Much more of substance from this meeting should be made available to the public.
[him] moderator
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Fund Board Conclusions and Recommendations
Three Diseases Fund First Annual Review Meeting
1–2 April 2008, Yangon
OVERVIEW AND PREAMBLE
1. Success and achievements
* All related bodies are established, operational and continue to develop their roles.
* The Annual Review Meeting (ARM) highlighted areas of success (noted below) and also identified areas where strengthening is required.
2. The Fund Board has made high level recommendations relating to these areas. These recommendations will be further operationalised by the Fund Manager (FM) following endorsement by the Donor Consortium (DC).
INSTITUTIONS
The FB noted that all related bodies have made a good start in operating effectively. Technical and Strategic Groups (TSGs) and the Coordination Body (CB) have met to develop and approve National Strategies for the three diseases, and National Operational Plans. However, there is a need to further strengthen dialogue within and between these bodies to:
- ensure increased effectiveness
- guide and oversee the whole (ie not just 3DF resourced) response to the diseases
- continue to develop programmes and indicators of success
- identify gaps in the response and make proposals for ways in which these can be addressed.
The FB has noted the request to upgrade information sharing with the TSGs in relation to resource allocation and would welcome continued dialogue on the best way of achieving this.
The FM has successfully developed and implemented policies and systems for effective fund management. The FB is concerned that there is now a danger of work overload, and of pre-empting programme development responsibilities which should rest with the TSGs and CB. We believe that it is an appropriate time for the FM team to focus on priority management areas, and will set priorities for the FM in the coming year to reflect this.
The Firewall has been established to ensure a clear distinction between Programme Development (a core responsibility of the TSGs and CB) on the one hand, and Resource Allocation (the responsibility of the FM and FB) on the other to ensure no conflict of interest. Maintaining the institutional integrity of the Firewall will remain a priority for the FB.
RESOURCES
The 3DF has been highly effective in accessing and mobilising resources in the period since it was established. However, the FB views with concern the serious mismatch between available resources and levels of need for an effective response that can be rapidly scaled up. Mobilising additional resources must remain a priority. Demonstrating effective use of resources, and success in achieving results will be key.
The FB notes the need for government to allocate more resources to health, including to address these three priority diseases. We also request the Ministry of Health to consider how they might mobilise and use additional resources from other parts of government and other donors.
The Global Fund for AIDS, TB and Malaria (GFATM) has the potential to be the source of significant funding to meet the current gap in resources.
PROGRAMME CONTENT
The FB has noted the achievements of the TSGs and National Disease Control Programmes in developing Operational Plans based upon the National Strategies. We suggest that there is now a need for ongoing dialogue within TSGs and between them and the FM team to identify ways in which the national responses can be made more efficient and thus achieve greater impact.
A major driver of efficient and effective programme development will be partnerships based upon up to date strategic information (particularly on levels and distribution of disease burden) and delivery of “state of the art” interventions.
OPERATIONAL ISSUES
Access is central to 3DF effective programming. This includes both access to marginalized and under-served groups, as well as access by IPs to agreed project site areas.
FB acknowledges that NGOs should act within the frameworks of their approved MOUs. FB also emphasises the important role the Government must play in providing timely approval of MOUs and travel permissions so those NGOs can function effectively.
It would also be helpful if the Government could recognise the key role local NGOs and CBOs can play in reaching marginalised and remote populations. FB welcomes the MoH offer to help facilitate registration process for local organizations.
Communications are, and will continue to be, a crucial aspect of 3DF management. A uniquely challenging set of stakeholder issues defines the 3DF operational context. It is important that no compromise is made on transparency and openness and that the FM continues to communicate effectively.
Good progress on communicating 3DF achievements has already been made by the FM office. This includes the show-casing of 3DF-supported projects at the ARM, the rolling out of the 3DF logo, and development of a number of publicity materials.
The good work already being done needs to be built on and developed, and several suggestions have been made during the ARM as to how this can be done, both inside the country as well as externally.
Procurement and resource tracking are other important elements related to 3DF accountability. It is encouraging to see that efficient systems are in place and that savings in time and money have already been made. There is a need for constant vigilance to ensure that these mechanisms continue to function well as this is essential for accountability and transparency and will, in themselves, be instrumental in attracting more funds.
Data collection and sharing is a fundamental operational issue. Without quality data it will not be possible to achieve intended results or to strengthen programming. There is a need for better use to be made of existing data and an increased sharing of information and evidence between operational partners.
In relation to this, the FB notes the cost of collecting new data and the need to be selective about what additional studies are conducted. Decisions on this must be in line with existing 3DF policy: for example, our commitment to ensuring geographical and gender equity.
Partnerships and coordination are at the heart of effective programming and implementation. The FB has heard and seen evidence of good collaboration and coordination between partners at the Annual Review Meeting. This needs to be broadened and deepened.
Specific examples have been given of where partnerships need to be strengthened - such as township level coordination and planning. Opportunities have also been identified for increased collaboration with a broader range of partners, including other parts of Government and the private sector.
Advocacy on what 3DF is doing, and why and how, needs to be increased at all levels to ensure better understanding. This will contribute to a more enabling environment.
FB recognizes that the strengthening of partnerships involves considerable work and that this needs to be supported in whatever ways possible.
