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1 The RBM Partnership in action: Securing Financing for Countries in Collaboration with the Global Fund Purpose The purpose of this document is to present the successful process used by RBM to support countries to develop Global Fund malaria grants starting in round 7 (2007). This document provides both a historical overview of the support provided and lessons learnt that could be used by other organizations to develop successful approaches for supporting countries to develop proposals to various funding mechanisms. Background The Roll Back Malaria Partnership (RBM) is the global platform for coordinated action against malaria. Launched in 1998 by WHO, UNICEF, UNDP and the World Bank, RBM mobilizes for action, resources both financial and human and forges consensus among partners worldwide on malaria prevention and control strategies and approaches. The Partnership comprises hundreds of partners from malaria affected countries, their bilateral and multilateral development partners, the private sector, nongovernmental and community 2002, and based organizations, foundations, and research and academic institutions. RBM and the Global Fund Financing from the Global Fund to Fight HIVAIDS, TB and Malaria ( Global Fund ) began to flow in by 2005/6 significant funding was being made available to countries through its grant making process. However, malaria had the lowest success rates of the diseasee specific proposals in rounds 5 and 6 (23% and 32% successs rates respectively). At the 11 th RBM Board meeting in November 2006, the Executive Director of the Global Fund challenged the RBM Partnership to create a strategy to support countries to develop Global Fund malaria proposals with the aim of achieving a success rate of at least 50% in Round 7. In parallel, in response to the 2006 RBM evaluation, the Partnership was also in the process of overhauling its architecture to offer better support to high malaria burden countries, especially in Africa. The Global Fund s challenge was referred by the RBM Board to the newly created RBM Harmonization Working Group (HWG). The HWG was created to support revitalized country support on the basis of the Three Ones principles (one action framework, one national coordinating authority, one monitoring and evaluation system), by: 1. Assisting countries to identify scaling up support needs through the development of a transparent and comprehensive validation/gap analysis process (including the identification and development of appropriate gap analysis/validation tools for use by partners and countries); 2. Tracking resource flows from partners to countries, monitoring country progresss and disseminating information; 3. Harmonizing partner support to fill country identifiea rapid response mechanism to support countries to overcome implementation bottlenecks whether reactively or pro actively; and gaps; 4. Facilitating the development of 5. Ensuring high level success rates of applications for Global Fund and other major donor resources. 1

2 Meeting the GF Round 7 Challenge With an initial membership drawn from all RBM constituencies, 1 the HWG agreed in January 2007 to rapidly develop a strategy to support countries to develop Global Fund Round 7 malaria proposals. This was developed and marketed directly to donors to mobilize catalytic funding for a full package of support to countries including technical assistance (TA). Initial funds to implement the strategy came from the US Government, the private sector, and the RBM Partnership Work Plan (PWP) budget, while other partners contributed staff time, funded country participation in workshops and/or in country consultative processes. Malaria country support package For each country targeted for support, the HWG put in place a package comprising a trained international consultant and provided funding for countries to hire a national consultant and conduct in country consultative processes. Partners were identified at country level that could be asked to step in and provide technical and/or financial support for proposal development processes (e.g. some in country partners contributed staff to work on the proposal, paid for proposal writing/review workshops and/or paid for some members of the proposal team to travel to various workshops). The HWG also set aside funds to support partner missions to countries if the proposal development process was not on track or needed additional support. The package included sponsoring a country team, external consultants and partners to participate in a Global Fund orientation meeting (including an introduction to the proposal form and guidelines), and a mock Technical Review Panel (TRP) workshop for peer and expert review of the draft proposals. Experts were also identified to be on standby to provide a final last minute remote review of proposals just prior to submission to the Global Fund. The implementation of the country support package was facilitated by different mechanisms of the Partnership including the HWG, RBM Sub Regional Networks (SRNs) and RBM Secretariat. A summary of the support process by rounds