update and decision points from the harmonisation working group

Update and Decision Points from the Harmonisation Working Group

Harmonization Working Group November 2007

The Harmonization Working GroupBoard Endorsed TORs

Secure additional resources from the Global Fund, PMI, World Bank and others in support of country scale-up

1

Assist countries to identify support needs for scaling-up through comprehensive needs assessments

2

Coordinate a process to support the development of and adherence to the “3-ones” concept at country level

3

Harmonize partner efforts to fill country-identified gaps4

Facilitate the development of a “rapid-response” mechanism to support countries to overcome implementation bottlenecks (reactively and proactively)

5

Track and Facilitate resource flows from partners to countries6


Board Decisions

Endorsed the terms of reference and the areas of focus for 2008:● Gap analysis/needs assessments● Matching resources to identified gaps● Information development and tool development

1

Endorsed the need for incremental financing and staff support to:● HWG partners –particularly in the Implementation support

mechanism● The RBM secretariat (for co-ordination and facilitation)

2

Approved the “Malaria Implementation Support Team” name change

3


Secure Additional Resources – GFATM Round 7 Support Process

● First fully coordinated effort to develop high quality proposals

● Support to 19 programmes: Angola, Burundi, Burkina Faso, (CAR), Congo, Chad, DRC, Ethiopia, Ghana, Liberia, Madagascar, Malawi, Rwanda, Senegal, Sierra Leone, Sudan (North and South) Tanzania, Zanzibar and Zambia

● Realistic and publicly announced target (>60% success rate)

● Prioritization and tailoring of country support

● High level of partner involvement in planning, execution, and fundraising and intense level of Secretariat support.

● Contracting out to expand partnership capacity

1


Secure Additional Resources – Round 7 Support Package

● Synthesis of information on unsuccessful applications from earlier Rounds and existing grants including identification of bottlenecks;

● Modification of the GFATM template to increase “malaria friendliness”

● Selection of experienced internal and external consultants

● Training workshops for consultants and country teams (including members of the CCM and Malaria Control Programmes) on proposal development and gap analysis

● Mock TRP session for the draft proposals prior to finalization (over 120 participants from 24 countries)

● Individual assistance missions to countries, where required,

● Expert review of final stage of proposals

● Briefing of the TRP

1


Secure Additional Resources –Significant inputs from donors

1

Cost Centre US$

Proposal writing Training Workshops

300,000

Support to in-country processes (Local consultants, proposal writing, and consultative processes) (US$ 20,000/country)

400,000

External Consultants 300,000

Mock Technical Review Panel 200,000

Staff time and travel (agency contributions)

735,00

Total US$ 1,935,000

RBM Sect. 347,000

Total cash received

$1,314,000

USAID 200,000

ExxonMobil 87,000

Malaria No More 200,000

UNICEF 30,000

Vestergaard-Fransden

100,000

WHO 100,000

Millennium Project 250,000


Secure Additional Resources – Significant Individual Commitments

● Steering Committee: Trent Ruebush, Sergio Spinaci, Valentina Buj, Rick Steketee, Melanie Renshaw, Suprotik Basu

● RBM Secretariat: James Banda, Richard Carr, Betty Udom, Sophie Schmidt Claude Rwagacondo

● WHO: Sergio Spinaci, Robert Agyarko, Valentina Buj, Jose Nkuni, Charles Paluku, Peter Olumese, Stephane Tohon, Khoti Gausi, Walter Kazadi, Josephine Namboze

● Millennium Project: Awash Teklehaimanot, Yemane Ye-ebiyo Yihdego, Hailay Desta Teklehaimanot Daniel Madandi, Sékou Fantamady Traore, Belco Poudiougou, Abdoulaye Mohamed Touré, Aklilu Seyoum, Ousmane Faye

● UNICEF: Melanie Renshaw, Rory Nefdt, Angus Spiers

● World Bank: Suprotik Basu, Jean Pierre Marshande, John Paul Clark

● GFATM: Mabingue Ngom, Mark Grabowsky, Joanne Barczyk, Karmen Bennet, David Curry, Ilze Kalnina, Sophie Logez, Sandrine Lourenco, David Powell

