quarter 1 2009 (table 4);

• Took note of the provisional statement of income and expenditures for Quarter 1, 2009 (table 5);

• Requested formally that all partners provide to the Secretariat, as 2009 progresses, information on contributions to support core RBM mechanisms (Working Groups, Task Forces, Sub-regional networks) that are not channeled through the WHO accounts but are channeled directly to the mechanism or through other partners.

516th RBM Board meeting< 14/15 May 2009

Financial Report Next steps

• The Secretariat will prepare monthly reporting to the Finance Committee including: (i) income and expenditure statement; (ii) cash flow statement; and (iii) balance sheet including accounts receivable and accounts payable.

• The Secretariat will use a template for a "shadow system" for monitoring income and expenditure until the GSM Oracle-based system is fully validated for accuracy, comprehensiveness, and real time access.

• The Secretariat will include in the report for Q2 2009 a breakdown of staff by type of contract and the proportion of staff costs to overall activity for each area of work.

• The Secretariat will develop a note concerning procedures relating to WHO audit results in case changes in data are needed.


Financial Report additional next steps

• Shadow system to be expanded to include direct contributions to RBM Working Groups or other mechanisms and special projects outside the RBM funds within WHO.

• Budget template to be developed to provide budgetary information for proposals that are submitted to the Board for decision.

• Financial reporting of income and expenditure to include notes explaining significant variances (between projected budgets/actual expenditures and expenditure shifts between priority areas).

• Template to be developed to better understand and present the timings of income and expenditures.


Conflict of Interest Decision point – Next Steps

• Postpone further discussion until the end of July 2009 and request interested members of the Partnership Board to develop a revised policy and declaration form.


Board decisions on Global Fund MOU

• Approved the proposed revised MOU between The Global Fund and the RBM Partnership

• Requested the Executive Director, in consultation with the Executive Committee, to finalize and sign the MOU with The Global Fund Executive Director

• No budget implications for the signing of the MOU. However there will be budget implications in the operationalisation of the MOU.


Next steps for Global Fund MOU

• Following approval by the RBM Board, the revised MOU will be resubmitted to The Global Fund Secretariat for transmittal to its Policy and Strategy Committee and its Board.

• Any substantive revisions that may be requested by The Global Fund will be referred to the RBM Executive Director and Executive Committee.

• The RBM Secretariat, in consultation with The World Bank and other interested partners, will work with the Global Fund Secretariat to prepare proactively for implementation of the MOU.

• Once the MOU is agreed by RBM and The Global Fund, and signed by their respective Executive Directors, RBM and The Global Fund will implement the provisions of the MOU.


Board decision Forum VI in 2011

• Agreement in principle to not organize a stand alone Forum.

• Approval in principle to organize a Global High-Level Event on RBM Progress towards the 2010 targets alongside the UN General Assembly meeting in September 2011.

• Approval of an Oversight Subcommittee representative of RBM partner constituencies, to guide the organisation of the Global High-Level Event in terms of scope, format, content and objectives as per Board recommendations.

• Subcomitee to develop a calendar of events worldwide, leading to the Global High Level Event.

• Request the RBM Secretariat to detail activities and budget and engage partners in creating momentum towards the 2011 Global High-Level Event.


RBM Workplan 2010-2011 Decison Points

• The Board decided that the harmonized Partnership Workplan will be referred to as the “RBM Partnership Work Plan”.


RBM Workplan 2010-2011 Decison Point:

The Board adopted objective 1 "Achieve Universal Coverage by 2010" with the following targets:

80% of the people at risk from malaria are using locally appropriate vector control methods such as long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS) and, in some settings, other environmental and biological measures where appropriate based on scientific evidence;

80% of malaria patients are diagnosed and treated with effective anti-malarial treatments;

In areas of high transmission, 100% of pregnant women receive intermittent preventive treatment (IPT);

The global malaria burden is reduced by 50% of the 2000 levels: ~175 - 250M cases annually and less than 500,000 deaths annually from malaria


RBM Workplan 2010-2011 Decision Point:

The Board adopted objective 2 "Sustain Universal Coverage through 2015" with the following targets:

Universal coverage continues with effective interventions

Near zero global & national mortality for preventable deaths

The global malaria burden is reduced by 75% of the 2000 levels: ~85 - 125M cases annually

Achieve malaria-related MDGs (halting & reversing the incidence of malaria)



The Board adopted objective 3 "Prepare for Elimination" with the following targets:

Provide support to elimination efforts in 8-10 countries to achieve zero transmission of locally transmitted disease by 2015

MalERA to complete the elimination R&D agenda and promote its implementation



To meet the Partnership's objectives, the RBM mechanisms to develop targets across 4 priority areas (as appropriate)

A. Keep malaria high on the global agenda

B. Ensure future funding for countries

C. Make the funding work (effective implementation)

D. Ensure quality reporting on country progress

Each target should be specific, measurable and timebound.


RBM Workplan 2010-2011: Next Steps

From May to October 2009: Continuous consultation with Working Groups and Sub-Regional Networks

15 May 2009: Special Session of African Health Ministers

End of June 2009: MERG to map schedule of planned surveys (DHS, MICS, MIS) and to draw up a list of additional MIS required to produce a global report First findings of the External evaluation

July-August 2009: WHO/Sub Regional Networks (SRNs) annual planning and review meetings in all four African regions

August 2009: Identify key actions required through ministerial consultation with Asian & Latin American – Caribbean countries

September 2009: External independent evaluation report on optimal ways of working to implement 2010¬2011 RBM partnership Work Plan Board retreat, Operating Framework revision Stakeholders meeting: 2010-2011 Work Plan finalized and agreement on the method of work.