is presented in table 1. Table 1 Summary of Support Process by Global Fund Round round Success rate External Workshops Comments (successful proposals/ total supported) consultants /partners Orient ation Mock TRP Strat Plan Rev 7 75% (15/20) Convened orientation/ training workshops in French and English 8 76% (13/17) Combined French and English countries in both the Orientation/training workshop and the mock TRP 9 57% (8/14) 20 1 Did not convene an orientation/training workshop because the application forms/proposal guidance were similar to rd % (13/15) 11 1 TFM 100% (7/7) Round 11 was cancelled by the Global Fund. NFM 100% (43/43)* 88** 4 7*** 2 RBM also convened two Concept Note external review workshops for individual countries. *All countries that apply for the NFM will ultimately be successful even if multiple reiterations of the concept note are required. **33 Consultants hired for pre Concept Note analytical components and 55 consultants hired to develop Concept Notes ***Includes a malaria grant costed extension external review workshop for three countries. 1 WHO, UNICEF, World Bank, UNDP, The Global Fund, Private Sector (Vestergaard Frandsen, BASF), UN Foundation, Bill and Melinda Gates Foundation, US President s Malaria Initiative/CDC, DFID, NGOs (PSI, PATH/MACEPA, Malaria No More (US), Global Health Advocates, Malaria Consortium), Research and Academia (Johns Hopkins University, Earth Institute Columbia University), endemic country representatives, RBM working group co Chairs, SRN Co Chairs and Coordinators and the RBM Secretariat. HWG membership has subsequently evolved over time to reflect the active engagement of different partners. 2

3 Dramatic Results The targeted support strategy had dramatic results on the overall malaria proposal success rate, increasing it from 32% in round 6 to 62% in round 7 (surpassing the 50% challenge). Countries receiving the full HWG support package had a 75% success rate (accounting for US$735 million of the total amount for malaria of US$1.3 billion) (see table 2). Due to the success of the process, the HWG was consistently able to raise resources to support countries to develop their Global Fund malaria proposals for subsequent rounds. Key steps of the RBM Global Fund proposal support strategy 1. Identification of countries that would be eligible for support. It was agreed that the HWG would actively target the whole support package at those countries with extremely pressing funding gaps and not in receipt of recent or current Global Fund grants. Countries that were performing poorly on Global Fund grants would receive support to improve grant implementation and would then be targeted for proposal support in subsequent funding rounds as historical trends were an external factor in influencing TRP financial decisions. This prioritization/stratification of country readiness to prepare the most eligible concept note was key in ensuring countries could pass the TRP and be awarded a grant. The countries to be supported were selected through a consultative approach with partners, the SRNs, and by reviewing Global Fund grant data. The selected countries represented a consensus among the group and those that did not make the list could receive some support but were not entitled to the full support package. Once the countries were identified, RBM proactively wrote to each CCM many months prior to the anticipated launch of that year s round and indicated that RBM would provide support to the country to develop their malaria proposal if the country were to apply. 2. Packaging of RBM guidance tools and adaptation of Global Fund proposal materials To support the development of proposals the HWG developed a standardized process for conducting a malaria programme needs assessment. This approach later evolved into a programmatic gap analysis tool to help countries determine their commodity and other programme needs for the five years going forward. The HWG also conducted an analysis of previous TRP comments on malaria proposals and developed a guidance document (updated for each Round) on proposal specific issues and operational best practices. WHO produced a summary of current technical recommendations for each intervention (also updated for each round). As the Global Fund has itself been an active member of the HWG since its establishment in 2006, the development of a close working relationship allowed RBM to provide inputs on draft proposal Global Fund forms, to make them more relevant to malaria, and to gain consensus on guidance documents and the Gap Analysis Tool. The Global Fund currently accepts the results of the HWG Gap Analysis tool and allows countries to use the tool s outputs to populate the gap table of their proposals. Global Fund representatives from various units have also participated in many of the grant application orientation workshops, mock TRPs and gap analysis workshops. 3. Development of RBM Expert Roster To find expertise to work with countries on proposal development, RBM launched several calls for proposals from independent consultants and consulting companies. Potential consultants were rated according to their experience, language ability and previous performance. A roster of qualified consultants/experts was established, and over the course of several rounds, the roster was refined according to performance. National consultants that performed well were often recruited to become international consultants during 3

