technical support needs of indigenous civil society principal recipients of global fund grants
TRANSCRIPT
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Copyright ICASO, 2012
until we end aids
Techn ica l Suppor t Needs
of I nd igenous Civ i l Soc ie ty Pr inc ipa l Rec ip ients
of G lobal Fund Grants
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2
Abbreviations 3
1 Introduction and aim 4
2 Methodology 5
3 What it takes to be a Principal Recipient 6
31 Minimum capacity requirements 7
32 Process and role of PR 8
33 Special considerations for CSOs becoming PRs 10
4 CSO needs for technical support 12
41 The decision to seek a CCM's nomination to be a PR 14
42 PR Nomination and proposal development 16
43 During the LFA Assessment andgrant agreement negotiations 1844 Implementation 20
45 Post-grant "exit" strategy 22
5 Who will provide technical support? 24
51 Current and potential sources of TS 24
52 ICASO role 25
6 Conclusions 26
7. Recommendations 28
8. Reections 30
9 Annexes 31
Annex 1 Form of the survey 31
Annex 2 Respondents and interviewed experts 33
Table o f Contents
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Abbrev ia t ions
ANCS National Alliance Against AIDS from Senegal
(in French Alliance Nationale Contre le SIDA)
CCM Country Coordinating Mechanism
CSAT Civil Society Action Team
CSO Civil Society Organization
CSS Community Systems Strengthening
DTF Dual Track Financing
ICASO International Council of AIDS Service Organizations
LFA Local Fund Agent
M&E Monitoring and Evaluation
MENAHRA Middle East and North Africa Harm Reduction AssociationOSI Open Society Institute
PLHIV People Living with HIV
PR Principal Recipient (in the Global Funds projects)
PSM Procurement and Supply Management
RAA Romanian Angel Appeal
RBP+ The Burundian Network of PLHIV/AIDS
(in French Rseau Burundais des Personnes Vivant avec le VIH/SIDA)
RHRN Russian Harm Reduction Network (also known as ESVERO)
SAT Southern African AIDS Trust
SOGI Sexual Orientation and Gender Identity policy
SR Sub-recipient (in the Global Funds projects)
SSR Sub-sub-recipient (in the Global Funds projects)
TS Technical Support
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1 . I n t roduct ion and a im
The Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) is among the largest and most
important mechanisms through which developing nations access resources to combat persistent
epidemics of each disease In recent years, civil society organizations (CSOs) have played increasingly
important roles in the context of the Global Fund framework Particularly, the number of CSOs assuming
the role of Principal Recipients (PRs) has grown With this role comes an ethical and legal responsibility
to achieve results Being a PRwhether from civil society, government, or other sectorsrequires great
commitment, strong management systems, programmatic expertise, and the ability to maintain diverse
partnerships Experience shows that while they are often very successful in achieving results, CSO PRs,
particularly from national indigenous groups, have specic needs and challenges, as well as a growing
body of experience that can be usefully shared
This report analyses the technical support needs of indigenous CSOs1 in building their capacity to
be effective PRs It examines the perspectives of recent CSO PRs and collaborating stakeholders on
successes and possible ways to overcome the most common challenges for indigenous CSO PRs with
technical support and capacity building The intended audience of the report includes stakeholders
involved in Global Fund processes, technical support providers, and other partners Additionally, CSOs
which are considering taking on the PR role may nd the report useful.
1 In this report, indigenous civil society groups are understood as groups initiated, established and led by local,
stakeholders CSOs that are branches of global networks and large CSOs are not regarded indigenous CSOs
Note: Research for this report was conducted in 2010
In 2011, the Global Fund announced major changes to its granting mechanism, resulting
in the New Funding Model (NFM). While there are signicant differences between the NFM
and the former, rounds-based funding model, most of the PR role remains intact Therefore,
the insights obtained for this report remain relevant and useful for a variety of stakeholdersHowever, further research will need to be conducted within the context of the NFM, so that
perspectives on new procedures can be gleaned Where appropriate, this report indicates
and comments on policies and procedures associated with the NFM
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2 . Methodo logy
Many of the CSOs taking on the PR role are international organizations or groups afliated with major
international organizations, such as PSI, Care, the International HIV/AIDS Alliance, and World Vision
ICASO narrowed our analysis to the needs of indigenous CSO PRs as they often have less access
to technical assistance. After the review of current PRs identied through the Global Funds online
database, in consultation with the ICASO partners in the CSAT1 initiative team and the Global Fund
Secretariat, a sample of CSOs was identied. Eleven of them agreed to participate in the survey.
These included three that were not yet PRs; one that was undergoing assessment and negotiations
with the Global Fund; one that had submitted a failed regional application in Round 9 but that was to
be resubmitted in Round 10; and one that was nominated as PR but failed to demonstrate sufcient
capacity during the LFA assessment All major geographical regions were covered: Sub-Saharan
Africa (3 CSOs), Middle East and North Africa (1), Eastern Europe and Central Asia (3), Asia (3) andLatin America/Caribbean (1) A standard English questionnaire was used for the survey (see Annex
1) As translation (French and Russian) was arranged only at the request of respondents, language
barriers may have compromised the comprehensiveness or quality of some responses In addition,
ve experts in the eld were intervieweda combination of organizational and technical support
providers and staff of the Global Funds Civil Society Partnership team A full list of individuals and
organizations that were contacted for the report is provided in Annex 2 The interviews and surveys
were conducted in May-July 2010
Since the CSO PR representatives who were interviewed expressed views on experience over the
prior 1-6 years, some recent developments in the Global Funds policies are not reected, such as
the possibility for PRs to use the Global Funds grants for technical support (TS) in preparation for
new projects, the requirement to have costed TS plans in preparation for implementation, or new
recommendations to dedicate 3-5% of requested budgets to management and technical support
in new applications to the Global Fund (starting with Round 10) As noted above, this research was
conducted prior to the development and announcement of the New Funding Model, and therefore
reections on the NFM are not included.
