Post on 12-Jul-2020
Invest for Impact: Global Fund Session
29th Stop TB Partnership Coordinating Board Meeting
Berlin 17th May
TRP Review Window 1
Absorption of TB grants
Catalytic Funding
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3
1
Agenda
Largest review window in Global Fund history
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• The 91 funding requests represented almost US$4.8 billion, US$920 million PAAR, and
$60.1 million in Matching Funds
• This is nearly 47% of the total allocation for the current period
72 7 12 137*
$0.8B$2.3B $1.6B $5.5B
Program continuation
Full review
Tailored
Other windows
Funding request submission and allocation by application approach (window 1)
Amount of allocation, out of $10.3 billion
Funding requests submitted, out of 228*
*based on current projections
Summary of TRP recommendations
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16 2 18
• 91 applications reviewed
• 95% of applications recommended for grant-making
89%
11%
19 in Full/Tailored Review
Grant-making Iteration
96%
4%
72 in Program Continuation
Grant-making Iteration
95%
5%
All Application Approaches
Grant-making Iteration
The TRP notes that many Program Continuation requests were approved for grant-making with the expectation of an
upcoming program review. This may lead to reprogramming during implementation.
• 14 TB applications ($.28 billion)• 14 TB/HIV applications ($1.75 billion)• 2 TB/HIV/malaria applications – both program continuation ($.13 billion)
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11
1
2
TB Application Approach
Program Continuation Tailored Full
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3
2
TB/HIV Application Approach
Program Continuation Tailored Full
TB and TB/HIV funding request submissions for window 1
1. Good quality of proposals in this funding window
2. Differentiated application process positively received
3. More boldness needed with matching funds applications
4. Sustainability not yet sufficiently addressed
5. Malaria resurgence concern in some countries in Central and Eastern Africa
Window 1
General lessons learned
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• Expansion of Xpert continuing quickly but optimization of use still needed
• Digital radiography: Efforts to expand access to the CXR, however operationalization issues and
expected outcomes related to digital x-rays missing.
• Countries moving slowly on MDR-TB diagnosis (case finding targets not achieved). Most countries
are moving to shortened regimen however a few holding back for lack of SLD–DST. TRP encourages
prioritizing short-course regimen as capacity for SLD–DST is built for treatment optimization and better
patient outcomes.
• TB prevalence surveys have confirmed large proportion of missing TB cases in many settings.
Funding requests appropriately mention interventions to find these cases, but lack sufficient analysis of
who is missing, where and why. Missing bold steps and significant innovation.
• Countries with big TB/HIV disease burdens making tremendous progress in bi-directional testing and
ART coverage. Slow progress if at all in low TB/HIV burden countries. IPT: % of PLHIV on IPT is low
overall.
• Human rights/gender issues broadly are not well addressed in TB applications.
Lessons learned
TB
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TB grants
Absorption rates of the three diseases in the active grants
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76%73%
68%
44%
71%
0%
10%
20%
30%
40%
50%
60%
70%
80%
HIV/AIDS Tuberculosis Malaria HIV/TB Total
TGF global active grants absorption rate
Source: Global Fund data
Outcome of active grants reviewed till end of Q1 2017
TB active grants absorption rates compared to other disease components
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47%
67%
72%
80%
73%
73%
71%
75%
88%
72%
54%
82%
24%
58%
69%
48%
52%
32%
44%
59%
76%
67%
63%
62%
67%
69%
55%
72%
61%
52%
69%
68%
81%
59%
75%
68%
73%
60%
0% 50% 100% 150% 200% 250% 300%
Central Africa
Eastern Europe and Central Asia
High Impact Africa 1
High Impact Africa 2
High Impact Asia
LAC
Middle east and north Africa
South and East Asia
Southern and Eastern Africa
Western Africa
TB absorption rates compared to other disease components in regions
HIV/AIDS HIV/TB Malaria Tuberculosis
Source: Global Fund data
Active TB grants absorption rates by regions:
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81%
75%
73%
69%
68%
68%
61%
60%
59%
52%
40% 45% 50% 55% 60% 65% 70% 75% 80% 85%
High Impact Asia
Middle east and north Africa
Southern and Eastern Africa
High Impact Africa 1
South and East Asia
High Impact Africa 2
Central Africa
Western Africa
LAC
Eastern Europe and Central Asia
Regional TB absorption rates (%)
Source: Global Fund Data
102,211,614
164,662,257
422,634,793
153,131,457
354,943,388
65,289,246
97,421,590
96,654,840
184,283,315
1,449,226,390
Investments amounts in USD
Active HIV/TB grants absorption rates by regions:
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82%
69%
58%
54%
52%
48%
44%
32%
24%
20% 30% 40% 50% 60% 70% 80% 90%
Eastern Europe andCentral Asia
High Impact Asia
High Impact Africa 2
Central Africa
Middle east and northAfrica
LAC