4 the next round. This helped to maintain and expand the expert/consultant roster in subsequent rounds and build national/regional capacity. 4. Global Fund Orientation/Training Workshops Orientation/Training workshops were convened in countries as soon as the Global Fund launched a new round and the proposal forms and guidance were available. A team from each targeted country consisting of the National Malaria Control Programme (NMCP) Manager, the NMCP Global fund Focal Point, the WHO malaria National Professional Officer (NPO) (or International Professional Officer), a Global Fund Country Coordinating Mechanism (CCM) representative, a representative from a Civil Society Organization (CSO) and a national consultant were invited to participate in the workshop. Countries were also free to invite other partners who would help with the writing of the proposal. The same country team was retained throughout the proposal development process. International consultants were invited to the orientation workshops and where possible, an attempt was made to match them with countries in advance of the workshop, or directly after the workshop, to develop a working relationship with the country team as early as possible in the proposal development process. Initially, the orientation workshops were convened for countries based on language (English or French). However country participants preferred to participate in one workshop together with simultaneous translation to ensure the same messages were delivered to all countries at the same time. Orientation/training workshops allowed countries to review the proposal templates and guidance and then ask questions to the Global Fund directly for clarifications. The other advantage of the workshop was that countries worked back from the submission deadline to develop a work plan with timelines for developing and submitting the proposal. This was important for providing a starting point for the proposal development process. 5. Proposal Peer Review, mock TRP Workshops In 2006, RBM convened three peer review workshops in Africa to review Round 6 proposals. The peer review workshops were scheduled quite late with only 2 weeks left before the submission date. Despite this eleventh hour approach, countries that attended a workshop had a proposal success rate of 50% (whereas countries that did not participate in a peer review workshop had an overall success rate of 32%). This gave an initial demonstration of the power of the peer review process and how it could contribute to the development of successful proposals. The peer review process was further refined at the RBM East Africa Network Annual Planning and Review meeting in Zanzibar (November 2006). In Round 7, the HWG was able to build upon this experience convening a mock TRP where country groups and experts reviewed each other s proposals and fed back their comments to the other countries in the group. This methodology provided an excellent review mechanism and helped countries to better understand the weaknesses in their own proposals from their peers as opposed to only external expert opinion. As with the Global Fund orientation workshops, the same country proposal team 2 was invited to attend the mock TRP. CCMs have traditionally been stronger in their appreciation of HIV/AIDS programming and funding challenges; having the CCM and CSOs involved in the malaria proposal development process from the beginning increased the CCM s knowledge of the countries malaria needs, and facilitated better oversight and ultimate approval of the proposal prior to submission. The timing of the mock TRP was critical; convening the workshop too early would result in countries coming to the workshop with incomplete proposal drafts. Convening the workshop too late did not give countries enough time to respond to the comments and finalize the proposal. By trial and error over several Rounds the HWG had the best results when the mock TRP was scheduled about 5 weeks from the submission deadline. 2 NMCP Manager, NMCP Global fund Focal Point, WHO malaria National Professional Officer (NPO) (or International Professional Officer), CCM representative, CSO representative, national consultant. 4