1 The Civil Society Action Team (CSAT) was a civil society-led global initiative that coordinated, brokered and
advocated for technical support to civil society organizations implementing or seeking grants from the Global Fund to
Fight AIDS, TB and Malaria
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3 . What i t takes to be a Pr inc ipa l Recip ient
the nominated PRs [should] understand what their rolesand responsibilities are. There is a need and a role for
indigenous NGOs as PRs, but they need to be clear aboutthe various pros and cons of the PR role.
To facilitate grant management, the Global Fund requests theCCM to propose one or a few suitable Principal Recipients
(PRs) at the country level to be legally responsible forprogram results and nancial accountability. PRs receive
periodic disbursements of funds directly from the GlobalFund employ these funds towards the implementation ofthe approved proposal, and periodically report on progress
... to the Global Fund and CCM.
Sh
annonKowalski,
OpenSociety
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3 . 1 . M in imum capac i ty requ i rementsPRs from all sectors must have certain baseline capacities As many CSOs may not have been
originally built for roles such as Global Fund PR, it is important that these capacities be assessed The
minimum capacity requirements fall into ve categories: Financial Management and Systems, Program
Management, Sub-recipient Management, Pharmaceutical and Health Product Management, and
Monitoring and Evaluation Systems
Selected & Abridged Detail of PR Minimum Capacity Requirements
(a) Financial Management and Systems that:
(i) Accurately and promptly record all transactions, disbursements and balances;
(ii) Disburse funds to SRs, procurement agents and suppliers in a timely and
accountable manner;
(iii) Maintain an adequate internal control system;
(b) Program Management Capacity and Arrangements including:(i) Effective organizational management and transparent decision making and
accountability systems;
(ii) Adequate infrastructure and information systems to support grant implementation,
including the monitoring of performance of SRs and outsourced entities in a timely
and accountable manner
(c) Sub-recipient Management Capacity, including:
(i) Effective systems for undertaking SS capacity assessments and providing TS as
needed, to ensure that any proposed SRs have the required capacities to implement
the program activities;
(ii) Adequate management arrangements that ensure PR oversight of grant
implementation at the SR level facilitating effective and timely program
implementation and resource management by SRs
(d) Pharmaceutical and Health Product Management Systems that:
(i) Procure, store and distribute health products in accordance with
Global Fund PSM policies
(e) Monitoring and Evaluation Systems that:(i) Collect and record programmatic data with appropriate quality control measures;
(ii) Support the preparation of regular reliable programmatic reports; and
(iii) Make data available for the purpose of evaluations and other studies 1
Complete requirements and assessment tools are available
in LFA guidelines for the PR Assessment, March 2011
https://www.google.com/url?q=http://www.theglobalfund.org/documents/lfa/LFA_PRAssessments_Guidelines_en/&sa=U&ei=FRLKUJH4NuSRiQeI14CYBw&ved=0CAkQFjAB&client=internal-uds-cse&usg=AFQjCNEduoMdWIkFwQ9C8exSmR7BsKMlmAhttps://www.google.com/url?q=http://www.theglobalfund.org/documents/lfa/LFA_PRAssessments_Guidelines_en/&sa=U&ei=FRLKUJH4NuSRiQeI14CYBw&ved=0CAkQFjAB&client=internal-uds-cse&usg=AFQjCNEduoMdWIkFwQ9C8exSmR7BsKMlmA -
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3 .2 . Process and ro le o f PR
PRs are selected and nominated by Country Coordinating Mechanisms (CCMs) Typically CCMs use a
nominating process through which potential PRs submit expressions of interest However, in the NFM,
a Country Dialogue, led by the CCM, is intended to include various stakeholders, and presumably all
serious potential PRs This Country Dialogue will likely be the process in which potential PRs (and some
SRs) make expressions of interest
The CCM is responsible for submitting the proposal (or Concept Note in the NFM) to the Global Fund
After a successful technical review of the proposal (which may have several iterations), the proposal
is sent to the Global Fund Board for approval Once the Global Funds Board approves a proposal,
nominated PRs undergo assessment of their capacity by the Global Funds Local Fund Agent (LFA)
The LFA provides recommendations on whether nominated PRs have adequate capacity for grantimplementation and how that capacity could be strengthened in a timely and cost-effective manner LFA
recommendations may be incorporated into the Global Fund and PR agreement as a condition of the
grant Based on the LFA assessment results, the Global Fund can decide not to sign the agreement
with the nominated PR and ask the CCM to nominate a new PR
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ApproveAdjusted
Funding
Amount
Figure 1: New Funding Model, Step-by-Step Process1
Adapted fromThe Global Fund Website
http://www.theglobalfund.org/en/activities/fundingmodel/process/http://www.theglobalfund.org/en/activities/fundingmodel/process/ -
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Once the grant agreement is signed, a PR is responsible for program implementation, thus for achieving
results, disbursing funds and reporting progress The PR reports to the CCM and must secure its
endorsement of all workplans and budgets Also, the PR submits disbursement requests and program
and nancial reports to the GF, and provides access and information to the LFA for the required
program progress verications. It negotiates adjustments to the grant workplan and budget, program
continuation, and has overall responsibility for planning and implementing grant closure Full details are
available inThe Global Funds Operational Guide: The Key To Global Fund Policy and Processes
Figure 2: Funding and reporting mechanisms including role of PRs in the Global Fund1
Adapted from The Global Fund Fiduciary Arrangements for Grant Recipients
The Global FundCCMPrepares and
submits proposals
Selects
principal recipient(s)
Provides governance
during implementation/
oversight of PR
Monitors Impact
Local Fund
Agent
Trustee(World Bank)Sub-recipients
Board
Technical
Review Panel
Secretariat
Principal
Recipients
Academic/Educational
Sector
Government
NGOs/CBOs
PLW Diseases
Private
Sector
Religious/
Faith-BasedOrganizations
Multi-/BilateralDevelopment
Partners
ADVISEGRANT AGREEMENT
REPORTS
PROPOSAL
FUNDS
FUNDSREPORTS
APPROVAL
TECHNICAL REVIEW
SCREENING
INSTRUCTIONTO DISBURSE
ASSESSMENT
http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/documents/core/grants/Core_Fiduciary_Arrangements_en/http://www.theglobalfund.org/documents/core/grants/Core_Fiduciary_Arrangements_en/http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/ -
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3 .3 . Spec ia l cons idera t ions for CSOs becoming PRs
Most experts agreed that the trend toward having more civil society groups serving as PRs is a positive
development that should be supported Adequate capacity is essential for a CSO in the role of a PR, but
