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From: PlusNews <[email protected]>
Date: Tue, Jul 24, 2012 at 4:41 PM
Subject: HIV/AIDS: Straight Talk with Mark Eldon-Edington, Global Fund
director of country programmes
To: Elisabeth Janaina <[email protected]>


HIV/AIDS: Straight Talk with Mark Eldon-Edington, Global Fund director
of country programmes

WASHINGTON DC, 24 July 2012 (PLUSNEWS) - The Global Fund to Fight
AIDS, Tuberculosis (TB) and Malaria is changing the way it does
business, and the way it disburses money. In 2010, after allegations
of fraud among fund recipients in Mali, Mauritania and Zambia, the
Global Fund put together an independent, high-level panel to review
its financial controls and how grant money is spent. The Fund is now
implementing the panel's recommendations.

IRIN/PlusNews sat down with Mark Eldon-Edington, the Fund's Director
of Country Programmes, at the 19th International AIDS Conference, in
Washington, to find out what the changes in the grant-making process
will mean for beneficiaries.

QUESTION: Why reform grant management?

ANSWER: One [reason] is better predictability of funding for
countries. We'll probably move away from a round-based system that
comes every one or two years, to a series of funding windows.

We want to significantly increase the success rate of proposals. If
you look at the success rates among HIV proposals in recent years,
it's about 40 percent and that's unacceptable - that's a lot of wasted
time.

It would be better to have a concept note approved and signed off
before proposals were developed in detail. The process hasn't been
worked out yet, but [if] proposals were approved as concept notes,
that would allow us to weed out inappropriate interventions and cut
costs, and it wouldn't be just us, but the technical partners such as
RBM [the World Health Organization (WHO) Roll Back Malaria programme],
the [WHO] Stop TB Partnership [and others].

I've been pushing hard for the concept of grant-ready proposals and
disbursement-ready grants. We need to cut down the one-year
negotiation time that happens after the [Global Fund] Board has
approved proposals. I have a list of approved grants against which no
disbursement has ever been made. Honestly, I don't think some will
ever be made. Why? Because some of those grants had 58 different
conditions when they were signed. You focus on signing a grant, but
you don't focus on signing disbursement-ready grants.

Q: What changes have you made at your Geneva secretariat?

A: We've put about 75 percent of Global Fund staff resources towards
grant management... we've eliminated a lot of positions that were not
directly relevant to grant management. We've created three high-impact
units, which [oversee] 20 focus countries that account for more than
70 percent of the global disease burden within the three diseases. Two
teams deal with Africa and one [with] Asia. The idea behind this is
that if we can move the needle in those 20 countries, than we can move
the needle globally.

We've also applied the country-team approach to grant management. It
used to be that you'd have someone from procurement, someone from
legal... on teams. Those people used to sit on different floors and in
different departments. We're trying to break down silos by forcing
people to sit together. We haven't yet filled all the positions under
the new structure. It's taken a while is because we're trying to raise
the bar. We're being picky about the people we're choosing.

It's not hard to restructure - what takes time is changing the
culture. The Global Fund has become very risk-averse in recent years.
We're saying, 'let's roll out operation risk management frameworks,
let's have good assessments of principle recipients, and let's
mitigate risk where we can with development partners'.

But we also need to be clear about the risk we can expect. The
greatest risk we face is. that we don't deliver on that mission
because we're too risk-averse. Don't tell me we can't make
disbursements, tell me how we can. It's about delivering on the Fund's
mission. It will take several more months to drive that culture
downwards.

Q: What will these changes mean for countries?

A: There will be an increased presence of portfolio fund managers and
country teams on the ground. From the high-impact countries where
we've done this, we're starting to hear some positive results. There's
starting to be some engagement to identify issues - how do we get
disbursements unlocked, and how do we get things moving. I won't
pretend that this is happening in every country yet.

We've identified significant issues with the Local Fund Agents [LFAs]
[hired to oversee grant performance]. I suspect it can't be easy being
an LFA because they don't seem to be very loved.

We need to move away from a one-size-fits-all approach that has been
quite prevalent in the last couple of years, which probably - and
rightly - results in frustration on the part of the PRs [Principal
Recipients]. I have resisted making quick changes to the LFA until
it's clear what our risk tolerance will be.

All of the LFA contracts are up for tender at the end of the year
[2012], so that timing works well. If I had to guess, I'd say we'll
continue to have LFAs because we won't be able to have enough
country-team time in-country to compensate. I would like to see a
minimum level of LFA work with Principle Recipients. Next year [2013],
I'd expect the LFA budget go down, and for their work to be more
strategic and more risk-based and more effective.

Q: What changes will the new funding model bring?

A: There's quite a bit of concern. about this. No decisions have been
made, and the funding model is still under discussion. There are still
a lot of opportunities for people to shape how the new funding model
will look through consultations. I want to put to bed the idea that
decisions have already been taken.

Q: What will the changes mean for civil society involvement?

A: The Global Fund remains absolutely committed to civil society, and
not solely for ideological reasons but for business reasons. If we are
to deliver on our mission, we need to reach the people [that]
governments can't or won't reach. Civil society is the way to reach
those people. who are most at risk, like men who have sex with men and
sex workers, but also those in remote areas.

We need civil society to be able to deliver on the Global Fund
mission. We have a dual-track financing policy and we will continue.
[funding both governments and civil society]. About 40 percent of our
grants are implemented through civil society. [ dual track:
http://www.scribd.com/doc/100912294 ]

Q: Will middle-income countries be excluded in the future?

A: The Global Fund eligibility requirements have not changed and we
will continue to fund MARP [most at risk populations]-related
activities in those. countries. Obviously, we are focusing on lower-
and lower-middle-income countries, and that will continue.

To quote US Secretary of State Hillary Clinton, 'We need to fight the
virus where it is', and if it's MARPs in middle-income countries, I
don't see that the funding model will change. It may sharpen the focus
on activities, and they may be under more scrutiny, but I don't see us
about to cut out a bunch of middle-income countries. [ Middle income:
http://www.plusnews.org/Report/94293/HIV-AIDS-Global-Fund-cancels-funding
]

llg/he[END]

This report online: http://www.plusnews.org/report.aspx?reportID=95941



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