Welcome to the Global Fund e-learning module on Program Split: Dividing allocated funding between eligible diseases and cross-cutting health systems strengthening. Click the Next button to continue. 1
By the end of this e-learning module, Country Coordinating Mechanisms, or CCMs, should be able to conduct a transparent and inclusive program split process through: Understanding the five steps of the program split process. Knowing what CCMs should do at each step of the program split process. To navigate this course, click on the Previous and Next buttons. The documents and links mentioned in this e-learning module, as well as other information, can be found in the Resources tab. You can read along with the narration by clicking on the Narration tab. A glossary is also available for terms which are commonly used within the Global Fund. 2
Under the new funding model, the Global Fund communicates upfront to countries the total amount of funding that they may receive. Countries are then responsible for deciding how to prioritize their investments across diseases and cross-cutting health systems strengthening. This process is known as program split. 3
The discussion about program split will take place during CCM-led country dialogue. CCMs take a leading role in coordinating the inclusive discussions around the development of the Global Fund concept note and therefore the discussion around program split. It is essential that the program split discussion involves a broad range of stakeholders, including representatives for each disease community and health systems experts. 4
There are five steps involved in finalizing the program split decision. Click "Next" to find out what the five steps are. Step 1 -The CCM is informed of the funding allocation Step 2 - The CCM prepares for program split discussion Step 3 - The CCM conducts the program split discussion Step 4 - The CCM submits the program split to the Global Fund Step 5 - The Global Fund reviews the proposed program split Now, let s look at each step in more detail. Click "Next" to continue. 5
Step 1 The CCM is informed of the funding allocation 6
In the period leading up to concept note development, the Global Fund communicates to CCMs, via the allocation letter, the total amount of funds for which countries may expect Global Fund financing during the allocation period. 7
So what does the allocation letter contain? Click Next to learn more. One total allocation amount In the allocation letter, the Global Fund provides one total allocation amount to be split across eligible diseases and cross-cutting health systems strengthening. The total allocation amount includes existing funding as of 31 st December 2013 and new funding. A breakdown by disease component The allocation letter also contains a breakdown by disease component. This breakdown is for the CCM information only. It is not a recommendation from the Global Fund. 8
Once the allocation letter is received, CCMs may decide to revise the allocation between eligible disease components and/or cross-cutting health systems strengthening. Alternatively, CCMs may choose to adopt the amount for each disease communicated in the allocation letter. 9
Step 2 The CCM prepares for program split discussion. 10
Through the CCM-led country dialogue, a broad range of stakeholders should discuss how to split and best use the funding from the Global Fund across the eligible diseases and cross-cutting health systems strengthening interventions. Advance preparation will allow the CCM to save time and to mitigate potential conflicts. 11
Click the Next button to find out more about each preparation step. Step 2a Who should be involved in the program split discussion? The first preparation step is about defining Who should be involved. Some questions to consider include: Who should be involved in order to have a balanced representation across eligible diseases? For instance: inviting non-ccm members to meetings; giving different weights to votes from under-represented diseases. Who can best represent health systems strengthening stakeholders? How should key populations be engaged? People familiar with reproductive maternal neonatal and child health should also be included in the program split discussion. Step 2b How should the program split discussion take place? The second preparation step is about defining How should the discussion take place. Some questions to consider include: 12
When must the decision be made by? What could be the decision-making process? What is each group s and each participant s role? What information will be needed to make a decision? What information should be brought by each group? How should consensus be reached? Step 2c How should the final decision be made? Finally, the third preparation step is about defining How should the final decision be made. Some questions to consider include: How should crucial decisions be voted on? For instance, consider anonymous vote. Who should be the ultimate decision-maker if no agreement is reached? 12
Step 3 The CCM conducts the program split discussion. 13
The factors that the CCM should consider during the program split discussion include, but are not limited to: Willingness-to-pay; Existing funding; Absorptive capacity; and Cross-cutting health systems strengthening In the following slides, we ll learn more about each individual factor. 14
Willingness-to-pay The split should reflect confirmed willingness-to-pay commitments or the preliminary commitments. The willingness-to-pay requirement means that 15 percent of the allocation amount can only be accessed when a country commits additional, and increasing, co-investments in disease programs. This contribution is made in addition to the counterpart financing requirements. Each country has specific considerations and willingness-to-pay requirements. CCMs should contact their Fund Portfolio Manager to learn more. Existing funding The proposed program split should reflect the total funding allocation and not just the new funding. In their proposed program split, CCMs should reflect on how they are planning to use the existing funds. They should also reflect on how much funds will be used before and after grant signing. The total amount of funds should equal the total allocation. 15