there are other important factors to consider The PR role might be attractive for CSOs, particularly due
to the power and resources it confers, but the decision to pursue this role should be driven by country
needs Becoming a PR can change the nature and size of the organization, and its relationships with
other CSOs and the CCM
Reasons that are often given as to why NGOsconsider becoming PRs are: to increase access to
resources by CSOs and by extension to communities;to build indigenous capacity and promote sustainable
development; and organizational growth. Dangers citedinclude lost of identity and inability to meet both their
original mandate and the new PR mandate.Felicitas(Flanny)
Chiganze
,
SouthernAfr
ican
AIDS
Trus
t
There is traction in getting more CSOs to be PRs. It isgood generally. But a number of NGOs choose that
because of money, not realizing that it will change theirorganization so much. Often they cannot make an
informed decision.LeeAbdelfadil,
I
nternationalHIV/
AIDS
Alliance
-
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Being a PR often requires organizations to step away from their core identities as advocates and direct
implementerswhich they may have spent years developingto take on the primary role of managers
of large projects with multiple implementers This may represent a major shift for organizations that
have focused on advocacy and government accountability: after becoming implementers, its not them
that hold government and others accountable they are accountable to others, one expert noted
Similarly, CSO PRs may experience challenges with other CSOs, as their relationship evolves, particularly
with watchdog organizations and new SRs When CSOs become PRs, their relationships with other
implementing CSOs are substantially dened by legal contracts and a newfound power relative toorganizations that may have been on more equal footing in the past They now have to assume the role
of funders with oversight and TS responsibilities, and may have to decline future funding to SRs if there
are problems with grant deliverables
Government-dominated CCMs may have less understanding of the role of CSOs and often make the
decision to nominate a CSO as a PR because the GF recommends doing so, rather than because they
recognize civil society as a key partner Thus even at early stages when CSOs are being considered as
PRs and indicate their capacity building needs, it is often difcult for them to convince CCMs to include
sufcient technical support for management and other areas. Building CCM understanding of the
importance of civil society leadership can be a long-term process, requiring the participation of numerous
stakeholders, including the Global Fund Secretariat, UN agencies, and other CSOs
Importantly, as one expert pointed out, the question of which organizations should become PRs
should only be posed once there is an understanding of local needs and agreement on how the
response should be shaped It might require consensusamong government, civil society and affected
communitieson how to build health and community systems, ensure their continuity, and build
capacity The Country Dialogue component of the NFM should aid in this process
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Nearly all CSOs need some capacity building assistance in order to be successful PRs CSOs should
have a capacity building plan that encompasses a variety of needs and modes of TS and involves one
main consultant TS provider Such work was successful in Lesotho where the Southern African AIDS
Trust (SAT) provided support to the Lesotho Council of NGOs to prepare for and implement the PR
role. Even CSOs with signicant capacity should make honest assessments of themselves, as thereare most likely areas for capacity enhancement
PRs and experts emphasized that TS and capacity building should start with an assessment and
TS providers should insist on a needs assessment before providing the TSa step that was
identied as a top recommendation to TS providers by surveyed CSOs. TS must be practical and not
generic; knowing the context and local language is important Moreover, the consultants should be
accountable to PRs
4 . CSO needs for techn ica l suppor t
Identication of needs [for technical support] wasbased on the trial and error method.
Lank
aJatikaSarvodaya
Sharm
adanaSangamaya,
SriLanka(currentPR)
Sometimes [it] is difcult to understand the various,creative and committed ways that Ecuadorian NGOs useto sustain their capacities. We dont have public resources
and mainly depend on projects. [] It is necessary toinclude institutional support in grants.
Kimirina,
Ecuador
(currentPR)
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Technical support
Typical forms of technical support include:
Short-term consultancies
Workshops and trainings
Interim management and secondments
Personnel mentoring and coaching
1
Adapted from GTZ (2010) Summary of technical support provided by the German BACKUP Initiative for the development of
proposals to the Global Fund
Key points
CSOs interested in the PR role should have a comprehensive capacity building
plan to address various current and anticipated needs for the PR role Planning
should take place proactively and early on, and should acknowledge the need
for external support
Before starting TS, TS providers should (re)assess the CSOs capacity needs
and other demands related to the changing roles of the CSO
http://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdfhttp://www2.gtz.de/dokumente/bib/gtz2010-0082en-global-fund-proposal.pdf -
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4 . 1 . The dec is ion to seek a CCM's nominat ion t o be a PR
For most CSOs surveyed for this report, the decision to apply for the PR role was made by their boards
and senior management Once the decision was made, the groups often initiate strategic planning
and/or a management assessment The PR role was a natural next step for groups with Global Fundexperience All the experts interviewed for this study pointed out that the decision is not always rooted in
what is best for the national response, but rather in a groups self-interest
Reasons CSOs Seek PR Position
The opportunity to expand actions to tackle high burdens of disease
A lack of management capacity among other local groups
A desire to more effectively channel funding to civil society groups
The need to ll gaps in reaching underserved and marginalized groups
Seen as essential for sustainable development
Pressure from network members
None of the surveyed groups sought specic TS during the decision-making process, but most
used strategic planning as a necessary step after the decision was made The decision, as some
recommended, requires a rm understanding of Global Fund guidelines and requirements. Many
reported that TS for this was needed and that they received it through the Global Funds online
resources, workshops, the GF Secretariat, or existing PRs At the time of this research, there were noclear specialized TS providers for this process, and funding to support potential PRs for their decision-
making was extremely scarce
Deciding and preparing for a PR nomination is the mostimportant stage. People tend to forget its importance.