● US/PMI: Trent Ruebush, Larry Slutsker, Robert Wirtz, Angus Spiers

● MACEPA: Rick Steketee, Hana Bilak, Paul Libiszowski PSI: Ricki Orford

● Global health advocates: Louis da Gama MAWG special working group

1


Secure Additional Resources – Results

1

● 17 Round 7 and 3 RCC proposals

● 12/17 Round 7 proposals awarded

● 3/3 RCC proposals awarded

● Total 15/20 = 75%

19 countries supported

0

10

20

30

40

50

60

70

80

Round 5 Round 6 Round 7 Round 7HWG

SuccessPercent


Secure Additional Resources – Results: Additional Funds Available from GF

1

HWG support:

● Phase 1: US$388 M

● Phase 1 and 2: US$817 M

050

100150200250300350400450500

1

Phase 1USD

Malaria overall:

● Phase 1: 642 M

● Phase 1 and 2 US$1.3 B

Round

2 3 4 5 6 7


Secure Additional Resources

“The support of the RBM partners to countries during Round 7 has been extraordinary and filled an essential role in the application process. In many ways, this effort was the fulfillment of our collective vision of the RBM Partnership at its best. I trust that you will consider-making this a "normal" part of RBM Partnership activities..”

1

Michel Kazatchkine Executive Director, The Global Fund


Secure Additional Resources – Next Steps

● Evaluate Round 7 process for lessons learned ● Support appeals and category 2 countries to answer TRP

questions and provide technical support where necessary to address TRP identified weaknesses

● Support successful countries to achieve signature – including completion of monitoring and evaluation (MERG), procurement/supply management (PSMWG) and workplans (HWG)– Currently the average time to signature is 290 days

● Work with GFATM to accelerate signature process including understanding what HWG can do and what GFATM must do alone

● Evaluate Round 7 process for lessons learned ● Support appeals and category 2 countries to answer TRP

questions and provide technical support where necessary to address TRP identified weaknesses

● Support successful countries to achieve signature – including completion of monitoring and evaluation (MERG), procurement/supply management (PSMWG) and workplans (HWG)– Currently the average time to signature is 290 days

● Work with GFATM to accelerate signature process including understanding what HWG can do and what GFATM must do alone

1


Secure Additional Resources – Next Steps

● Introducing a Round 8 proposal taskforce● Identify countries for Round 8 support. Provisionally:

– Cameroon CAR– Comoros Congo– DRC Equatorial Guinea– Ethiopia Gabon– Ghana Kenya– Mozambique Nigeria– Zanzibar Zimbabwe

● Complete needs assessments in round 8 countries including partnership capacities

● Assist countries/World Bank in preparation of Booster Program Phase 2 (>US$500 million expected)

● Introducing a Round 8 proposal taskforce● Identify countries for Round 8 support. Provisionally:

– Cameroon CAR– Comoros Congo– DRC Equatorial Guinea– Ethiopia Gabon– Ghana Kenya– Mozambique Nigeria– Zanzibar Zimbabwe

● Complete needs assessments in round 8 countries including partnership capacities

● Assist countries/World Bank in preparation of Booster Program Phase 2 (>US$500 million expected)

1


Assist countries to identify SUFI support needs through comprehensive needs assessments

2a

Mozambique Experience

●Comprehensive needs assessment (1 month) informed strategic planning and successful GFATM Round 6 proposal

●Joint mission in Feb 07 (WHO, UNICEF, WB, RBM Secretariat)

–Recommended support to finalisation of an operational/business plan

–Provide long-term RBM facilitator to co-ordinate partner support, hosted by WHO

–Needs assessments will be updated in future through routine programme reviews


Assist countries to identify SUFI support needs Needs Assessment – Origins

2a

September 2006, Dakar Conference “Striking Back at Malaria in sub-Saharan Africa”, delegates from 16 African countries called for the following:

● Existing resources must be utilized effectively

● For performing countries, money and technical support should not be the rate-limiting factor to Scale-up for Impact

● We commit to accelerating our efforts and actions to ensure that countries that are most ready are supported to achieve their targets. We will also accelerate our work with those countries that will require more assistance to quantify their needs

● We must validate existing business and operational plans to be convened by the RBM Harmonization WG with a simultaneous meeting of key donors to match country-identified needs as supported by performance based data


Assist countries to identify SUFI support needs through comprehensive needs assessments

2a

● Support 45 national programs to develop malaria needs assessments and business plans over the next 4-6 months that will result in achievement of 2010 RBM Goals (>80% coverage)

● Plans will result in an improved understanding of country support needs (financial and technical/implementation support) and the resources and strategies required to fill them.