5 If limited funding is available, the mock TRP is probably the most important workshop to prioritize. Mock TRP Workshop To facilitate the review process, 2 3 countries with similar malaria situations or that face similar challenges should be grouped by language. One or two external experts/facilitators should be assigned to each group. The morning of the first day is normally spent reviewing the Global Fund template/guidance, recommendations for completing the proposal template, and a review of current normative guidance. The group work normally starts in the afternoon (this allows time for the draft proposals to be printed since the draft proposals are almost never sent in advance of the workshop). Each group reviews first their own proposal and then the proposal of one other country in the group. The next day and a half are spent reviewing proposals and providing feedback within the group. The third day of the workshop usually starts with a plenary session for all to discuss common questions/challenges identified during the review process. After the plenary session, the group work can continue until mid afternoon. In the late afternoon, countries usually work individually to revise their proposal work plan activities and timelines, requesting any additional support from technical partners/hwg as required. The HWG can then mobilize any additional required assistance to countries prior to the proposal submission deadline. 6. Final Remote Review of Proposals Prior to Submission The HWG contacted all partners and pre identified experts to be on standby to conduct a final remote review of malaria proposals prior to submission. Countries were offered a final remote review of their proposal with the assurance of feedback from the expert(s) within 48 hours. Over many rounds a significant number of countries submitted their proposals for a final remote review. This provided a last quality assurance step to ensure that technically sound, well written, coherent proposals were submitted to the Global Fund. As teams were often working until the very last hour ensuring coherence between various documents and templates was vital to presenting a cohesive picture to the TRP. 7. HWG Briefing of TRP The HWG was invited to brief the TRP on the technical guidance provided to countries and the type of support countries received. This provided an important contribution towards making the TRP aware of the current normative guidance. 8. New Funding Model In March 2014, the Global Fund launched its New Funding Model (NFM). The funding model incorporated several features that determined the way applicants apply for and receive funding and then manage their grants in particular an allocation methodology that awarded countries an envelope of financing against their disease control priorities with suggestions for the amounts that should be allocated per disease. The NFM is characterized by flexible timelines, enhanced engagement through a country dialogue process and improved predictability of funding. The basis for NFM grants is a technically sound, feasible to implement and impact oriented National Strategic Plan. One of the new elements of the NFM process was the emphasis on broader maternal, newborn and child health (MNCH) integration and the countries ability to include in their malaria and health system strengthening (HSS) grant proposals expenses associated with the development or expansion of integrated community case management (iccm) approaches to diagnosing and treating the febrile child. This provided a unique opportunity to work with high burden countries to sharpen community based treatment strategies and plans and leverage the necessary resources from the Global Fund and other potential sources of cofinancing. 5

6 HWG developed a country support package for African countries in anticipation of the launch of the Global Fund NFM in March The HWG convened a workshop in December 2013 with all African countries to introduce them to the NFM; review, update and extend their programmatic gap analyses to 2017; to map the status of their malaria programme reviews (MPRs) and schedule support to review and update national malaria strategic plans; and to assess countries interests in integrating iccm into the NFM malaria concept notes. To reach all African countries and adapt to the countries changing needs, from December 2013 to November 2015, RBM convened four NFM Orientation/Training workshops; two national strategic plan review workshops, six mock TRP review workshops, two in country external Concept Note Review workshops and an external review workshop for countries developing costed extensions of current malaria grants. An iccm Financing Task Team (iccm FTT) 3 trained in the same manner as the HWG, attended these workshops and promoted iccm integration through sharing of guides and tools and serving as reviewers of the national iccm strategies, gap analyses, and concept notes. The iccm FTT has supported 21 African countries through provision of TA in the form of dedicated consultants per country or via core Task Team TA and/or sharing of the various tools prepared by the iccm FTT, to integrate iccm into the malaria concept notes (phase 1 support) and iccm gap analysis tool, as well as providing implementation planning assistance to a selection of countries which have been successful in securing iccm funding from the GF (phase 2 support). Overall, RBM supported 40 African countries (and a few outside the African continent but to a much lesser extent) to develop malaria Concept Notes and three countries in complex situations to develop costed extensions of current grants nearly half of these also benefited from support for MNCH activities, especially iccm. RBM pledged to help other African countries without access to Global