LeeAbd
elfadil,
Interna
tional
HIV/A
IDS
Alliance
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Key Technical Support Needs at This Stage
Guidance to the key documentation of the GF requirements, guidelines, and
policies that affect PRs specically, including a possible self-assessment.
Peer and other groups advice on advantages and possible implications of the PR
role on the organization, if or how to balance advocacy, direct service provision and
management roles and changing relations with other CSOs and partners as well as
how the PR role could help address local needs
Mentoring through strategic planning that would include honest discussions
about the reasons for becoming PR among other steps and conclude with the
CSOs decision
Help to review the practical steps in the next phases of becoming a PR (once
the decision is made), including communication with the CCM and building capacity
Nonetheless, experts emphasized the need for a comprehensive and honest review of the implications
of becoming a PR within the CSO and externally with other stakeholders This should include a
review of the organizations mission, relationships, and capacities, leading to a decision on the role
the organization believes is most appropriate: manager, implementer, watchdog, or advocateor
combination thereof
However, in order to receive this support from TS providers, a CSO would rst be required to identify
its needs, to trust the TS providers assistance and to be open about its capacities and reasons for
pursuing a PR role Strategic planning before the decision is highly recommended by experts The
Country Dialogue in the NFM may provide a critical venue for the delivery of TS at this stage
Key points
CSO Board and membership, in consultation with management and external
partners including other CSOs, should lead the decision-making process
Preferably, strategic planning should take place before the decision is made
External advice should not be underestimated and should come from TSproviders, current or former PRs, including CSOs, as necessary
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4 .2 . PR Nominat ion and proposa l deve lopment
Once the decision to seek nomination is made by a CSO, most of them start their capacity building
process, as well as work to secure the CCMs nomination, and to develop and defend workplans andbudgets within the countrys proposal Most groups had their capacity assessment at this stage, often
using internal resources But most capacity building processes take place at a later stage, once the
nomination and grant are approved
Surveyed CSOs and experts suggest that PR candidates have their capacity assessed as early as
possible, with external help, to analyze workload and nancial needs for a comprehensive administrative,
management, sub-granting, nance, and M&E review. Consultation with UNAIDS, the Global Fund or
other multilateral organizations, or with other PRs (CSO or otherwise) have been helpful Preparatory
workshops have also helped to build understanding of: new Global Fund guidelines, how to better
address capacities for submitting applications, and other key PR competencies The capacity buildingneeds of CSO PR candidates should be dened and budgeted in proposals to the Global Fund.
CSOs report varying experiences with CCMs regarding nomination and proposal development Medicam
needed to present their candidacy for the PR role at least twice to convince the government to nominate
the organization From its experience, Ecuadorian PR Kimirina noted that the participation of an external
mediator is the key to making good decisions on nominations and work plans since CCMs usually have
members with competing interests ANCS also noted that the involvement of international colleagues in
negotiations and prioritization of civil society interventions was very effective In general there is a need
to prepare arguments that convince government representatives and other partners why a civil societyPR should be nominated (besides that it is recommended by the GF) and why the proposal to invest in
civil society capacity should be approved
Before the proposal writing process [began] many
national stakeholders were involved as TS providers ,[and] specic consultants were hired. Such TS appearedto be extremely helpful while preparing the Global Fund
application for being a PR.All-Ukra
inian
NetworkofPLHIV
(current
PR)
-
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Key Technical Support Needs at This Stage
External mediation of proposal development and PR nomination process within CCMs; Guidance on the proposal form (or Concept Note) and related tools;
Guidance on advocacy, budget arbitration and allocations for civil society PRs;
Analyses of needs and gaps in the current health environment
Overall, strong CSOs with leadership roles and true involvement in the CCM are reported to contribute
signicantly to effective discussions around PR nominations and development of country proposals.
Again, it is anticipated that the Country Dialogue and Concept Paper mechanisms in the NFM will
help facilitate this process
Key points
CSOs need to be supported to assess their capacity to become PRs
TS to CCMs that GF and technical partners provide should pay special
attention to building a better understanding of the roles and needs of CSOs
and MARPs, including through documentation and promotion of their
contributions and needs
Dual Track Financing, coupled with the requirement to include a TS plan in
proposals is a positive step
Surveyed organizations often had the capacity to develop project proposals through their past
experience as SRs or PRs but support on issues such as integrating different program components,
developing procurement and supply management plans or budgeting management costs, and planning
and costing of M&E may still be needed
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4 .3 . Dur ing the LFA Assessment and
grant agreement negot ia t i ons
The LFA Assessment is the formal PR capacity assessment, conducted after proposal approval, and
prior to grant signing. All the key elds that are in the Global Funds minimum requirements for PRs (seesection 31) are assessed by LFAs and were mentioned among areas in which CSO PR candidates
needed assistance Additionally, some tools have been more recently developed (eg Global Funds
Guide to Writing PSM Plans) While some groups manage to prepare the documentation needed with
internal resources (eg Medicam and RAA), others require substantial and immediate help The support
needed during this period is resource-intensive and requires diverse expertise in order to help the
organization create plans for multiple technical areas in a short period
LFA Assessment Required Documents
A recent reliable assessment of some other implemented programs
The Procurement and Supply Management Plan
A self-assessment of the national M&E system
A national or grant-specic M&E plan
Audit arrangements
The budget and workplan for Phase 1 of the program
Background information including latest audited nancial statements and annual report
Names of PR-authorized representatives and recipients for notices
A letter containing specimen signatures of people entitled to submit a disbursement request
and conrming the bank account details.1
FromThe Global Funds Operational Guide: The Key To Global Fund Policy and Processes
When a civil society organization is a PR along with anotherentity such as the government, they need enhanced
advocacy and negotiation capacity.