● Present plans to donors in mid 2007, as well as to individual partners (e.g. GF, WB, PMI), for immediate support

● Builds on HWG's gap analysis work for GF Round 7 and feeds into GF Round 8 proposals where necessary


Comprehensive Needs Assessments

SudanChadNiger

DRC

Angola

EthiopiaNigeria

Namibia

Tanzania

Mauritania

Zambia

Kenya

Botswana

Mozambique

MadagascarZimbabwe

Uganda

Eritrea

Malawi

BurundiRwanda

Djibouti

Swaziland

Cameroun

Eq Guinea

Central African Rep

South Africa

Lesotho

Somalia

October - January

February - April

December - February

January - March

Timeframe

Senegal

The Gambia

Guinea

Sierra Leone Liberia

Cote d'IvoireGhana

Togo

BeninBurkina Faso

Mali

GabonCongo


Assist countries to identify SUFI support needs through comprehensive needs assessments: Process

2a

● Discussion and formation of Needs Assessment and Business Planning (NABP) Task Force (3rd HWG Meeting, Sept 2007)

● HWG Workshop (Nairobi, October 2007) developed a common template with countries for needs assessments (MACEPA support)

● Countries lead needs assessment and business plan development (December 2007-March 2008)

– Each country is paired with a focal partner and additional supporting partners.

– Each country has a consultant support to assist in writing /documentation of assessment and plan

● RBM will aggregate assessments and plans (as foundation for Business Plan), and assist in the development of regional/cross-border investments/actions (March/April 2008)

● All outputs will feed into development of GF applications, WB Booster 2 design, and annual PMI malaria operational plans


Coordinate a process to support the development of and adherence to the “3-ones” concept at country level

2a

Business Plans to which countries and partners must adhere

● Template to be developed by MACEPA, building out from Needs Assessment

● Business Plans (the “who does what”) cannot be externally driven, but result from iterative discussions within country partnerships.

● Process for country level development to be coordinated by SRNs, and supported by RBM Partners with in-country presence, including WHO, Millennium project, UNICEF, MACEPA, US PMI, and the World Bank

● Country-based business plans to be consolidated into one overall scale-up business plan for the RBM partnership in Africa


Five outputs proposed in the process:

● 45 Needs assessments for comprehensive scale-up

● 45 Country-determined business plans

● Advocacy piece, including economic/financial analysis - "front-loading" on the rationale for rapid scale-up (needed for donor discussion as most assessments/plans will call for rapid and comprehensive coverage)

● Scientific/public health consensus statement for a rapid scale-up in sub-Saharan Africa and the possible results.

● Additional financial and technical support from donors/partners (including new donors/partners) to ensure scale-up needs are met with resources

Outcomes of Needs Assessment and Business Planning Process


Harmonize partner efforts to fill country-identified gaps – Resource Mobilization

● Very high reputational risk to the RBM Partnership and all partners if needs and gaps are not quickly matched with resources (financial and technical)

● Primary responsibility rests with RBM Executive Director and lead “opinion leaders” (Leadership Summit Participants?) in the public and private sector who will lay the foundation for the donor discussion, with the support of the RBM MAWG

● Present plans to a series of high-level donor meetings in mid 2007, as well as to individual partners (e.g. GF, WB, PMI), for immediate support

3


Facilitate the development of a “rapid-response” mechanism to support countries to overcome implementation bottlenecks

Guinea – GFATM alerted HWG to grant problems including implementing Rd 2 and signing of R6● High-level missions (GFATM, RBM, WHO) to support Guinea, and

advocate for management changes● Provision of 2HWG consultants to prepare detailed action plan, next

steps● Grant signed in October

Angola - GFATM related problems including ineligible CCM, problems with ACT roll-out, and concerns around phase 2 extension:● High-level mission (UNDP, UNICEF, PMI) to support Angola in the

implementation of GFATM round 3 Feb 07● WB supported a comprehensive gap analysis which formed the basis of

a new strategic plan● PMI supported a consultant and workshop to realign the CCM● HWG prioritised Angola for round 7 support (UNICEF, WHO, PMI, PSI)● Round 7 success and extension of round 3 phase 2

