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Implementing the New Funding Model: Early Applicants

Three early applicants submitted five concept notes as the first countries to apply for grants under the new funding model. These grant applications were approved in June 2013 for a total amount of $622 million.

  • El Salvador: one concept note for HIV/AIDS, $26.9  million approved
  • Myanmar: three concept notes for HIV/AIDS, tuberculosis and malaria, $316 million approved across all three programs
  • Zimbabwe: one concept note for HIV/AIDS, $278.9 million approved

Under the new model, countries can apply for two types of funding, indicative and incentive funding. Indicative funding is for a country's priority interventions, and each country receives a needs-based range at the start of an application process estimating the amount of indicative funding available. Incentive funding is a competitive pool intended to reward ambitious, high-impact proposals and alignment with national strategies. Of the three early applicants approved so far, Myanmar and El Salvador both won incentive funding to supplement their programs, while Zimbabwe’s approved amount is entirely indicative funding.



El Salvador

Population: 6.1 million
Previously Approved: $66 million
Disbursed till date: $64 million

New Funding Model Summary

  • 1 concept note submitted for HIV/AIDS
  • Approved incremental HIV/AIDS funding: $26.9 million
    • Indicative: $20.2 million
    • Incentive: $2.9 million
    • Renewals: $3.9 million

HIV/AIDS Country Landscape

  • Two active Global Fund HIV/AIDS grants totaling $56 million ($55 has been disbursed)
  • Prevalence rate of 0.8%. 24,000 people living with HIV. Less than 500 deaths from HIV in 2011
  • Vulnerable groups include sex workers, men who have sex with men and transgendered populations
  • Government provides 80% of resources for national HIV/AIDS response

Past Challenges

  • Coordination and standardization in prevention with an individual focus
  • Investment focus on general population and youth did not align with epidemiological data
  • Gaps in monitoring and evaluation systems
  • Weaknesses in procurement/supply chain management systems

New Proposed Activities & Goals

  • Focus on key populations, including men who have sex with men, female sex-workers, transgender individuals, and prisoners
  • Scaling up coverage of  treatment gaps
  • Strengthening PMTCT services
  • Capacity-building to improve M&E and project management
  • Decentralizing services
  • Incorporate human rights-based approach in providing key services


Myanmar

Population: 55 million
Previously Approved: $127 million
Disbursed till date: $125 million

New Funding Model Summary

  • 3 concept notes submitted for HIV/AIDS, TB and Malaria
  • Total approved incremental funding: $316.27 million

Past Challenges

  • Difficult inception of grants due to lack of country experience
  • Delays in procurement of health products
  • High program costs
  • Sustainability of interventions
  • Delays from the Government in issuing operational MoUs to international NGOs

HIV/AIDS

Funding: $161 million approved

  • Indicative: $39.5 million
  • Incentive: $30 million
  • Renewals: $91.7 million

Country Landscape

  • Three active Global Fund HIV/AIDS grants totaling $59 million ($58 million has been disbursed)
  • Prevalence rate of 0.60%, with 220,000 people living with HIV and 16,000 HIV deaths reported in 2011
  • HIV primarily affects sex-workers, injecting drug-users and men who have sex with men
  • 46,000 people receiving ARTs

Proposed Activities and Goals:

  • Scaling up National AIDS response
  • Reducing HIV transmission, HIV-related morbidity, disability and socio-economic impact
  • Reducing service gaps and increasing coverage of prevention among key populations
  • Implementing harm reduction programs in high transmission areas, such as border regions

Tuberculosis

Funding: $82.7 million approved

  • Indicative: $26.3 million
  • Incentive: $14 million
  • Renewals: $42.4 million

Country Landscape

  • Three active Global Fund TB grants, with an approved and disbursed amount of $31 million
  • Very high TB prevalence of 240,000. 20,000 cases of HIV-TB co-infection.
  • 23,000 TB deaths annually

Proposed goals and activities

  • Scaling up of active case finding, diagnosis and treatment of MDR-TB
  • Ensuring adequate training and human resources for technical and administrative support of the plan
  • Improving diagnosis and procurement of first line TB drugs
  • Scaling up HIV/TB services

Malaria

Funding: $72.35 million approved

  • Indicative: $26 million
  • Incentive: $12 million
  • Renewals: $34.3 million

Country Landscape

  • Three active Global Fund malaria grants, totaling $36 million ($35 million disbursed)
  • 1.3 million insecticide-treated bed nets have been distributed to date
  • 70% of population lives in malaria endemic areas
  • 500,000 cases of malaria deaths reported annually, actual burden is estimated to be higher.
  • Highest burden of any country in South East Asia.

 Proposed Goals & Activities

  • Replacing of LLINs to expand coverage to 70%
  • Transforming the Country Coordinating Mechanism into a Health Sector Coordinating Committee
  • Achieving strong partner involvement of partners and high level political support
  • Mapping malaria by endemicity
  • Developing synergies with other donors and private sector
  • Capacity-building  in health information systems


Zimbabwe

Population: 13 million
Previously Approved: $565 million
Disbursed till date: $486 million

New Funding Model Summary

  • 1 concept note submitted for HIV/AIDS
  • Approved incremental HIV/AIDS funding: $278.9 million
    • Indicative: $278.9 million
    • Incentive: none recommended
    • Existing funding: $32.3 for an existing Round 8 grant

HIV/AIDS Country Landscape

  • Three active Global Fund HIV/AIDS grants totaling $335 million ($283 million has been disbursed)
  • 1.2 million people living with HIV (most affected country in Sub-Saharan Africa), and 440,000 currently receiving ARTs
  • Key drivers of HIV transmission: multiple concurrent partnerships, inter-generational sex, discordant couples
  • HIV prevalence is declining due to prevention strategies, high condom use and reduction of multiple sexual partners.

Past Challenges

  • Integration of TB and HIV programs
  • Accelerating targeted prevention, treatment and care programming
  • Limited data on HIV prevalence within most at-risk populations, including female sex workers and prisoners

Proposed Activities & Goals

  • Scaling up prevention of adult and child HIV infection,
  • Reducing mortality among people living with HIV,
  • Expanding universal treatment coverage
  • Expanding sound technical and normative guidance on testing and counseling and improving access to testing, counseling and condoms
  • Introducing high impact interventions such as male circumcision and self-testing