ANCS,
Senegal
(currentP
R)
http://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/documents/core/guides/Core_GlobalFundPoliciesAndProcessesOperational_Guide_en/http://www.theglobalfund.org/en/procurement/guide/?lang=enhttp://www.theglobalfund.org/en/procurement/guide/?lang=en -
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The conclusions of the LFA Assessment help to identify further needs for capacity building before
assuming the PR role, frequently related to management, M&E or PSM Those further needs often
require help from external consultants and are relatively costly, costing up to US$400,000 for short-term
technical support and coaching for M&E and PSM planning1 Generally, experts note that with the Dual
Track Financing (DTF) policy in place, access to technical support for the LFA assessment is improving
with time; funding or direct assistance can often be received from UNAIDS, WHO, GIZ or others
All but two CSOs surveyed indicated that they did not need assistance in grant negotiations to nalizethe performance framework which contains the country-dened indicators, targets and time frame.
1 Amounts are based on data provided by All-Ukrainian Network of PLHIV, information from OSF about their support to
two groups preparing for the PR role, and Novibs published report of their support to one PR
Key points
UNAIDS, WHO, TB Technical Assistance Team and Roll Back Malaria, theInternational HIV/AIDS Alliance, other TS providers, should support the
formation of special TS teams to be available during the LFA Assessment and
grant negotiation period for the nominated CSO PRs, particularly rst-time
PRs
The LFA Assessment process will prepare PRs for grant negotiation, as many
of the same documents and assurances are required for grant agreement
signing
The ndings of the LFA Assessment can be of immense value to the CSO on
their ownthe GF Secretariat is responsible for communicating the ndings tothe nominated PR
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4 .4 . Implementat ion
At this stage it is particularly important to learn how to provide documentation to and communicate withthe Global Funds Secretariat, the CCM, and LFA Capacity building and mentoring are most needed
in the start-up period leading up to the rst project fund disbursement and the rst report and second
disbursement request to the Global Fund CSOs that received technical support in the previous stage
found it effective to continue collaboration with the same TS provider, as in the case of the Romanian PR
ARAS assistance to Serbian CSO PR Youth of Jazas
We have already passed through all the processas a PR. But we need continuous capacitybuilding in all indicated areas [in minimum
requirements for PRs].
EthiopianInterfaith
Forum
for
Developm
ent,
Dialogue
and
Action(currentPR)
Identity incongruity of the Network required TS fordevelopment of organization capacity as a projectimplementing unit maintaining the function of acommunity-based grassroots network of PLHIV.
All-Ukrainian
NetworkofPLH
IV
(currentPR)
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Key Technical Support Needs at This Stage
1. M&E: Developing a system with information support and reporting formats, training staff
in the PR and SRs, and mentoring on Global Fund requirements;
2. Financial management: Introducing and adapting software for tracking the status of
sub-granted contracts, developing policy manuals, solidifying contract monitoring and
fund transfer systems;
3. Human resource management: Possible restructuring, reviewing personnel policies,
staff expansion and recruitment;
4. PSM: Nearly all CSOs need TS for PSM Includes developing sound practices in
tendering, inventory management, and supply chain management, and establishing
partnerships with external providers of PSM support
5. Programmatic capacity: Community system strengthening (CSS) knowledge is vital
for PRs PRs will need some level of competency with issues and policies affecting all
programs they manage, even if being delivered by specialist SRs
6. SR management: Most needs and requests for assistance are linked with SRmanagement SR management includes:
Building and operating grants management system inside the PR
Selection and oversight of Sub-recipients
TS for nancial management and M&E, and general organizational development
7. Management of the change in relationships with other groups and within the
organization: A common challenge for indigenous CSOs, particularly important at this
stage. Conicts of interest are apt to arise among SRs with oversight roles or which are
members of networks managed by the PR
Key points
First-time PRs should seek mentoring to learn to develop documentation for
and to communicate with the Global Fund, their CCM, and the LFA
The Global Fund should support and promote horizontal cooperation among
PRs
Current CSO PRs should have comprehensive, budgeted technical support
plans with the grant as the main source of funding and work proactively with
the UNAIDS family, WHO and others to identify TS providers and engage
international and local resources
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4 .5 . Post -grant "ex i t " s t ra tegy
It is crucial for us to increase our capacities to generateour own resources. We work for that in research
proposals , we do consultancies with fees forpeople who can afford them. Donors demand
sustainability as though it was an automatic process.
K
imirina,Ecuador
(currentPR)
Our exit strategy will be to advocate with thegovernment to accept the existence of the NGOsand other similar organizations who could also be
partners in disease control and prevention.LankaJatik
a
Sarvodaya
Sharmadan
a
Sangamaya,
SriLanka
(currentPR
)
-
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Two levels of exit of Global Fund grants were assessed: sustaining services after funding is over, and
management of changes in organizations once they conclude their role as PRs
All the surveyed organizations foresaw their long-term involvement in large project management and
planned to continue their PR role if their countries remain eligible It is not logical to apply just for one
round to be a PR given the big investment in management, the Cambodian group commented But
a few groups acknowledged too that there would be a need for support if they were to conclude their
role as PRs in order to manage the changes in their organization in terms of their size, nature, services,and income Two groups, Kimirina and RAA, had already started consultancy work to generate
alternative income but acknowledged that it was challenging
In general, very little TS experience exists in the eld of phasing out grants for management of CSO
changes, building program funding sustainability and policy change With more CSOs phasing out
their grants and more CSOs starting their PR role there will be increasing need for a particular type of
TS for CSOs with grants that are ending Part of this support is to do strategic planning for the CSO
PR The other parts are: intense work with government and other structures for the sustainability
of the programs, and ensuring that grants do build community systems that can be sustained with
comparatively low funding
Key points
CCMs and CSO PRs, particularly from upper-income countries, together with
in-country partners and international networks, should build in an advocacy
and policy dialogue plan for sustaining the services in community and health
systems in Global Fund grants
Because most PRs aspire to a long-term PR role, there is a dearth of post-
grant planning, and consequently the relevant TS
ICASO should initiate dialogue with key TS providers on developing TS for
(CSO) PRs exiting GF grants, including strategic planning and diversifying
donors
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5 . 1 . Current and potent i a l sources o f TS
Standard sources of technical support and capacity building include UN agencies, WHO, USAID-
funded Grant Management Solutions, GIZ, the Clinton Foundation, and specialized consulting
groups and experts Their support (and funding for their work) is mostly available to CSOs only once
they have received the PR nomination. However, a desire for more exibility and access to local
experts has been expressed by CSOs
The Global Fund Secretariat, though not a TS provider, could be helpful: it informs countries and
TS providers about Global Fund requirements, provides guidelines and tools and can link relevant
groups to help them get additional support The GF Secretariat might also facilitate horizontal TS
relationships CSO PRs
5 . Who wi l l prov ide techn ica l suppor t?