4



● Burundi and Liberia had no external resources for their malaria programme when GF grants finished in 06, neither were successful in round 6– Established HWG Focal Points– Appealed GF Round 6 rejection– not successful– UNICEF/WHO emergency proposal to UNITAID to maintain ACT

supplies - successful– Countries included in 20 countries for round 7 proposal support– Round 7 funds awarded

● Lesson Learned: Real time implementation support has been successful, but has been relatively ad-hoc (dependant on individuals, not systems) and demand has outstripped supply (HWG, including SRNs), e.g., Cameroon

5



Malaria Implementation Support team (MIST)

● May 2007 Board Meeting endorsed the MIST and charged HWG with its development

● Gates Foundation Leadership summit re-emphasized this call calling for a “team to focus on a dramatic country-led scale-up and effective regional strategies (especially in Africa)…the team will focus on the immediate need to eliminate malaria as a public health threat, and will feed into the broader agenda and business plan of the RBM Partnership

● Team of malaria and non-malaria specialists at all levels (global, regional, sub-regional and country) capable of driving the malaria scale-up. Leadership Summit called for the “most dedicated, talented, and committed professionals to focus exclusively on the goal.”

5



● Malaria Implementation Support team (MIST) Proposed Architecture developed by MIST Task Force (formed at September 2007 HWG Meeting)

● MIST will be a combination of

– strengthened capacity of partner organizations (e.g. embedding full-time staff within partners, if needed, to exploit comparative advantages) and;

– a core-team that works full time on global, regional, and country-level strategy and support to reach 80% coverage within 36 months

● The team will draw on support from WHO, UNICEF, WB, PMI, MACEPA, Millennium Project, SRNs etc and from technical assistance pools (consultants) identified by RBM working groups and through RFPs.

● An Early Warning System and Support Hotline monitored by MIST.

5


HWG Deliverables (1/3)

The RBM HWG/MIST will provide timely quality planning, technical and implementation support to 45 priority malaria endemic countries in sub-Saharan Africa

Planning

● 45 comprehensive needs assessments completed by May 2008 identifying implementation bottlenecks, technical and implementation assistance, financing and commodity requirements to support SUFI

● 45 technically sound, operationally feasible, country and partner owned SUFI business plans completed by June 2008, building on existing business plans developed by countries and partners (e.g. PMI operational plans, World Bank annual plans, etc)



Financing and Implementation Support

● 45 Countries have adequate and sustained funds for each of their SUFI business plans through: – 100% of SSA countries with successful round 7 proposals will have signed grants by

April 2008 (including support to finalize PSM and M &E plans) – >70% of SSA countries applying for funding in Round 8 (GFATM) are successful– At least 95% of countries currently getting funding should maintain this funding. – At least 80% of countries with existing Global Fund assistance should perform at "A"

or “B1” ranking over the life of the existing grants– Donor meeting to attract additional resources (from existing donors and new donors)

held by April 2008, with at least 50% of country needs filled



Technical and implementation support

● Increase access to and utilization of high quality technical and implementation support with 80% of support needs being successfully addressed within 30 days of request/as planned.

● Development, launch, and implementation of the Implementation Assistance Hotline and Early Warning System (EWS) by January 2008.


Decision Points

● Recognizing the Board’s previous commitment to the development of a “rapid-response” mechanism to support countries to overcome implementation bottlenecks, the Board:– Endorses the timeline and deliverables laid out in the

Harmonization Working Group work-plan.– Charges the Chair of the Executive Committee to

develop a plan that includes:1) Operationalizing the Malaria Implementation Support

Team (MIST) through a combination of virtual and co-located team members;

2) Defining linkages with existing RBM structures and support teams; and

3) Identifying and securing additional resources.

update and decision points from the harmonisation working group

Documents

draft proposals

torsworking draft

groupworking draft

trp1working draft

pmboard decisionsworking

support process

trent ruebush

melanie renshaw