The Global Fund has adopted new minimum standards for country coordinating mechanisms (CCMs). The Fund has also modified the wording of one of the six CCM minimum requirements, and has designed a CCM Performance Assessment Tool which CCMs will be required to use annually.
Currently, CCMs must meet the six minimum requirements to be eligible to receive funding for programmes to fight HIV, TB and malaria and to strengthen health systems. As of 1 January 2015, CCMs will also be required to meet the new minimum standards to receive such funding.
Each minimum standard is attached to one of the existing minimum requirements. Thus, in future, for those minimum requirements that have minimum standards attached, determining compliance with both the minimum requirements and the minimum standards will be done at the same time.
Starting in 2014, CCMs will be required to conduct a self-assessment annually using the CCM Eligibility and Performance Assessment Tool. (CCMs can start this process now if they choose to.) The purpose of the self-assessments is to allow the CCM to determine not only if it is compliant with the minimum requirements and minimum standards, but also how well the CCM is functioning. The Global Fund Secretariat says that the self-assessment exercise will produce a “complete diagnostic” of the CCM.
The Global Fund Secretariat is planning to revise the existing CCM Guidelines to reflect the new minimum standards and related changes. Revisions to the CCM Guidelines will likely have to be approved by the Board.
Change to one minimum requirement
The wording of Requirement 4 has been modified to include key affected populations and to add a reference to human rights and gender.
The old wording of Requirement 4 was as follows:
“The Global Fund requires all CCMs to show evidence of membership of people living with HIV and of people affected by TB or malaria (where funding is requested or has previously been approved for the respective disease). People affected by TB or malaria include people who have lived with these diseases in the past or who come from communities where the diseases are endemic.”
For the new wording of Requirement 4, see the table in the next section.
New minimum standards
One of the most significant new minimum standards is the requirement that the number of voting CCM members with a conflict of interest (COI) not exceed one per constituency. (This is related to Minimum Requirement 6 which is about COI.) The minimum standards do not define “constituency.” The Global Fund Secretariat told GFO that NGOs and faith-based organisations are two examples of constituencies in the civil society sector.
Another important minimum standard is the requirement that 40% of the CCM membership be drawn from the national civil society sector. The existing CCM Guidelines recommend that at least 40% of CCM membership be from non-government constituencies.
The new minimum standards also require that the CCM have balanced representation from men and women.
The complete list of new minimum standards is shown in the table below, along with the minimum requirements to which they relate. There are no minimum standards for Requirements 1 and 2.
Table: CCM Minimum requirements and minimum standards adopted by the Global Fund
Minimum requirement and related minimum standards
Minimum requirement #1:
The Global Fund requires all CCMs to: (i) Coordinate the development of all funding applications through transparent and documented processes that engage a broad range of stakeholders – including CCM members and non-members – in the solicitation and the review of activities to be included in the application. (ii) Clearly document efforts to engage key population groups in the development of funding applications, including most-at-risk populations.
Related minimum standards: None.
Minimum requirement #2:
The Global Fund therefore requires all CCMs to: (i) Nominate one or more PR(s) at the time of submission of their application for funding. (ii) Document a transparent process for the nomination of all new and continuing PRs based on clearly defined and objective criteria. (iii) Document the management of any potential conflicts of interest that may affect the PR nomination process.
Related minimum standards: None.
Minimum requirement #3:
Recognizing the importance of oversight, the Global Fund requires all CCMs to submit and follow an oversight plan for all financing approved by the Global Fund. The plan must detail oversight activities, and must describe how the CCM will engage program stakeholders in oversight, including CCM members and non-members, and in particular non-government constituencies and people living with and/or affected by the diseases.
Related minimum standards:
Minimum requirement #4:
“The Global Fund requires all CCMs to show evidence of membership of people that are both living with and representing people living with HIV, and of people affected* by and representing people affected by Tuberculosis ** and Malaria*** as well as people from and representing Key Affected Populations****, based on epidemiological as well as human rights and gender considerations.
* Either people who have lived with these diseases in the past or who come from communities where the diseases are endemic
** In countries where Tuberculosis is a public health problem or funding is requested or has previously been approved for Tuberculosis
*** In countries where there is on-going evidence of Malaria transmission or funding is requested or has previously been approved for Malaria
**** The Secretariat may waive the requirement of representation of Key Affected Populations as it deems appropriate to protect individuals”
Related minimum standard:
Minimum requirement #5:
The Global Fund requires all CCM members representing non-government constituencies to be selected by their own constituencies based on a documented, transparent process, developed within each constituency. This requirement applies to all non-government members including those members under Requirement 4, but not to multilateral and bilateral partners.
Related minimum standards:
Minimum requirement #6:
To ensure adequate management of conflict of interest, the Global Fund requires all CCMs to: (i) Develop and publish a policy to manage conflict of interest that applies to all CCM members, across all CCM functions. The policy must state that CCM members will periodically declare conflicts of interest affecting themselves or other CCM members. The policy must state and CCMs must document that members will not take part in decisions where there is an obvious conflict of interest, including decisions related to oversight, and selection or financing PRs or SRs. (ii) Apply their conflict of interest policy throughout the life of Global Fund grants, and present documented evidence of its application to the Global Fund on request.
Related minimum standard:
CCM Performance Assessment Tool
The Global Fund Secretariat says that the self-assessment of the CCM using the new CCM Performance Assessment Tool will produce a complete diagnostic that takes into account information from in-country partners. The tool is available (in English) on the Fund’s website here. The Global Fund says that other-language versions of the tool will be posted soon.
The Secretariat requires that CCMs request technical assistance (TA) when they conduct the self-assessments. A partial list of TA providers is available on the Global Fund website here. Additional providers will be added to the list in future. CCMs wishing to use a TA provider not on the list must consult their fund portfolio manager. The plan is that all TA providers working on the self-assessments will have received training on how to conduct them. The Secretariat told GFO that the goal is to ensure a consistent approach to the self-assessments across all CCMs.
According to the Global Fund, the TA provider will work with the CCM to analyse the internal functioning and dynamics of the CCM and conduct interviews with key in-country stakeholders. In the process, the TA provider will produce an improvement plan for each CCM, which will be submitted to the Global Fund Secretariat. The Secretariat will review each self-assessment.
CCMs that are fully compliant will be granted “CCM Eligibility Clearance” for one year from the assessment. This clearance allows the CCM to submit a concept note without having to go through a CCM eligibility screening process for Requirements 3–6. (However, Requirements 1 and 2 will be assessed at the time of concept note submission.
Note: In 2014, CCMs need to be compliant with the six minimum requirements (as is the case now). Starting on 1 January 2015, CCMs will also need to be compliant with the new minimum standards.
The Global Fund says that for CCMs that are non-compliant, TA providers will support the CCM to elaborate a milestone-driven improvement plan. The Global Fund Secretariat must approve the plan. According to the Fund, “non-adherence to the improvement plan will impact current and future funding.”
The CCM Performance Assessment Tool was used by the CCMs participating as early applicants in the transition phase of the new funding model.
Information for this article was taken from the CCM pages of the Global Fund website and from direct communication with the CCM Hub at the Secretariat. GFO plans to write a more detailed article on the CCM Performance Assessment Tool in the near future.
By David Garmaise
5 October 2013