CCMs and PRs structure and functions & civil society opportunities

The Global Fund philosophy

« The Global Fund recognizes that only through a country-driven, coordinated and multi-sectoral approach involving all relevant partners will additional resources have a significant impact on the reduction of infections, illness and death from the three diseases. Thus, a variety of actors, each with unique skills, background and experience, must be involved in the development of proposals and decisions on the allocation and utilization of Global Fund financial resources. To achieve this, the Global Fund expects grant proposals to be coordinated among a broad range of stakeholders through a Country Coordinated Mechanism (CCM) and that the CCM will oversee the implementation of approved proposals. » CCM Guidelines, GF, p. 1

What is a CCM?

« CCMs are partnerships comprised of representatives from both the public and civil society sectors who coordinate the submission of one national proposal based on priority needs. Additionally, CCMs are responsible to oversee the progress of program implementation…The CCM [is] a central pillar of the Global Fund’s architecture to ensure country-driven, coordinated, and multi-sectoral processes for leveraging and effecting additional resources …to fight AIDS, TB and malaria.»

Clarifications, GF, p. 1

Key Principles of CCMs

1. Multi-sectoral partnership2. Broad participation3. Non-government

representatives4. Consensual decision-

making5. Transparency6. Documentation7. Active communication and

consultation with stakeholders

8. Grant oversight

CCMs: Six Minimum Criteria

1. Transparent selection process for CCM nongovernmental members

2. Membership of persons affected by HIV/AIDS, TB, and malaria

3. Transparent and documented process to solicit and review proposal submissions

4. Transparent and documented process for nominating the PR and overseeing program implementation

5. Ensure the input of a broad range of stakeholders6. Have a written conflict-of-interest plan, especially when the

CCM chair or vice chair represents the same institution as the principal recipient

CCM Composition• Government• Education/Universities• NGOs, CBOs• Assoc. of people living w. diseases• Private sector• FBOs, religious leaders• Bilateral and multilateral development

partners• Key affected populations

At least 40% of CCM seats

Attention required to gender balance on the CCM !Attention required to geographical representation on the CCM !

CCMs: Principal Responsibilities

• Identify national priorities and gaps in programmatic, technical, & geographic coverage or financial support

• Promote multi-sectoral participation• Ensure the harmonization of Global Fund grants with other

support for the three diseases• Coordinate and ratify grant proposals• Designate the Principal Recipients• Ensure grant oversight and evaluate Phase 2 progress• Resolve problems surpassing the authority & competence of

Principal Recipients• Submit Phase 2 and Rolling Continuation Channel requests• Ensure transparency with stakeholders and the Global Fund

CCM: A national, representative, multi-sectoral governance body

Members represent their constituency, not themselves or their institution.

The CCM governs in the national interest.

The CCM neither manages nor executes Global Fund grants.

4.Oversight of

grants & Principal

Recipients

The 5 Key Functions of a CCM

3.Proposal develop-

ment

5.Documen-

tation & communi-cation with constituen-cies & GF

2.Harmoni-

zation of GF funds with

other resources

1.Organization

& functioning of the CCM

& itsSecretariat

CCM Oversight

Every CCM should be able to answer these questions about each grant:

1.Where is the money ?

1.Where are the drugs, commodities, equipment?

1.Are SRs receiving the resources they require?

1.Are the projects being carried out as planned?

– What are the results; is the grant on target?

CCMs: Frequent Problems

• Under-designed as structures• Conflicts of interest• Dominated by the Minister of Health or public & health

sectors• Poor representation of sectors (members believe they

represent only their organization; motivation is to ensure my organization gets GF funds)

• Confusion between the CCM and other national bodies• Lack of political will• Poor or non-existent oversight, little support of PRs to

resolve cross-cutting problems & bottlenecks

Who can be a PR?

• Government ministry or agency, or National AIDS Commission

• National NGO, faith-based organization, or foundation

• Multilateral agency (e.g., UNDP, UNICEF)• International PVO with in-country presence

(e.g., Red Crescent, CARE, PACT, PSI)• Private-sector organization

CCM & PR: Boundaries

• CCM designates the PR, manages & validates the proposal

• CCM is responsible for the proposal until the GF approves the new PR

• CCM oversees implementation • CCM resolves systemic

problems and bottlenecks the PR cannot solve

• CCM ensures transparency of its activities, decisions, and proposal development

• CCM approves requests to reprogram funds, for Phase 2, RCC

• PR selects SRs if they were not chosen during proposal development

• The GF negotiates directly with the future PR before signature, once the PR passes the PR assessment

• PR manages the grant• PR submits quarterly reports

directly to the LFA• PR resolves grant problems or

asks the CCM for help• PR ensures transparency and

communicates grant results• PR and SRs develop

reprogramming, Phase 2 and RCC requests

Civil society opportunities

Sub-Recipients &Sub-Sub-Recipients

SSR

SSR

SSR

CSOs Can Serve . . .

• On the Country Coordinating Mechanism (CCM)

• As Principal Recipients (PR)• As Sub-Recipients (SR)• As Sub-Sub-Recipients (SSR)• As contractors or service providers

Who can be an SR?

