Performance based funding Global Fund to fight AIDS, Tuberculosis and Malaria

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Performance based fundingGlobal Fund to
fight AIDS, Tuberculosis and Malaria progress
and challengesKirsi Viisainen, MD, PhD
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The Global Fund is an international financing
institution mandated
What is the Global Fund?
- To raise and to disburse substantial new funds
Invest it
- To operate transparently and accountably
- To achieve sustained impact on HIV/AIDS,
tuberculosis and malaria
BG/290607/1
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Why we do PBF at the Global Fund

• Performance based funding is one of founding
  principles of the Global Fund (2003)
• In making its funding decisions, the Global Fund
  will focus on performance by linking resources
  to the achievement of clear, measurable and
  sustainable results.
• Paris Declaration on effective aid (2005) One of
  Five Principles (Managing for Results) 
• Managing for results means managing and
  implementing aid in a way that focuses on the
  desired results and uses information to improve
  decision-making
• One of three major priorities in Accra Action
  Agenda (2008)
• Achieving development results and openly
  accounting for them must be at the heart of all
  we do.

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What type of PBF do we do at the Global Fund

• Performance-based funding (PBF) ensures funding
  decisions are based on a transparent assessment
  of results against time-bound targets.

What it is
What it is not

• All funding decision based on tranparent rating
  of results against targets
• Investment in capacity building and in ME
  (5-10)
• Measurement of services delivered to people and
  impact
• Reallocation of funding
• Systematic application (gt 890 grants in 150
  countries)

• Not buying results directly, but aim to promote
  improved performance
• Not results based financing e.g. of health
  workers focuses on PBF between Global Fund and
  Principal Recipient in country
• No direct in-country results based management
  (limited country presence)

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How is performance based funding done at the
Global Fund
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PBF to support decisions on improved performance
at all levels and in diverse contexts
Performance Country Adjustments to improve programs
A Niger, Malaria Accelerate ITNs with local partners towards universal coverage
B1 Malawi, HIV HIV treatment human resources bottleneck, invested US 40 million
B2 Sudan, HIV Identified bottlenecks, now strongly performing
C Senegal, Nigeria Reformed CCM, rebuilt ME system, signed new grants
Making performance decisions

1. Accelerate
2. Systems Strengthening
3. Revisions and efficiencies where required

What made the difference is you gave us a clear
warning, that we were in the red zone .. We could
lose our money if we didnt deliver results. We
looked at it, we could focus and we both saw the
problem .. Performance based funding helped us
think through implementation Ethiopia PR
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Performance of portfolio
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Challenges from implementing RBF

• CGD review of PBF
• Applauds GF for implementing PBF in practice
• Invest more systematically in country data
• Improve focus on impact
• Consistency in decision making

• GF Five Year Evaluation
• PBF one of the stronger achievements of the
  Global Fund with management benefits and health
  system contributions
• A more systematic partner approach is needed to
  invest in strengthening weak country health
  information systems.
• Simplification and streamlining of performance
  based funding, particularly at country level
• A greater emphasis on impact and outcome

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Summary

• Global Fund experience of implementing
  performance based funding in practice has proven
  the usefulness of the model, but also shown areas
  for improvement
• Global Fund PBF model focuses on decisions to
  improve performance, ability to implement at all
  levels in diverse contexts
• Common challenges improve country data, service
  quality and impact, enhance performance based
  decision making in programs
• GF is learning from experience and improving the
  model with new grant architecture