Finally, CCMs should also consider reprogramming the unused existing funding in order to maximize the potential impact of the new program developed in the concept note. Absorptive capacity Absorptive capacity should also be part of the program split discussion. Absorptive capacity is the country s ability to accurately forecast spending within a defined period of time. Leaving funds unabsorbed in one program is a disservice to other programs that could have utilized the funds. Ultimately, this will undermine the impact that the country and the Global Fund want to achieve. That s why it is important to discuss the re-allocation of funds that may not be able to be absorbed by one program, to another disease program that may be able to absorb them. Cross-cutting health systems strengthening Cross-cutting health systems strengthening interventions contribute to maximizing the impact of more than one of the eligible disease programs. For instance: 1) They contribute to scaling-up availability, increasing accessibility and improving quality of service delivery. 2) They contribute to strengthening health information systems; procurement and supply chain management system. Disease-specific health systems strengthening interventions are considered part of the relevant disease concept notes. But the program split should only reflect the allocation to cross-cutting health systems strengthening. Cross-cutting health systems strengthening funds can be programmed, if eligible, either as stand-alone grant, or as part of one disease component concept note. It is not recommended to split cross-cutting health system strengthening across multiple disease components. 15
The Global Fund investment guidance for cross-cutting health systems strengthening is as follows: Band 1: investment is strongly encouraged. Bands 2 and 3: investment is encouraged. Band 4: investment will be considered on an exceptional basis. The historic funding levels for cross-cutting health systems strengthening are provided here for your information only. CCMs should still invest what is needed for their country: Band 1: historical average of 11 percent. Bands 2 and 3: historical average of 8 percent. Countries can learn more in the Information Note on Health Systems Strengthening for Global Fund Applicants. The document is available in the Resources tab. 16
CCMs should not base their program split decision on any assumption of receiving incentive funding. There is indeed only a limited amount of incentive funding available that will be awarded based on a number of factors. This means that many countries eligible for incentive funding will ultimately not be awarded incentive funding. 17
Step 4 The CCM submits the program split to the Global fund. 18
The program split may be submitted any time up to when the CCM submits its first concept note. The Global Fund recommends that CCMs submit their program split well before the first concept note submission. This will ensure that there are no delays in case the Global Fund asks the CCM to reconsider the program split. CCMs should submit the proposed program split via the online grant management platform. Guidelines on how to access the Online Grant Management Platform can be found in the Resources tab. Click Next to learn about which documentation to submit along with the proposed program split. 19
Documentation of the decision-making process The proposed program split must be submitted along with the documentation of the decision-making process. For example: the CCM meeting minutes; the list of participants and criteria for prioritization. Confirmation of CCM endorsement The proposed program split must also be submitted with the confirmation of CCM endorsement with the supporting signatures. Rationale for the proposed split Finally, the rationale for the proposed split must also be submitted. It should include an explanation of why the proposed split is appropriate and strategic for the country. 20
Step 5 The Global Fund reviews the proposed program split. 21
Once the communication is received from the CCM, the Global Fund Secretariat will review the proposed split based on set criteria. Click "Next" to learn how the review process works. Case-by-case basis review The proposed split will be reviewed on a case-by-case basis against the Secretariat s understanding of the country context. The Secretariat will also consider the strength of the program split rationale submitted by the CCM. Decision-making process Documentation on the decision-making process will also be reviewed. This is to ensure that an inclusive process, involving representatives from all eligible diseases and health systems strengthening, was followed in arriving at the proposed split. 22
Over-allocation If the proposed split results in components becoming increasingly overallocated, it will be reviewed with careful attention. While in some exceptional cases it may be accepted, it is less likely that the Global Fund will approve a split that increases over-allocation. 22
Based on this review, three follow-up scenarios are possible. The Secretariat may: Accept the proposed split; Request the CCM to clarify the justification or supporting documentation; Request the CCM to reconsider the program split. Any concept note must reflect the program split agreed on with the Secretariat. In the event that a proposed program split is communicated to the Secretariat at the time of concept note submission and the proposed split is not agreed by the Secretariat, the submitted concept note must be revised by the CCM and re-submitted. 23
This brings us to the end of this e-learning module. Remember the following elements in the program split decision making process: The Global Fund will inform each eligible country of its allocation. Countries will be responsible for deciding, through an inclusive decisionmaking process, how to divide this allocation between disease components and cross-cutting health systems strengthening interventions. Program split discussions should take into account: o Willingness-to-pay commitments; o Existing funding; o Absorptive capacity; and o Cross-cutting health systems strengthening. The proposed program split should be endorsed by the CCM and submitted to the Global Fund via the online grant management platform. 24
Now that you ve completed this course, please complete a brief survey on your experience. The Global Fund will use your feedback to improve the courses. Click on the icon on your screen to access the survey online. Remember to click on the Resources tab for relevant documents and links. Additional e-learning modules on the other new funding model topics are available on the Global Fund website. Thank you for taking this course! 25