PHA-Exchange> NGO participation in the Global Fund

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Enclosed is a copy of a Review Paper on NGO Participation in the Global
Fund.  This paper summarises a review undertaken by the International
HIV/AIDS Alliance (the Alliance) in August and September 2002, assessing the
participation of HIV non-governmental organisations (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 countries.
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 developing countries.

Recommendations Summary:
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.

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.

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.

4.
NGOs as Principal Recipients to facilitate disbursement

4.1
Full public support by the Secretariat to be given to national NGO
intermediary organisations to disburse funds to civil society.
4.2     NGO-based disbursement of funds needs to be backed by on-going
technical support to these organisations
Summary

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 governments' 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 importance of supporting broader needs of people living with
HIV/AIDS, which was facilitated by their inclusion in the development of the
proposal.

Experiences varied greatly between countries.  In some, NGOs were involved
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 extremely 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 nature 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

      Recommendations:
      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 development
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 stakeholders beyond the 'high-level' members,
putting the others at a clear disadvantage.  This is a simple issue of
ensuring wider dissemination of information (e.g. electronically) via the
Global Fund Secretariat (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
communication 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 local project proposals, but
without much success.

      This is compounded by the current decision to provide only the
Executive Summary of successful proposals.  The principle of additionality
may be undermined by the inability of national organisations not involved 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 proposals.  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 compulsory.

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

      Recommendations:
      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 representatives
have taken most of the important decisions.  Commitments to working with
NGOs seems to have been motivated primarily by the desire to ensure that the
proposal receives the funding rather than a genuine willingness for their
participation.

      Involving civil society actors is not an easy task for many
governments 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 consultation and as funding recipients but
are decision-makers as well. Experience in the first rounds suggests
governments need additional incentives for this to happen and for the Global
Fund processes to deliver on the core objectives of supporting 'innovative'
and 'true partnerships'.

      While fully supporting the principle of a country-led process, the
Secretariat must take responsibility for ensuring meaningful involvement of
NGOs.  This could involve a requirement that CCMs create binding governance
structures and legal frameworks that ensure all members 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' institution needs to be identified
and given the responsibility for monitoring and evaluating the participation
process, with clear and transparent 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 uncertain 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

      Recommendations:
      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
relationship and the identified expertise of the NGO representative. In
countries where there was broader NGO involvement in the proposal
development 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 proposals.  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 vulnerable and marginalised.

      The status of NGO networks is clearly variable from country to
country.   However, in many the capacity to coordinate and strengthen
networks 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 necessary use
independent facilitators, such as UNAIDS, to provide a neutral ground to
begin consultation and collaboration.

      Moreover, to ensure proper representation and accountability,
individual 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

Recommendations:
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 technical
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 disbursements to
NGOs and civil society.  Experiences of governments providing 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 disbursements, and to monitor and evaluate
their implementation.

For the Global Fund to realise its aim of delivering rapid disbursement of
funds to all players it needs to continue to publicly support the option of
the Principal Recipients being non-governmental agencies.  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 immediately 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 technical/financial
support organisations can lack.  The criteria for selecting 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 www.aidsalliance/ngosupport)
<http://www.aidsalliance/ngosupport)> .

--------
Kieran Daly
Policy Officer
The International HIV/AIDS Alliance
Queensbury House
104-109 Queens Road
Brighton, BN1 3XF
United Kingdom

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