Fund financing to raise other resources for their malaria programmes, notably through collaboration with the RBM Malaria Advocacy Working Group (MAWG) which had recently developed an Advocacy for Resource Mobilization (ARM) Guide to provide malaria stakeholders in endemic countries with an advocacy implementation guide, case studies and tools to assist them with mobilizing resources for malaria control and elimination at country level. Because the NFM aims to align with a country s strategic plan, RBM developed a strategic plan review tool and convened two strategic plan review workshops building on the peer review methodology for proposals. This helped countries to update their strategic plans to ensure that they were technically sound, feasible to implement and if fully implemented would achieve the desired impact. The mock TRP model was adapted for the NFM, with countries first conducting a self assessment of their proposal prior to reviewing the other country s proposal. This helped the country proposal teams to fully understand their own proposal before reviewing another country s proposal. This was especially important for the CCM and CSO representatives on the proposal development team who were not always fully engaged in the proposal development process. The collaboration between the iccm FTT and the HWG at these mock TRP meetings fostered collaboration between child health and the NMCP communities. 3 Due to the limited time window of opportunity through the GF NFM process, it was felt that a dedicated core group of individuals was needed to lead this effort and provide the necessary time, energy and push to ensure that critical tasks were completed. Thus the iccm Financing Task Team (iccm FTT), a collaboration led by UNICEF, along with MDGHA, USAID, Save the Children, JSI/MCSP, IFRC, CHAI, MSH/SIAPS, and others, was formed in February 2014 to ensure countries received appropriate and timely technical assistance to complete high quality malaria and HSS Global Fund concept notes that include iccm. 6

7 Results of the RBM Global Fund Proposal Support Process Table 2 Global Fund Malaria Proposals Success Rates Rounds Success rate for malaria proposals worldwide RBM supported countries in SSA success rate Overall funding approved for malaria five year period US$ RBM specific funding five year period US$ Round 7 62% (28/45) 75% (15/20) 1,300,000, ,308,059 Round 8 68% (28/41) 76% (13/17) 3,014,000,000 1,853,218,007 Round 9 55% (17/31) 57% (8/14) 1,309,000, ,573,634 Round 10 79% (19/24) 87% (13/15) 1,543,630,262 1,353,491,467 TFM* 79% (11/14) 100% (7/7) 201,000, ,829,930 Total 66% (103/155) 77% (56/73) 7,367,630,262 4,897,421,097 *TFM funding varies by grant and does not cover the same time period Since 2007 (Global Fund Round 7), 66% (103/155) of all submitted malaria proposals have been successful, resulting in the approval of nearly US$7.4 billion in funding for malaria control worldwide. The RBM Partnership has successfully supported 56/73 malaria proposals (77% success rate) resulting in potential funding of nearly US$4.9 billion, mostly to sub Saharan African countries where the need was highest. Table 3 Global Fund Proposals Success Rates all Diseases Round Global malaria proposal success rate RBM supported countries success rate TB Proposal Global Success Rate HIV Proposal Global Success rate Round 7 62% (28/45) 75% (15/20) 46% (19/41) 41% (26/64) Round 8 68% (28/41) 76% (13/17) 51% (29/57) 49% (37/76) Round 9 55% (17/31) 57% (8/14) 59% (32/54) 41% (30/74) Round 10 79% (19/24) 87% (13/15) 54% (26/48) 44% (34/78) TFM* 79% (11/14) 100% (7/7) 86% (18/21) 62% (16/26) Total 66% (103/155) 77% (56/73) 56% (124/221) 45% (143/318) Table 3 shows that since Round 7, the overall success rate of malaria proposals was higher than all other diseases except for Round 9 and the TFM. The RBM supported success rate is higher than all other diseases except for TB proposals in Round 9. For Round 9, RBM attempted a light approach with less intensive support to countries, but given the lower success rate, reverted to the more intensive approach. The 66% cumulative success rate for all malaria proposals over the 5 year period was significantly higher than for other diseases. The rate for RBM supported countries of 77% was 21 points higher than TB, the next best performing set of disease proposals over the same timeframe. Thus RBM demonstrated that a targeted support approach, sustained over several rounds lifted the overall success rate for malaria proposals worldwide. Table 4 Percentage of Overall Global Fund Funding by Disease* Disease Round TFM NFM HIV 41% 54% 48% 38% 45% 42% 27% 50% Malaria 26% 24% 42% 51% 30% 33% 49% 32% TB 28% 22.5% 10% 11% 25% 17% 25% 18% *Based on TRP 5 year maximum funding recommendations, does not include reduction for efficiency gains or final grant amounts 7

