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AFRO-NETS> NGO participation in the Global Fund

  • Subject: AFRO-NETS> NGO participation in the Global Fund
  • From: Claudio Schuftan <aviva@netnam.vn>
  • Date: Mon, 7 Oct 2002 05:59:10 -0400 (EDT)

NGO participation in the Global Fund

Enclosed is a copy of a Review Paper on NGO Participation in the
Global Fund. This paper summarises a review undertaken by the Inter-
national HIV/AIDS Alliance (the Alliance) in August and September
2002, assessing the participation of HIV non-governmental organisa-
tions (NGOs) in 6 country-level processes of the Global Fund for
AIDS, TB and Malaria. These processes include the Country Coordinated
Mechanism (CCM), the Country Coordinated Proposal (CCP) and all other
Global Fund related activities and consultations.

The review was undertaken on the basis of anonymity, so all quotes
and experiences are not attributed to specific individuals or coun-
tries. Recommendations are made based on these NGO experiences and
from broader Alliance experience in providing technical and financial
support to NGOs and community-based organisations in over 40 develop-
ing countries.


In the majority of the countries reviewed, participation in the
Global Fund processes has resulted in a relative improvement in the
relationship between NGOs and government, providing new opportunities
to work together more effectively. In particular, shifts in govern-
ments' priorities have been observed. For example, in one country
this shift is reflected in a movement away from just looking at
building infrastructure and procuring drugs, to recognising the im-
portance of supporting broader needs of people living with HIV/AIDS,
which was facilitated by their inclusion in the development of the

Experiences varied greatly between countries. In some, NGOs were in-
volved at all stages of the CCP development, as members of the CCM,
in drafting elements of the proposals and taking part in technical
working groups and broad NGO consultations. Many CCMs have drawn on
the expertise of implementing organisations to identify priorities
and review proposals.

This direct NGO involvement in the drafting of parts of the CCP in
many countries has provided them with a real opportunity to influence
the proposal. However, while the Secretariat guidelines on the CCM
process states that all members of the CCM are to be 'treated as full
partners', in most countries reviewed this was far from the case. In
particular, NGO involvement post-approval of the funds has been ex-
tremely limited.

Faced with a new funding instrument and the speed at which it was
created, many countries had just weeks to put together a proposal and
the guidelines and information for proposal development were limited.
This has led to both concerns over the quality and the innovative na-
ture of the final CCPs. It has also raised a number of issues that
need to be addressed in relation to NGO involvement. These range from
lack of access to information, limited involvement in decision-
making, weak NGO networks and the need to ensure effective funding
disbursement to civil society.

1. Access to information is limiting effective NGO participation

1.1 Set up simple strategies for wider dissemination of information
to all stakeholders from the Secretariat and national (CCM) levels.

1.2 Improve transparency of proposal process, particularly the full
disclosure of successful proposals.

The review and decision-making process at the CCM, Technical Review
Panel and Secretariat levels need to include access to information
for all stakeholders. Many NGOs involved in the CCM and proposal de-
velopment processes are not receiving essential information from the
Global Fund Secretariat such as guidelines, critical decisions
adopted, and the proposal review feedback. Most information is being
sent to CCM Chairs and it is not being passed on to other stake-
holders beyond the 'high-level' members, putting the others at a
clear disadvantage. This is a simple issue of ensuring wider dissemi-
nation of information (e.g. electronically) via the Global Fund Se-
cretariat (even if for confidentiality reasons this is restricted to
members of the CCM).

This is related to the broader issue of a lack of effective communi-
cation mechanisms to NGOs and other stakeholders. Many NGOs are not
even aware that they can participate in both the proposal development
and implementation. In many countries NGOs have been demanding
greater transparency of the consultation process, CCM selection,
their mandates and accountabilities, and the selection process of lo-
cal project proposals, but without much success.

This is compounded by the current decision to provide only the Execu-
tive Summary of successful proposals. The principle of additionality
may be undermined by the inability of national organisations not in-
volved in the CCM to undertake a full evaluation of the proposal.
This could result in duplication of efforts and act as a barrier to
broader civil society participation in the implementation of the pro-
posals. This is particularly important where civil society is being
asked to play the monitoring role. There is no clear rationale for
why full disclosure of these successful proposals is not being made

2. 'Participation' of NGOs needs to mean more than 'consultation'

2.1 Establish clear legal and process frameworks from the beginning
to ensure an equal balance of power in the decision-making process.

2.2 Clear and transparent assessment criteria for NGO involvement
need to be developed by the Secretariat and linked to conditions of
review and funding.

What has been clear from the first two rounds of proposal development
is that involvement has meant little more than consultation in most
cases. While at a superficial level the NGO involvement box can be
ticked for the CCP review, there has been limited NGO involvement in
the decision-making process. On the whole, national government repre-
sentatives have taken most of the important decisions. Commitments to
working with NGOs seem to have been motivated primarily by the desire
to ensure that the proposal receives the funding rather than a genu-
ine willingness for their participation.