SUMMARY OF RECOMMENDATIONS
INSTITUTIONS AND STRUCTURES
* The Fund Board acknowledges the importance of projects being fully in line with the National Strategies and Operational Plans.
* Dialogue between the Coordination Body, Donors, and the Fund Board should be strengthened including discussion of the role of the Coordination Body in providing oversight of national responses.
* The Fund Board should continue to ensure that 3DF resources are mobilized and efficiently used to address priority gaps.
* A positive start has been made by TSGs in overseeing strategy development and planning. Further development of this role should be a priority for the coming year.
[Special recommendations are made below for consideration by the Coordination Body and for support as approved by the Fund Board and Fund Manager]
* Efficient and effective systems for resource allocation and management have been established. The Fund Management Office should now increase its focus on key management responsibilities, whilst ensuring that other bodies are supported to fully meet their responsibilities.
* The Firewall will continue to play a vital role in separating 3DF fund allocation and programme development. Maintaining the Firewall will remain a top priority for the Fund Board.
RESOURCE MOBILISATION
* The Fund Board and Fund Manager should increase efforts to present evidence of success to support the MoH and implementing partners to mobilise additional resources, including from other donors, to support both 3DF and complementary actions consistent with the National Strategies.
* The Annual Review Meeting noted the continued low level of government funding to the health sector and recommends that government makes significantly increased levels of funding available to ensure an effective response to three diseases.
* The FB proposes that the government now consider formalising the structures that would enable development of a proposal to the Global Fund for Round 9 in March 2009.
PROGRAMME CONTENT
* TSGs should continue to:
I. refine and update operational plans based on strategic information;
II. ensure that equity and coverage issues are fully addressed;
III. regularly review M & E frameworks; and,
IV. adjust targets in light of progress to maximise efficiency and impact.
* Operational Plans should reflect the totality of resources available from all sources and, on this basis, identify gaps in the response, which should be communicated to the FM to inform resource allocation.
* TSGs should take forward recommendations for further technical policy development relating to the three diseases and discuss with the FM what implications this might have for resource allocation (ie, identification of existing or new priority areas of intervention).
OPERATIONAL ISSUES
Access
* Noting that access is central to an effective response to the three diseases, in line with the Guiding Principles for the Provision of Humanitarian Aid (reference1), the FB requests:
- IPs to use 3DF funds within the framework of their MoU;
- Government to provide timely approvals of MoU and travel permissions for IPs as agreed in the Programme Document (16/6/2006).
* FB welcomes the CB recognition of the important role LNGOs/CBOs play in reaching marginalised and remote populations as reflected in National Strategic Plans, and appreciates the MoH offer to support the registration process for these organisations.
* The FB requests the FM to ensure that due consideration be given to gender and equity in all 3DF-funded projects.
COMMUNICATIONS
* The FB appreciates the development by the FM of a culture of transparency, openness and accountability and recommends continued emphasis on communicating 3DF achievements to all stakeholders. It is now a priority to promote increased understanding and knowledge of 3DF purpose and approaches in order to:
- maintain support and attract further resources;
- create an enabling environment; and,
- increase beneficiaries’ awareness about the use of 3DF resources.
* The FB requests the FM office to continue to develop a communication strategy in ways which will achieve the above.
PROCUREMENT AND COMMODITY TRACKING
* FM should continue to provide procurement services for those IPs that do not have in-house capacity, whilst also contracting out procurement to those agencies which have demonstrated capacity to ensure value for money and compliance with international standards.
* FM should continue to ensure adherence to procurement guidelines and Standard Operating Procedures (SOPs).
* FB welcomes plans for an independent commodity tracking system and requests FM to take this forward as soon as possible and to ensure that tracking reports are published widely.
FUND FLOW MECHANISM
* FB note the establishment, by WHO, of a system to disburse funds to local civilian administrations. FB requests WHO to fully operationalise this and to develop a plan for TMO capacity building which will lead to eventual TMO management.
* WHO should continue to provide the FM with regular (ie quarterly) updates on progress.
DATA COLLECTION AND ANALYSIS
* FB notes with concern the lack of basic data (including clear quantification of denominators) to inform resource allocation, programme design and implementation. This is essential to demonstrate outcomes and, over time, impact. FB recommends that National Programmes and TSGs address this as a priority, including effective coordination of information management.
* FM should prioritise its monitoring to ensure that:
- IPs meet their contracted responsibilities to deliver agreed outputs; and,
- 3DF resources are efficiently spent to achieve results.
* FB acknowledges the primary responsibility of IPs to monitor and report on implementation.
* FM will develop guidelines for local NGOs and CBOs to ensure effective monitoring and reporting on all aspects of use of 3DF resources.
* The ARM identified the need for additional strategic information. The FB recommends that priority information needs should be identified and met by:
- TSGs, who should discuss proposals for information generation with FM for consideration for funding;
- FB/FM.
* FB requests all parties to increase the use and sharing of existing data.
PARTNERSHIPS AND ADVOCACY
* FB encourages FM and TSGs to continue to identify and build on opportunities to broaden and deepen partnerships and would welcome specific recommendations on how to take this forward, including at township level and with other government agencies.
* FB recognises that we, and all other 3DF stakeholders, have a shared responsibility for 3DF advocacy and recommends that FB and FM jointly develop an advocacy framework.
1 Proposal Three Diseases Fund, 16 June 2006 Annex I
http://www.3dfund.org/ARMnews#attachments