8 As table 4 highlights, the success of malaria proposals since 2007 has led to a higher percentage of the GF resources being allocated to malaria. This had an important impact on the NFM funding allocations with 32% reserved for malaria compared to the 24 26% that might have been available based on the percentage of funding malaria received in Round 5/Round 6. New Funding Model Results The intensive support to prepare countries for the Global Fund NFM paid off. Many African countries were able to develop and submit their malaria Global Fund Concept Notes in the first few TRP windows, enabling them to access critical resources in a timely fashion. By the end of December 2014, 41 countries (25 from Africa) had submitted malaria Concept Notes requesting allocations totalling US$ 2.7 billion for their malaria programmes. The early TRP windows were dominated by malaria which helped countries move quickly into the grant making process, fill critical funding gaps and start implementation as soon as possible. All iccm FTT supported countries, which have submitted iccm enhanced concept notes, have received GF approvals. Based on the approved concept notes and the additional co financing data available, approximately $200 million has been mobilized for iccm (about $80 million directly from the GF). Costs of Intensive Country Support Package The direct costs to support countries to develop successful malaria proposals/concept Notes varied by round and was based on the number of workshops, the time period for support, in kind contributions from partners and other factors. The estimated cost of a full package of support to one country ranged between US$90, ,000. This is a small price to pay to facilitate access to Global Fund grants worth millions of US dollars over the 3 5 year time period. The cost of support to countries during the NFM process was higher than the rounds based process because many countries delayed submitting their Concept Notes from window to window, leading to higher costs for participation in multiple mock TRP workshops, participation in strategic plan review workshops and contract extensions for external consultants. Most countries underestimated the amount of work needed to prepare for the NFM (e.g. conduct programme review, update strategic plan, develop other documents M&E Plan, PSM Plan) and thus it took longer than expected. The iccm FTT has recently commissioned a review of the iccm integrated financing process, which will provide greater insights into its costs, benefits, and challenges. Lessons Learned for the Future Pre Funding round launch Successful support strategy requires commitment financial and in kind from all partners and high level endorsement (e.g. RBM Board). In country partners should be approached to provide dedicated staff to join the country proposal team and may be able to help finance in country workshops, the hiring of local consultants and/or travel costs to various workshops. Implementation of a support strategy requires a specially conceived task team or working group with agreed roles and responsibilities and support from their hosting institutions to devote the necessary time to the support process. 8

9 Support needs to be targeted to countries with the greatest current needs consensus among partners on which countries will be supported and which will not be targeted for support is critical. Support strategy should be focused on a manageable sub set of countries (e.g. for RBM geographically in Africa or by Region). It would be vastly more difficult to set up a global strategy unless the overall number of countries to be supported is small (i.e., less than 25). The support process should be started early (e.g. 4 6 months before the beginning of the funding round) to raise sufficient resources, recruit experts, establish an expert roster, develop guidance materials, etc. Close collaboration with the Global Fund (or other potential donors) throughout the whole process (e.g.. during the development of the proposal templates/guidance, Global Fund participation in workshops, and referral of questions to the Global Fund team for rapid response) is essential. The targeted countries should be proactively approached to offer the support package, even prior to the launch of the funding window. The development of consolidated guidance on the development of proposalss and a summary of WHO technical recommendations concerning malaria helped to ensure that countries are given consistent advice and that all the information is available in one place. Funding round launch/country Support Orientation/training workshops held at the launch of the funding window are helpful to kick start the proposal development process. Workshops are useful to push countries to create proposal 9