Western Africa
Southern and EasternAfrica
High Impact Africa 1
Regional HIV/TB absorption rates(%)
Source: Global Fund data
43,816,944
206,654,066
59,099,621
8,622,877
77,924,323
36,168,352
399,489,595
311,944,551
151,539,633
Investment amounts in USD
Top 5 and least 5 countries with TB absorption rates (HI) (%)
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100%
89% 89%84% 83%
66% 64%
56%50%
38%
0%
20%
40%
60%
80%
100%
120%
HIA.9 HIA.1 HIA.5 HIA1.6 HIA.7 HIA1.4 HIA1.2 HIA2.4 HIA2.8 HIA2.3
TB absorption rates (%) in high impact countries
LEAST COUNTRIES WITH TB ABSORTION
Source: Global Fund Data
¾ of the TB active investments are in the high impact countries
Comparing TB absorption with other disease components in least
performing countries
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76%
68%73%
60%
77%78%
57%
66%
82%
63%64%
38%
66%
56%50%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
HIA1.2 HIA2.3 HIA1.4 HIA2.4 HIA2.8
Absorption rates of disease components in 5 TB least performing countries
HIV/AIDS Malaria Tuberculosis
Source: Global Fund data
Permanent Secretaries and NTP Managers from HIA2; Nairobi, Feb,2017
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Follow-up action tracker on absorption
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Country Grant
Component
Grant
Amount
signed
Percentage disbursed to signed amounts (%) Priority action points
Dec. 2016 Sept. 2017 target June 2017
HIA2.3 TB 40.6mill USD 33% 63%
• Planning
Issues/Forecasting Issues
• Coordination/Process
• Funding Issues
• Infrastructure
• Partnership Issues
TB/HIV 63.7mill USD 42% 72%
HIA2.4 TB 21.4mill USD 56% 86%
TB/HIV 40.6mill USD 44% 74%
HIA2.5 TB 21.7mill USD 39% 69%
TB/HIV 21.4mill USD 42% 72%
HIA2.6 TB/HIV 21.7mill USD 46% 76%
HIA2.1 TB 58.2mill USD 63% 93%
HIA2.2 TB 63.7mill USD 45% 75%
HIA2.8 TB 38.8mill USD 48% 78%
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Catalytic Funding
Overview of Board-approved Catalytic Investments 2017-2019
~ 80%
directly to
country
programs
Illustrative Modality Total Funding (US$ m) % of FundingMatching Funds 356 44.5%Multi-County Proposals 272 34.0%Strategic Initiatives 172 21.5%Total 800
$200mHIV
TB
Malaria
RSSH
Broader
Strategic
Key Populations; Human Rights; Adolescent Girls & Young Women
Finding missing TB cases
Malaria Elimination, Drug and LLIN Resistance, Piloting first Malaria Vaccine
Program Sustainability, Service Delivery & Health Workforce; Supply Chain Strengthening; Data Systems & Use for Program Quality; Community Rights & Gender
Prospective Country Evaluations; Emergency Fund
$190m
$202m
$166m
$42m
Matching Funds - Strategic Priorities
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Allocation letter specifies strategic priority area(s) and matching funds available
• Scale-up of evidence-informed HIV programs for key populations
• Removing human rights barriers to access to HIV services
• Addressing HIV amongst adolescent girls and young women
• Finding missing TB and drug-resistant TB cases
• Integration of service delivery and improvement of health workforce
• Improving data systems, generation and use
HIV
TB
RSSH
• Catalyzing market entry of new long-lasting insecticidal netsMalaria
TB Catalytic Matching Funding
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No. Country Matching Funding
(US$ million)
Allocation (US$ million) Submission window
1Bangladesh 12 97.93 W1
2DRC 10 56.65 W1
3Indonesia 15 102.41 W2
4Myanmar 10 82.94 W2
5Nigeria 14 107.49 W2
6Pakistan 13 130.16 W2
7Philippines 10 78.54 W1
8South Africa 6 35.59 W4
9Tanzania 6 25.84 W2
10Ukraine 7 48.64 W2
11Kenya 6 45.50 W2
12Mozambique 6 45.12 W2
Total 115 856.81 (47%)
TB Strategic Initiative-US$10 million
• The main objective of catalytic strategic initiative is to address barriers and apply innovative practical approaches and tools to accelerate progress towards finding the missed TB cases
• The focus is 12 catalytic matching funding countries with additional impact in priority 14 countries and support to a regional initiative in West and Central Africa
• Overall SI will catalyze impact in 26 countries with 83% of missing cases globally and expected XXX additional cases by 2019
• Discussion on-going with WHO and Stop TB Partnership on specific activities, performance framework and measurable impact
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Strategic Initiative: Global Impact Counties
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Incidence Cases Missing cases
Allocation (US$
million) Submission
1 India 2,840,000 1,740,435 1,099,565 279.92 W2
2 Vietnam 128,000 102,676 25,324 47.28 W2
3 Thailand 117,000 66179 50,821 13.00 W2
4 Cambodia 59,000 35,638 23,362 13.81 W2
5 Ethiopia 191,000 137,960 53,040 51.59 W2
6 Uganda 79,000 43,736 35,264 21.10 W1
7 Zambia 63,000 41,588 21,412 10.00 W2
8 Zimbabwe 38,000 28,225 9,775 23.77 W1
9 Cote D'Ivoire 36,000 22,879 13,121 13.60 W1
10 Ghana 44,000 14,999 29,001 16.00 W2
11 Sudan 35,000 20,006 14,994 12.26 W1
12 Madagascar 57,000 29,939 27,061 9.30 W1 (F)
13 Malawi 33,000 17,104 15,896 9.00 W1
14 Cameroon 49,000 26,570 22,430 10.59 W3
1,441,066 531.22
Questions?
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Thank you!