We were disappointed in how some of the technicalassistances were provided because they were more oriented
toward favoring some NGOs to the detriment of others; completely ignoring the RBP+ which was ofcially designated
by the Burundi CCM .RBP+,Burundi
Indigenous NGOs are relatively poorly resourcedcompared to their international counterparts. Byextension, their organizational capacities are alsolimited. Any Global Fund grants to indigenous
NGOs should ordinarily include an allocation forcapacity development (both short and long term).
Felicitas(Flanny)
Chiganze,
SouthernAfrican
AIDS
Trust
http://www.gmsproject.org/http://www.giz.de/Themen/en/4356.htmhttp://www.giz.de/Themen/en/4356.htmhttp://www.gmsproject.org/ -
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Nonlocal PR responsibility to build national capacity
[] a multilateral organization or an international nongovernmental organization may be nominated as
Principal Recipient In the interests of country ownership and long-term sustainability, this arrangement
should be temporary and, thus, the non-local PR should develop an action plan and budget which aims
to enable a national entity to take over the role within an agreed time frame1
From Section I33 inThe Global Funds Operational Guide The Key To Global Fund Policy and Processes, August 2010
5 .2 . ICASO ro le
A set of tools, as well as expertise and capacity is available from existing CSO TS providers, like the
International HIV/AIDS Alliance, regional groups like the Southern Africa AIDS Trust (SAT), HIVOS, and
global and regional networks
In many cases, experts and PRs see current and former PRs as having substantial technical expertise
that can be used to help other groups interested in the PR role There are examples of such support
already ANCS from Senegal has hosted a number of study visits from interested organizations around
Africa RAA from Romania helped the Serbian CSO PR The All-Ukrainian Network of PLHIV providedconsultant support to possible PRs in the TB response in Ukraine, and assists with capacity building
and advice to PLHIV groups in Eastern Europe and Central Asia, who typically play the role of SRs or
SSRs Horizontal cooperation is additionally supported through the PR working group, an informal global
network of CSO PRs Current PRs could also provide mentoring and other TS in areas such as making
the decision to seek the PR role, applying and negotiating for a CCM nomination, and participating in the
resource-intense process of the LFA assessment
Multilaterals and international organizations that are currently PRs could be very helpful in providing
support for national groups to become PRs and even for handing over their PR role to indigenous CSOs
To date this has met with challenges Although GF grant agreements encourage multilaterals to build
local capacity, experts suggest that such international organizations would need incentives, relevant
resources, and tangible support
Experts and PRs do see a specic role for ICASO in relation to the CSO PRs. ICASO should advocate
for building political and technical capacities of civil society, including people living with the diseases and
key populations, for participation in national strategy planning, solutions for program sustainability and
further promote the DTF policy Principally, ICASO has a role in global advocacy for effective civil society
participation in national strategy planning supported through the Global Fund, as well as continued
participation of CSOs within the new grant architecture, nding better strategies for phasing out grants in
middle income countries and better access to funding for TS to CSOs
http://www.theglobalfund.org/documents/Operational_Guide_en.pdfhttp://www.aidsalliance.org/http://www.satregional.org/http://www.hivos.net/http://www.hivos.net/http://www.satregional.org/http://www.aidsalliance.org/http://www.theglobalfund.org/documents/Operational_Guide_en.pdf -
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6 . Conclus ions
The increasing involvement of CSOs as PRs and SRs requires a concomitant commitment from donors
and partners to fund and organize technical support and capacity building While indigenous CSOs are
often limited in terms of the internal management capacity that is the necessary foundation for becoming
an effective PR, they offer much in terms of local credibility and community expertise that governments
and multinationals cannot
Key areas of technical support needed
CSO management in all core areas for PRs Understanding of Global Fund guidelines, policies and processes and how
to use them to meet local needs, particularly as the new funding model is
implemented
Management of change in CSO structures and relationships with other
organizations as groups evolve into and conclude the PR role
Advocacy and political and technical expertise to negotiate and promote policy
dialogue with CCMs and other ofcial bodies.
The greatest need and lowest availability of support is often found among smaller indigenous
CSOs Such groups may require additional mentoring and linking to technical support and
networks of peer organizations
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Capacity assessment
CSOs often do capacity assessments themselves; additional external support to crystallize thinking
about needs and unrealized gaps is often valuable and can help formulate requests for technical support
throughout the life of a project
Techn ica l suppor t needs in d i f fe rent s tagesThe poor availability of TS and capacity building for CSOs at the initial and end-point stages of Global
Fund projects was identied as a challenge by several surveyed groups. During the other stages, TSis generally more available but stil l comes with challenges TS is frequently needed during the LFA
Assessment and at the start of implementation. Before Global Fund grants nish and/or middle-income
countries become ineligible, much more support is necessary for CSOs to nd alternative solutions for
generating income from other sources, or MARPs may be signicantly and negatively impacted.