10 development work plans as well as timeframes for submitting their proposals. Workshops are also useful to create proposal development teams that would (hopefully) be engaged throughout the proposal development process. The same team could then be invited to the mock TRP review workshop. Providing countries with funding for in country consultative processes is helpful. It is also possible to approach in country partners requesting them to fund in country proposal writing and review workshops when global level funding is inadequate. Funding national consultants develops national capacity and helps to identify future international consultants thus expanding the expert roster for future proposal development support. Advocate for partnerships that can complement country proposals with potential co financing options to provide additional sources of value (e.g., private sector, social impact financing) and provide technical assistance to facilitate the process. The peer review process during the mock Technical Review Panel (TRP) is a key quality assurance mechanism and helps countries to see the weaknesses in their own proposals. The mock TRPs need to be timed appropriately to ensure countries will bring nearly complete, quality proposals to the workshop. They will also need enough time to revisee their proposals and submit them to the CCM for final approval after the workshop. RBM found that 5 6 weeks prior to the submission date usually allowed sufficient time to provide additional last minute support (if required) and enabled countries to complete and submit high quality proposals by the deadline. Creating a roster of experts on stand by to conduct last minute reviews of proposals was found to be helpful and provided a final quality assurance step prior to submission. Post proposal submission Briefing the TRP on the technical guidance provided and the support countries received helped to ensure that the TRP and the HWG both had similar understandings of what constituted the current normative guidance. 10

11 Table 5 highlights some challenges and potential solutions during the proposal development support process. Table 5 Challenges and Solutions for proposal development support Stage of Challenges Solutions Proposal Development Pre round launch Insufficient technical experts/consultants Initiate a call for experts/consultants with well defined terms of reference. Convene a task team to review CVs and create a short list based on the ToRs and other skills (e.g. language, regional experience, etc.) Technical support Review process Insufficient financial resources to support all countries intending to apply Perceived low country ownership of proposal development process Countries arrive at mock TRP with poor quality draft or very incomplete proposals Countries don t share draft proposals prior to the mock TRP Proposals are not reviewed by experts and peers consistently Target support to countries most in need. Establish criteria for selecting countries to support. Foster consensus on which countries will receive support. Map potential country level partners that may be able to provide in kind and/financial support to the process. Some countries can receive partial support (e.g. sponsor participants to attend workshops but do not provide external consultants) Support a country proposal team approach, invite the same team to all workshops. Provide funds for the in country consultative processes including hiring a local consultant and facilitating participation in the proposal development process by a variety of stakeholders Convening the orientation meeting can help countries to kickstart the proposal development process Time mock TRP so that it is 5 6 weeks prior to the submission date. Collect the draft proposals the first morning of the workshop and print them in the morning. Start the group review process in the afternoon of the first day. Develop a reviewer s template for use in the mock TRP Submission Postsubmission Countries are unable to complete online proposal submission before deadline. TRP Clarifications/Grant Negotiation Countries need to plan on starting to upload proposal documents at least a week before the submission deadline. Ensure access to a facility with stable high quality internet access The same expert (in country consultant/external consultant) should be used to help countries to respond to TRP clarifications. In some cases they may also be able to help with the grant negotiation. Conclusions RBM demonstrated that the success rate of Global Fund malaria proposals could be significantly improved through the implementation of a focused country support strategy moving malaria proposals from the worst performing disease group to the best performing disease group in one year and sustaining this performance over a five year period. However, this process required substantial financial inputs and sustained commitment from dedicated partners and individuals to be successful. 11

12 Could this methodology work to help countries access donor funding for health or in other sectors? There is no reason why this process could not be adapted to support the development of other disease or HSS proposals to the Global Fund (perhaps targeting countries in a specific region) or possibly other funding mechanisms, (e.g. GAVI, The Global Financing Facility, etc.). The process works well to support access to funding to the Global Fund because the Global Fund permits countries to apply for substantial amounts of funding for their programmes and the same donors that contribute to the Global Fund have made it a priority to help countries effectively access the available funding. This has helped to build consensus on a support strategy, and facilitates resource mobilization, including in kind support, to implement the strategy in a harmonized way. 12