• Government ministry or agency, or AIDS commission

• National NGO, FBO, Foundation• Multilateral agency (UNDP, UNICEF)• International PVO with in-country presence (e.g.,

Red Crescent, CARE, PACT, PSI)• Private-sector organization (Shell Philippines)

As long as they are selected by the CCM or the PR and can pass the Global Fund assessment.

SRs May Have One or More SSRs

How the Global Fund envisioned the SRs:

• Locally present stakeholder institutions from all sectors

• Project implementers

Types & Numbers of SRs in 10 Countries (by Disease)

Source: Global Fund TERG 5-year Evaluation, Nov. 2008

Selection and Roles of Sub-recipientsSelection during proposal development: strategic advantage, named in the proposal• Technical expertise, special expertise or authority• Geographic coverage or niche targeting• More accurate targets and budgets

Roles for sub-recipients• Lead sub-recipients• Coordinating sub-recipient• Sub sub recipients

• Participation in strategic design, setting targets, defining roles for each partner institution

• Participation In final pre-signature planning & negotiations• Participation In monitoring and evaluation of performance

o Sub-sub-recipients• Participation In technical execution of activities

Some Expectations and Requirements of SRs and PRs

PR• Agreements/MoUs

clarifying roles and responsibilities

• Timely disbursements• Operations manual to

guide grant implementation• Technical support• Grouped procurement• Transparency

Sr’s• Annual work plans• Half-year/quarterly

financial and progress update reports on time

• Adherence to GF and national requirements

• Adherence to the work plan

• Transparency

How Civil Society can be effectively involved in Global Fund processes

Who do we mean by civil society?

● International Non-Governmental Organisations● Associations of people living with the diseases● Associations of people using drugs● National and local NGOs● Community Based Organisations● Faith Based Organisations● Trade Unions● Womens‘ organisations● Youth Organisations● Organisations supporting people with disabilities

The principle of „GIPA“

= To „support a greater involvement of people living with HIV/AIDS at all...levels...and to...stimulate the creation of supportive political, legal and social environments.“

● Endorsed by United Nations Member countries. ● Binding the expertise of PLWHAs. ● Support acceptance and preparedness. ● Enhance the effectiveness of services.

Why would we work with Civil Society?

● Reach beyond the formal infrastructure● Provide services to hard-to-reach communities● Involve people living with the diseases● Contribute to a wholistic approach ● React relatively flexible to new challenges and changes

►Evidence of civil society as strong implementers of programs at the country level. ►Programs with strong civil society involvement achieve very good results.

► ► Collaboration with civil society adds value.

The Added Value of Civil society

• Innovation in health service delivery for key affected populations

• Rapid response in terms of prevention, treatment and advocacy programs

• Importance of CS in roll-out/scale-up of treatment literacy

• Scaling-up prevention among key affected populations• National HIV Plans: represent the best speaker on

community needs

• Advocacy, raising awareness and fighting stigma and discrimination.

• Pioneer in establishment of programs for key affected populations: o IDU (Algeria, Egypt, Iran, Lebanon, Libya, Morocco, Syria)o Migrants and refugees (Algeria, Djibouti, Morocco, Somalia,

Sudan, Yemen)o Sex work (Algeria, Egypt, Iran, Lebanon, Morocco, Somalia,

Syria, Tunisia)o MSM (Morocco, Pakistan, Algeria, Lebanon, Tunisia,)

• Pioneer in delivering VCT services (Morocco and Algeria) and treatment literacy programs (Morocco)

Civil society in MENA

Health Services Pyramid

Community Based Health Services

Primary Health Care

Secondary Health Care

Tertiary Health Care

80% of resources 20% of population

CSS

DTFMajority of population

Civil Society in the Global Fund

The Fund will support programs that

Global Fund Framework Document, 2002

Governance

Board members

Non-Government Organizations

Faith-Based Organizations

Community-Based Organizations

Advocates

Watchdogs

Implementers

CCM members

Dual Track Financing

Affected and Most-at-Risk Populations

PRs, SRs, SSRs

Program Design

Early Warning

Grant Oversight

The role of Civil Society

Entry points for civil society engagement in grant implementation

Grant Signing

0

Proposal Development

• Defining key affected populations where necessary

• Identifying gaps in current activities• Developing strategies and

interventions • Including focus on CSS activities• Including CSOs as SRs

Phase 2 Request

• Addressing challenges through CCM

• Including CSOs as SRs for implementation

RCC Proposal Development

• Defining key affected populations where necessary

• Identifying gaps in current activities• Developing strategies and

interventions • Including focus on CSS activities• Including CSOs as SRs

RCCPhase 2Proposal Development

1 2 3 4 5

Implementation

• PR (dual-track financing)• SR

Engagement in/through CCM

• Proposal developmento New Round of fundingo Phase 2o RCC

• Ongoing oversighto Identifying challengeso Developing responses

involving CSOs

Through NGO representation on CCM

The Extent of Civil Society’s Role

Entry points in Governance & Implementation