This advocacy alert aims to create awareness and provide attention to opportunities within Global Fund processes and mechanisms in order to integrate and improve the quality of activities related to Sustainability, Transition and Co-financing (STC) in Global Fund funding requests (formerly known as “Concept Notes”) and the grant-making process during the 2017-2019 allocation cycle.
Even if your country has submitted a funding request for Windows 1 or 2, there are still opportunities to include STC-related activities in the grant request or during implementation.
Who is this Information Note for?
This information is intended for community, key populations and civil society actors with some level of engagement in Global Fund processes at national and regional levels. CCM members representing civil society – those who are and will be engaged in country dialogues and civil society groups in countries that are transitioning or preparing for transition are the primary audience of this advocacy alert.
Sustainability, Transition and Co-Financing in the context of the Global Fund
With its focus on achieving impact, the Global Fund’s 2017-2022 Strategy recognizes that ending the HIV and TB epidemics and eliminating malaria will require sustainable systems for health and national responses to the three diseases. As such, the Global Fund strongly encourages all countries to build sustainability planning into programme and grant design regardless of where they are on the development continuum.
There is ample evidence to suggest that successful transitions take time, and therefore early and proactive planning that includes members of communities, key populations and civil society is a key part of enhancing transition preparedness. For this reason, the STC Policy specifically encourages all UMI countries (for all levels of disease burden) and LMI countries (with low and moderate disease burden) to prepare as early as possible for eventual transition from Global Fund support, and to proactively integrate transition preparedness considerations into funding requests, grant-design and program design.
It is extremely important for discussions around sustainability and transition to include all stakeholders engaged in the disease responses. While communities, key population and civil society should be playing a central part in these discussions, governments and private sectors should also be part of the collaborative and open dialogues.
What is Transition Preparedness?
The Global Fund Access to Funding Operational Policy Note (available publicly here in the Operational Policy Manual) highlights that sustainability and transition preparedness should be included as part of discussions related to Global Fund funding requests. For all Upper Middle Income countries (regardless of disease burden) and Lower Middle Income countries (with low and moderate disease burden), stakeholders should also work to address sustainability and transition considerations during grant-making.
While ultimately transition preparedness activities will vary based on the epidemiological and financial context of countries, there are a number of key thematic areas related to transition preparedness, including (but not limited to):
- Strengthened transition planning and analysis;
- Strengthened focus on the absorption of core interventions by domestic financing, including key population interventions;
- Strengthened focus on addressing specific health system-related transition challenges, including issues related to contracting of non-state actors (“social contracting”), M&E, and procurement.
Please note that more information on these areas can be found in the Global Fund STC Guidance Note, available in the Technical Briefs section here.
What Can Communities, Key Population and Civil Society Do?
Successful transition may increase sustainability of the disease response in some contexts, including for community responses – however there are many risks that are associated with transition, especially when it is not planned properly, realistically and transparently. If you are working at the country level, some of the things that you might want to do is:
- Check whether your country is included in this projection
- Learn more about Global Fund STC Policy from this STC Guidance Note
- Make sure that there are representative of communities, key population and civil society in the discussions around STC. These discussions should take place in country dialogues or in CCM meetings
- Request more information about Transition Readiness Assessments or other analysis on transition readiness for your country
- Get involved in the development of country funding requests and make sure the funding requests include considerations related to STC. Where a Transition Readiness Assessment or sustainability analysis has taken place, it is important to take into account how the findings have been addressed in the funding request.
What if my country already submitted its funding request for window 1 or window 2?
If your country has submitted its funding request for window 1 or window 2, and there are still issues related to STC that have not been addressed, there may still be opportunities to make sure that transition and sustainability considerations are integrated into the final design of the grant and the supported program. These opportunities may include:
- After the TRP or GAC review: After the TRP and/or GAC complete their review, countries will receive a Review Form with recommendations and clarifications. There are often comments related to sustainability and/or transition preparedness in the review form, which will strengthen the importance of bringing these issues into the grant-making discussions. If an iteration of the Funding Request is requested, this may be an opportunity to raise and address issues related to STC as well.
- In the Grant Making/Negotiation Process: After the TRP reviews and recommends the funding request, the Global Fund Secretariat works with the country, CCM, and Principal Recipient to finalize the details of the grant. For all Upper Middle Income countries (regardless of disease burden) and Lower Middle Income countries (with low and moderate disease burden), this discussion should include addressing sustainability and transition considerations. It also may include how efficiencies found during the grant-making process could be reinvested to address specific transition preparedness considerations.
- During Reprogramming: During grant implementation, it is sometimes necessary to conduct reprogramming to strengthen the impact of the grant and address challenges that arise during implementation. It may be appropriate to address sustainability and transition considerations during this reprogramming.
- When discussing co-financing commitments – For funding requests that passed through Program Continuation in Window 1, countries will still need to provide co-financing commitments during grant-making. This may provide an opportunity to discuss transition preparedness and encourage national governments to progressively assume the cost of key interventions through domestic funding. More information on co-financing requirements can be found in the STC Guidance Note.
Where Can I Access Other Resources on STC?
Below you can find some useful documents that might help you further in working on STC.
- EANNASO: A Community Guide to the Global Fund’s Sustainability, Transition and Co- Financing Policy
- HealthGAP: Infographic on Global AIDS Funding
- EHRN: Transition and sustainability of HIV and TB responses in Eastern Europe and Central Asia
- Example of regional program focusing on STC: AFAO, APCOM APCASO – SHIFT Regional Program
If you need more information about Sustainability, Transition and Co-financing, please send an email to firstname.lastname@example.org