Techn ica l suppor t prov iders and donorsDonors and TS providers have limited resources and competing requests for support They have some
areas of specialization and coverage of TS but there are gaps in certain stages and technical areas
Horizontal exchange and more structured, longer-term TS, capacity building and mentoring could be a
role for current and former PRs Their experience and knowledge of local contexts and the Global Funds
work has proven to be useful in negotiations with CCMs and the Global Fund, to help build management
capacity during the LFA Assessment and project planning
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7 . Recommendations
UN agencies and TS providers should:1 Invest in long-term comprehensive capacity building of CSOs that can potentially become or
are already major implementers Where feasible, one capacity building facilitator (consultant
should work with a CSO throughout the process
2 Review how to promote greater access, support and investment for indigenous and rst-time
PRs and CSOs seeking nomination
The Global Fund and its partners should:1 Document the contribution and needs of indigenous and other CSOs in Global Fund grant
implementation and communicate this to CCMs
2 Promote horizontal cooperation among PRs and CSOs interested in the PR role, peer-to-peer
exchanges, and involve current and former PRs in technical support and mentoring
3 Regularly review how current non-indigenous PRs, such as UN and international organizations,
invest in building national capacity including indigenous CSOs
4 Review eligibility criteria to enable addressing the needs of poor and marginalized populations
in middle-income countries, rene strategies for improving post-grant sustainability, and seek toensure relevant support to CSOs and other PRs and CCMs
5 Evaluate whether the DTF policy has been successful in its objective to reach underserved,
vulnerable and key populations, and how achieving this objective could be further improved
including through community system strengthening
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CSOs seeking or in the PR role should:
1 Conduct strategic planning and request advice about the PR role before the decision to seek a
nomination as a PR
2 Plan and seek technical support and capacity building actively and early on, and openly
acknowledge the need for external help when relevant
Other civil society groups, CSO TS providers and ICASO and its partners should:
1 Continue to provide strategic information about the Global Fund, thus increasing the capacity
of CSOs to understand about how changes in the grant management affects thereby providing
more opportunities for CSO in-country and global engagement
2 Be vocal about the benets and challenges of being a PR, walk interested groups through
the stages of becoming a PR, and link them with former and current PRs, technical support
providers and donors when possible
3 Promote civil societys role as an independent actor in its participation on CCMs andcommunicate with donors in their capacity as watchdogs
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8 . Ref lect ions
The recent announcement of the New Funding Model (NFM) has raised many questions Per the Global
Fund, the NFM is intended to achieve greater impact, improve grant efciency, and promote greater
in-country dialogue and ownership While the basic framework has been articulated by the Global Fund,
many of the details are yet to be fully dened.
Within the NFM framework, there are some clear opportunities for increased civil society participation
most notably, the Country Dialogue The structure of the Country Dialogue has not been established,
and may ultimately manifest differently in different countries and regions But the outcome of all the
Country Dialogues will be the Concept Notethe equivalent of the proposal in the NFM The Concept
Note will outline the country prole, the total demand (need), and the proposed interventions. The
Concept Note is submitted by the CCM and should include the nominated PRs and some potential SRs
Whereas the proposal development process was almost entirely driven by the CCM in the past, the
Country Dialogue in the NFM is intended to involve a range of stakeholders, including civil society,
government, affected populations, and the Global Fund Secretariat, in an iterative and supportive
discourse As was highlighted in this report, the greatest gaps in available or accessible TS for
CSOs exist in the earliest and latest stages of a grant cycle. As the Country Dialogue is the rst
step for in-country stakeholders, there is an unprecedented opportunity to provide TS around the
potential PR assessment and decision to seek nominationthereby producing stronger PRs for grant
implementation The modest literature available on the Country Dialogues indicates that the Global Fund
Secretariats role is principally to aid in these assessments, provide guidance on minimum requirement of
PRs, and generally to work with the CCM to produce a strong, successful Concept Note, with all of the
right stakeholders involved
While there is an obvious opportunity in the lack of an established structure for the Country Dialogues,
there is also an inherent threat If CSOs, their advocates (such as ICASO and its partners), and
watchdogs are not proactive in shaping the Dialogues, country-by-country, and establishing a strong
civil society presence from the outset, they risk a diminished role not only in the Dialogue, but in the
Concept Note and the implementation of the grant Therefore it is critical that CSOs and their allies fully
understand the NFMand in particular the Country Dialogueand are prepared to come to the tableas soon as it is set Given the Global Funds professed desire to improve civil society participation and
country ownership, the future of CSO leadership in the response to HIV/AIDS is promising However, the
present opportunity must be seized
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9 . Annexes
Annex 1 . Form of the survey
1 Respondent and contacts
11 Name
12 Position in the organization
13 Organization name
14 Direct phone number and/or Skype
2 Decision to become a PR and TS before becoming a PR
(for the rst time if you are a PR for more than one grant)
21 How was the decision made? Did you undertake strategic planning or another process?
22 What did you have to do and change in the organization to become a PR?
23 What support have you received? From whom? Who provided funding?
24 What support was needed/would have been useful for that stage in addition to what you
received? For which areas of work? Did you identify your needs or did you have support to
identify your needs?
3 Preparation of the proposal(if you participated in more than one process, describe either the most recent process or all of them)
31 What technical support (TS) did you need? In which work areas? What type of TS?
How did you identify your needs (if you did)?
32 What TS did you receive? For which areas? Who provided the support, and who funded it?
33 Was the TS you received effective? How did you measure its quality?
34 What tools/information were important for you at the proposal preparation stage?
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4 Grant negotiation
41 What technical support (TS) did you need? What type of TS?
How did you identify your needs (if you did)?
42 What TS did you receive? For which areas? Who provided the support, and who funded it?
43 Who could provide such technical support, besides the group that provided it to you?
5 Implementation of the grant-supported project
51 Which were the key work areas where you needed TS (M&E, building capacity of sub-recipients,
nancial management, advocacy/policy/government relationships, human resource management,
procurement & supply management, innovative service related, other)? Please explain and provide
examples
52 How did you identify your priority needs? Did you use TS, tools or internal assessments, or
recommendations from related agencies?