November 2009: RBM Partnership Work Plan adopted and approved funding through the 17th Board Meeting

January 2010: RBM Partnership Work Plan implementation starts


Venue Board meeting & retreat : Decison Points

• Venue 17th RBM Board meeting: Sunday 15 to Tuesday 17 November 2009 in Brasil

• Venue for Board retreat in Switzerland at end of August or early September, depending on the availability of External Evaluation results


Challenges faced in accelerating progress towards 2010 Universal Coverage Targets Summary RBM Board Chair

Lack of country ownership/sustained political will

Funding/resource constraints

•Under –utilization/ inefficient use of resources already available

Harmonization/coordination

•Insufficient integration of fragmented malaria control initiatives at country level•Lack of comprehensive/detailed national operational plans

Commodities

•Lack of local commodity manufacturing capacities

•Inadequate access to ACTs

Health systems/capacities

•Inadequate procurement capacities/inefficiencies and bottlenecks in procurement systems

•Weaknesses in supply chain management systems, lack of effective procedures/capacities for tracking progress

•Inadequacy of effective M&E systems and capacities

•Overall health system weaknesses esp. inadequacy of HRH

Parasite/vector resistance

•Drug resistance of malaria parasite – largely due to continued use of mono-therapies

•Growing resistance of mosquitoes to insecticides

Research

•Inadequate attention to/support for operations research to address bottlenecks

Partnerships/collaborative efforts

•Inadequate use of complementary "high impact" strategies (e.g. social mobilization and leveraging of NGOs/CSOs capacities in effectively reaching communities with interventions)

•Insufficient engagement/mobilization of all sectors/stakeholders in the national malaria response

"Internal" challenges "External" challenges

Funding/resource constraints

•Significant funding gap faced by a number of countries

•Insufficient flexibility of funding mechanisms and the allocation of resources available

•Problems with the funding process: persistent/significant procedural delays between the funding approval stage to final disbursement of funds to countries

Harmonization/coordination

•Lack of harmonization among partners – slow progress towards harmonization and alignment of planning, budgeting and reporting processes

•Growing pressure against use of DDT (WHO guidelines – challenges of balancing health concerns related to chemical safety and insecticide resistance with the benefits of DDT as an effective malaria control tool)

Commodities

•Insufficient stocks of commodities – LLINs and ACTs available on the (global) market


Ministerial Consultation: Next Steps

• Provide a report on the ministerial special session to all participating ministers

• Feed the challenges identified during the special session into the development of the 2010-2011 RBM Partnership Workplan.


Summary of implementation challenges identified through Board events (13 to 15 May 2009)

Challenges (1) to inform development of RBM Partnership Workplan

– Strengthening Information Systems– Ensuring proper use of LLINs and treatment with ACTs– Integration of complimentary interventions– Securing additional funding and timely availability– Monitoring resistance (Artemisinin, Pyrethroids, DDT)– Governance of large programs– Managing geography of large countries– Maintaining coverage of insecticidal nets– Reducing cost of commodities– Strengthening health systems – human resources, infrastructure, Equipment,

Implementation capacity, Access to ACTs in all health centers, training (entomologists, management)

– Production capacity of commodities, manufacturing in endemic countries at international standards

– Procurement and tendering transparency, accountability

items in black arising from ministerial session; items in blue additional challenges identified by Information Session and Day 1 Board)


Summary of implementation challenges identified through Board events (13 to 15 May 2009)

Challenges (2) to inform development of RBM Partnership Workplan

– Developing public health insurance

– Environmental Management and Vector Control

– Mitigating different climates – epidemics, transmission settings

– Updating strategic plans – integrated vector control, operational research, communication,

– Quantification and forecasting

– Intersectoral, interministerial, intercountry/subregional approaches

– Cultural sensitivity – appropriate communication for behavior and social change

– Engaging new partners - Faith Based Organizations, NGOs, Communities

– Strong Strategic Planning

– Ownership of the fight against malaria

items in black arising from ministerial session; items in blue additional challenges identified by Information Session and Day 1 Board)


Resistance Taskforce: Decision & Next Steps • WHO, through RBM Case Management & WIN Working Group in particular, but

also in collaboration with MERG and HWG, takes the lead on these two issues (strategy for the RBM Partnership to comprehensively address pharmaceutical and insecticide resistance) to start addressing management solutions.

• A report should be available before the 17th RBM Board meeting.• PMI and GFATM will consider funding once the requirements are determined in

the strategy development process.


Any Other Business :Global Fund shared board seat Next Steps

• Board provides mandate to the RBM Executive Director to dialogue with UNITAID and StopTB regarding the use of the approved joint GFATM board seat.

• EXD to report back to Board


Any Other Business :Legal binding nature of RBM Partnership Operating Framework

• A legal opinion, commissioned by the Private Sector Constituency, indicates that the RBM Partnership Operating Framework does not create any legally binding engagements for partners in the Partnership or on the Board.


Board Chair Election

• The RBM Board elected Honourable Kapembwa Simbao, Minister of Health from Zambia as the new Chair of the RBM Board

Documents

16 th RBM Partnership Board meeting 14-15 May 2009 Decision points and next steps Ramada Park Hotel