The Global Fund (TGF) Strategy Committee (SC) is mandated with reviewing its Eligibility Policy. During the 4th SC meeting in June 2017, the SC discussed over 4-hour to determine the scope of the policy review by identifying issues within the current Eligibility policy and asked the Secretariat to come back to SC with analysis and options for models that can be used to improve the quality of the policy. It is expected that the review process will stretch throughout 2017 and early 2018 and that draft of the new policy will be presented to the Board for approval at the May 2018 Board meeting.

Current Eligibility policy was approved during 35th Board meeting in Cote d’Ivoire back in 2016, following extensive Equitable Access Initiative (EAI) discussions. The policy contains some progressive features such as the use of rolling GNI instead of annual GNI in determining economic cut off points (and therefore slow down countries/disease components transitioning out of Global Fund eligibility) and exception for small island economies. However, there are still some concerns such as:

  • Use of GNI per capita as single economic indicator: As pointed out by EAI report, GNI per capita is the most regularly available and updated economic metric, however GNI per capita alone is still not sufficient and does not provide full picture of a country economic position and needs
  • Slow Transitioning In: The use of rolling GNI have slowed down countries transitioning out of Global Fund Eligibility list, however on the other side, it also slowed down countries to be (re)eligible to receive Global Fund grants.
  • Disease Burden and KP Prevalence: Current disease burden threshold for HIV includes prevalence among key populations, however it is not represented in all of the scales (only in Low, Moderate, High but not in Severe and Extreme). Furthermore, the lack of quality in KP prevalence data needs to be addressed.
  • Short Transition Period: Current transition grace period (one additional allocation period after becoming ineligible) is unrealistic and not helpful in enabling changes in the long term
  • No Mechanism to Support CS in Transitioning and Transitioned Countries: While the NGO rule was set up to be used during 2014-2016 grant cycle, it was not fully utilized due to variety of barriers. The Global Fund needs a mechanism that can direct financial support for CS in UMICs or in immediately transitioning countries/components or post eligible countries/components.
  • And other issues: For more information, please check this position paper developed by three Communities and Civil Society Delegations to the Global Fund.

Attention Required

  • G20 countries that are transitioning into Upper Middle-Income Countries status with less than “Severe” disease burden (Indonesia – HIV & Malaria): Global Fund “G20 rule” in the Eligibility policy will be reviewed and will likely to have significant changes.
  • Countries/disease components that are ineligible for Global Fund grants and in crisis (such as Venezuela): the 37th Board meeting in Kigali instructed the Strategy Committee to discuss “funding for ineligible components” and to come up to the Board with recommendation. That discussion is currently being framed under the scope of Eligibility policy review.
  • Countries/disease components that are approaching transition (increased in GNI per capita or changes in disease burden status): as mentioned above, the review scope includes GNI and disease burden and therefore might have an impact to the eligibility cut off points.

For your action

Timelines 

Time Activity
June 2017 SC discussion to define scope of review
October 2017 Secretariat present to SC options and analysis based on the scope of review. SC will further refine options and analysis
March 2018 SC approvals for draft policy to be presented to the Board
May 2018 Board approval