5.3. Where do you search for TS in those work areas, or where would you suggest others nd TS?
54 How do you measure the quality of TS? Please provide examples
6 Post-grant strategy
61 Do you have an organizational strategy for what you will do after the Global Funds grant term?
If yes, what is it? If not, what possible exit strategies would you consider for your organization?
62 What kind of support do you think you will need to prepare for an exit strategy for after the
grant term?
7. Your involvement in technical support (TS)
7.1. Do you provide TS yourself? To whom? Sub-recipients (SRs) and SSRs? In what TS areas?
7.2. Have you provided formal or informal support to PRs, or to groups interested in becoming PRs, o
to groups interested in becoming SRs? Please provide examples
8. Recommendations
8.1. What would be 3 things that you would do differently if you were a major donor in the HIV /TB
Malaria eld, for better TS to NGOs that are PRs?
8.2. If you could make one recommendation to TS providers regarding how they could better
address NGO/PR needs, what would it be?8.3. Final comments
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Organization Country Round, working with other PRs,amount of grant agreement with the
organization
Contactperson
The Burundian
Network of PLHIV/
AIDS (RBP+)
Burundi Round 8 HIV (with governmental PR, US$
13,904,412)
Benjamin
Nicayenzi
Medicam Cambodia Round 9 HIV (with governmental PR)
negotiated
Dr Sin
Somuny
Corporacin Kimirina Ecuador Round 8 Malaria (with governmental PR,
which however has signicantly smaller
budget, US$ 4,442,653)
Round 9 HIV (with governmental PR) -
negotiated
Amira
Herdoiza
Ethiopian Interfaith
Forum For
Development,
Dialogue and Action
Ethiopia Round 7 for HIV (with one governmental PR
and one CSO PR; US$ 13,802,195)
Jihad keno
Abagero
TISI Sangam of Fiji Fiji Round 8 for TB (with one governmental PR)
- nominated by CCM but did not pass LFA
assessment due to insufcient capacity
Dorsami
Naidu
Annex 2 . Respondents and in terv iewed exper ts
CSOs that participated in the survey (Sorted alphabetically by country)
Table continued on page 34
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Middle East &
North Africa
Harm Reduction
Association
(MENAHRA)
Lebanon
(regional)
Prepares application for Round 10, based
on unsuccessful application for Round 9 that
had UNODC as aPR
Elie Aaraj
Romanian Angel
Appeal Foundation
(RAA)
Romania Round 6 for HIV (single PR, US$
11,370,707)
Round 6 for TB (single PR, US$ 10,413,467)
Sylvia Asandi
Russian HealthCare
Foundation
Russia Round 4 HIV (single PR - US$ 119,873,915)
Round 4 TB (single PR, USD 88,165,448)
Dmitry
Goliaev
National AllianceAgainst AIDS (ANCS) Senegal Round 1 HIV (with governmental PR, US$2,906,326)
Round 6 HIV (with governmental PR, US$
9,547,543)
MagatteMbodj and
Massogui
Thiandoume
All-Ukrainian Network
of PLWH
Ukraine Round 6 HIV (with other CSO, US$
52,314,214)
Now preparing for R10
Hanna
Shevchenko
Lanka Jatika
SarvodayaSharmadana
Sangamaya
Sri Lanka Round 1 TB (with government PR, US$
475,020; now inactive)Round 1 Malaria (with government PR, US$
5,176,412)
Round 4 Malaria (with government PR, US$
1,347,200)
Round 6 TB (with government PR; US$
957,593);
Round 8 Malaria (with government PR)
Dr LP
Chandradasa
Table continued from page 33
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Name Affiliation Experience / e-xpertise
Felicitas
(Flanny)
Chiganze
Deputy Executive
Director, SAT
SAT is a technical support provider in Southern Africa The
organization has conducted assessments of PR and SR needs
for the Lesotho Council of NGOs in their quest for PRship and
SAT Zambia for SRship
Katja Roll Senior Civil Society
Ofcer, Africa Unit,
The Global Fund
to Fight AIDS,
Tuberculosis and
Malaria
The Global Funds Civil Society team supports civil society groups
through direct involvement, raising awareness and access to the
Global Funds policies and guidelines and are in touch with CSO
PRs among other CSO groups They work closely with the Global
Funds Portfolio Managers and CCM teams to address civil
society needs
Dr LeeAbdelfadil
Senior Advisor andGF and Programme
Lead on Health and
Community System
Strengthening,
International HIV/
AIDS Alliance
To expand technical support and further strengthen civil societycapacity, the Alliance has established seven Regional Technical
Support Hubs, operating in Africa, Latin America and the
Caribbean, South Asia and Eastern Europe These Hubs have
been established to meet the demand from Alliance linking
organizations as well as other local NGOs and CBOs, for
technical assistance that matches what local people need, and
support that enables them to learn from and inuence their peers.
The Alliance organizes a number of international workshops
and technical support tools A number of the Alliance linking
organizations are also PRs for the Global Fund grants
Matthew
Greenall
HIV/AIDS and
Development
Consultant, Program
Advisor to CSAT
He has developed many proposals for the Global Fund and is co-
author of several Aidspan guides
Shannon
Kowalski
Senior Global
Fund Ofcer, Open
Society Foundations(OSF), also member
of Private Donor
Delegation to the
Global Funds Board
OSF is an implementing donor which supports public health
initiatives that reach marginalized groups in several regions
It particularly focuses on civil society groups It paid for andassisted with planning technical assistance to several CSO
PRs and proposal development processes (the Russian Harm
Reduction Network, Globus in Russia, a PR-to-be in Zambia,
etc) She is actively engaged in developing and monitoring
Global Fund policies and keeping civil society groups informed
about them
Experts Interviewed (Sorted alphabetically by name)
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