Involving civil society actors is not an easy task for many govern-
ments and any process of this kind will inevitably exclude one group
or another in the decision-making process. The challenge is to push
for an honest and real willingness by governments to respond to the
voices of the most affected and marginalised and those of NGOs. What
needs to be supported is the underlying principle of the CCM as a
'national consensus group' - where NGOs are not just used for consul-
tation and as funding recipients but are decision-makers as well. Ex-
perience in the first rounds suggests governments need additional in-
centives for this to happen and for the Global Fund processes to de-
liver on the core objectives of supporting 'innovative' and 'true

While fully supporting the principle of a country-led process, the
Secretariat must take responsibility for ensuring meaningful involve-
ment of NGOs. This could involve a requirement that CCMs create bind-
ing governance structures and legal frameworks that ensure all mem-
bers have equal status in the decision- making process.

Related to the need for these guarantees is the lack of clarity over
the process of assessing NGO involvement, how it is measured, who
will make the assessment and what weight is put on this element in
the proposal review and funding criteria. An 'independent' institu-
tion needs to be identified and given the responsibility for monitor-
ing and evaluating the participation process, with clear and trans-
parent assessment criteria. This assessment needs to be backed by a
level of conditionality associated with the Technical Review Panel
proposal decisions and subsequent funding disbursements. It is uncer-
tain whether private sector auditing firms, proposed by the Global
Fund to perform the Local Fund Agency role, will have the necessary
skills and experience to perform this effectively.

3. Need for improvements in NGO networks and accountability

3.1 Technical and financial support is needed to facilitate and build
up NGO networks to strengthen broader civil society involvement in
the Global Fund.

3.2 The selection process for NGO representation on CCMs and other
country and proposal mechanisms needs to be NGO-led.

In the countries reviewed, most NGOs were 'selected' or invited onto
the CCM by the government, largely as a result of their existing re-
lationship and the identified expertise of the NGO representative. In
countries where there was broader NGO involvement in the proposal de-
velopment and consultations, participation was largely a self-
selecting process. As a result of these approaches to 'selection'
there is an over-representation of NGOs based in the capital cities
and under-representation of non-traditional NGOs, many of whom are
working with the more marginalised and vulnerable groups.

As a result there have been concerns raised in some countries that
NGO members of CCMs are not providing a broad enough representation
of NGO perspectives. Experiences in the first rounds of the Global
Fund have shown that competing NGO interests and a lack of a cohesive
'voice' from civil society limited effective input into the propos-
als. National NGOs directly involved in the Global Fund processes
need to ensure that their legitimacy is maintained by strengthening
their links with the wider civil society, in particular the most vul-
nerable and marginalised.

The status of NGO networks is clearly variable from country to coun-
try. However, in many the capacity to coordinate and strengthen net-
works is limited by both the competition amongst NGOs and the lack of
resources and skills. Therefore both technical and financial support
needs to be given to NGOs to build networking capacity and where nec-
essary use independent facilitators, such as UNAIDS, to provide a
neutral ground to begin consultation and collaboration.

Moreover, to ensure proper representation and accountability, indi-
vidual NGO membership of the CCM should be selected by civil society
organisations themselves. For this to happen at a country level,
linked to recommendation 2.2, the Global Fund needs to either make
this a condition of funding or clearly state that it will be part of
the proposal assessment criteria.

4. NGOs as Principal Recipients to facilitate disbursement

4.1 Full public support by the Secretariat to be given to national
intermediary organisations to disburse funds to civil society.

4.2 NGO-based fund disbursement needs to be backed by on-going tech-
nical support to these organisations.

In a number of countries National AIDS Committees have acknowledged
that they lack the capacity to handle the funds, particularly in dis-
bursements to NGOs and civil society. Experiences of governments pro-
viding grants to NGOs for HIV/AIDS work have revealed clear technical
and managerial capacity issues. These include the ability to assess
proposals and NGO capabilities, to manage large numbers of small dis-
bursements, and to monitor and evaluate their implementation.

For the Global Fund to realise its aim of delivering rapid disburse-
ment of funds to all players it needs to continue to publicly support
the option of the Principal Recipients being non-governmental agen-
cies. In particular to support the channelling of funds committed to
civil society through intermediary NGOs with a proven capacity. In
selecting NGOs to either play a Principal Recipient or a sub-
disbursement role, consideration needs to be made of existing and
long-term organisational capacity. The Alliance's experience over the
last 9 years has shown that there are very few NGOs that can immedi-
ately and confidently play this type of role.

Implementing NGOs often lack the financial and organisational rigour
required for a funding disbursement agency, but have the essential
knowledge, technical skills and attitude that purely techni-
cal/financial support organisations can lack. The criteria for se-
lecting NGOs will have to acknowledge both aspects and ensure the
provision of ongoing organisational support. Baseline assessments of
NGO capacity and the development of strategies to measure and build
capacity over time are required for NGOs to play a sustainable and
effective funding support role (see toolkit at:
http://www.aidsalliance/ngosupport )

Kieran Daly
Policy Officer
The International HIV/AIDS Alliance
Queensbury House
104-109 Queens Road
Brighton, BN1 3XF, United Kingdom
Direct line: +44-1273-71-8977
Main line: +44-1273-71-8900
Fax: +44-1273-71-8901
Supporting Community Action on AIDS in Developing Countries

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