At the beginning of each funding cycle (every three years) the Global Fund allocates the money raised from donor contributions to eligible countries so they can achieve greater impact in their fight against HIV, TB and malaria. Using the total amount of funding pledged by donors, the Global Fund determines the amount of resources expected to be available over the three-year period. They then divide these resources between the three diseases HIV, TB and malaria, and allocate maximum amounts for each disease available to each eligible country.
Countries can apply for the funding allocated to their country at any time during the three-year cycle. This allows them to align the funding request with their own national processes as well as with their national strategic plan for the diseases.
Eligibility for Global Fund support takes into account the health and economic landscape of countries and regions in order to optimise the investment of financial resources. The Global Fund’s Eligibility Policy is designed to ensure that the available resources are allocated to those countries who have the highest disease burden and lowest economic capacity, as well as to key and vulnerable populations disproportionately affected by the three diseases. Eligibility is determined by a country’s income classification, as measured by gross national income per capita, and official disease burden classification.
The formula for determining the exacting level of funding for each country’s disease programme is based on their economic capacity and disease burden. However, it takes into account extra factors such as financing from other organisations working in the same areas. In addition, the Global Fund may amend allocations during a ‘qualitative adjustment’ process. This process looks at specific country situations, such as the needs of key populations disproportionately affected by the diseases.
Countries can make adjustments to how their overall allocation is divided among the three diseases if needed, with the approval of the Global Fund. For example, a portion of the allocation for one disease can be used for another disease. Countries may also decide to use some of the funding to invest in strengthening health systems rather than a specific disease.
As of 2016 in order to “maximize impact against HIV, TB and malaria by tailoring investments and processes to specific characteristics of a country portfolio”, the Global Fund has adopted a differentiated approach across its portfolio.
The differentiated approach aims to establish three approaches tailored to each country situation. This aims to respond more effectively to the diverse range of contexts in which Global Fund grants are implemented. The Global Fund will differentiate the processes countries use to apply for the funding, how they request and how they report on the money.
All Global Fund countries that are eligible to receive funding have been divided in three ‘Portfolio Categories’, based on certain criteria:
Differentiation is carried out based on multiple factors including disease burden and income level of a country, epidemiologic and other socio-political contextual dimensions; financing gaps; fiscal space; absorptive capacity; risk; and where and how the Global Fund can have the most impact.
The three new portfolio categories are:
Focused countries: which have smaller portfolios, a lower disease burden, and which are less critical to achieving the Global Fund’s overall goals. This includes all countries with a current total country allocation under US$ 75 million, plus most regional grants.
Core countries: have larger portfolios, a higher disease burden and higher risk. This includes all countries with a current allocation between $75 million and $400 million.
High-Impact countries: have very large portfolios and a high disease burden. It includes countries with a current allocation of $400 million or more.
The current list of countries and their category is available in the Global Fund Operational Policy Manual and may be updated periodically.
Differentiated processes for applying for funds and for managing the funds are applied to each country category.
The requirements and process that focused and core countries will go through to request and access funding will be comparatively lighter than in the past (in terms of the funding request and the review process for instance), and also lighter than the process that high impact countries will need to follow. The Global Fund is still finalising the details of the access to funding processes and policy.
Reporting requirements will be different for each portfolio category.
All countries will receive an Annual Funding Decision covering 12 months plus up to six months buffer period and disbursements will normally be released on a quarterly basis. For focused countries, disbursements will be made as planned in the disbursement schedule, whereas for core and high-impact countries, active approval of disbursements from the Global Fund Secretariat will still be required.
The composition of Country Teams will vary depending on the portfolio category with the Global Fund Secretariat concentrating on countries in focused countries. For focused countries the Country Team will be comprised of the Fund Portfolio Manager, Senior Fund Portfolio Assistant, the Public Health and M&E Specialist, the Health Product Management Specialist and the Legal Officer. For Core and High Impact Countries, the Country Team includes the Fund Portfolio Manager, Programme Officer, Public Health and M&E Specialist, HPM Specialist, Finance Specialist and Legal Officer.