Annual Report: Challenge TB – Global Fund Hub Year 2

In March 2016, the GF Hub was officially established with the recruitment of a GF Officer, Sara Massaut, who is based within the Challenge TB Project Management Unit (PMU). The primary role of the GF Hub and GF Officer is to ensure that CTB contributes to the success of GF grants in CTB countries, from grant making through implementation. Through a general mapping exercise, CTB now has an overall picture of grant performance in the 21 countries where it operates. At the end of Year 2, there were 35 signed grants in the 21 CTB countries, with a majority ending in December 2017. The full TB allocation of USD 2.5 billion GF has been signed into grants, of which USD 1.2 billion is in CTB countries. As Figure 1 shows, within CTB countries, only 32% of the GF TB grant signed amounts are disbursed to the country level. With December 2017 in view, absorption is a major concern. Of the three disease portfolios, TB is facing the most challenges, and in the next 15 months, it is estimated that approximately USD 750-900 million will need to be spent to close the current gap. The GF Hub is focused on getting CTB countries ready for the new funding cycle that will start in 2017. A key operational component within the new strategy is "differentiation," which will be applied to the management of GF grants and application processes. The premise behind differentiation is based on lessons learned from the current funding cycle. There was an outspoken need to simplify processes while understanding that one size does not fit all. The approach to manage grants and the application process will be based on the country portfolio categorizations. The GF Hub is taking an active approach to keep CTB countries informed of these changes and what they mean in terms of developing new concept notes and managing grants in the new funding cycle. Although countries will need to wait for the Allocation letters from GF to know which application modality will be recommended, during Year 2, the GF Hub already started taking steps to jump-start planning and better understand the potential STTA needs at country level for concept development. All CTB countries are mapped, and country teams have initiated discussions with their NTP counterparts to start planning for concept note development. The GF Hub activities include global monitoring of GF performance, CTB country status, and coordination of STTA planning in CTB countries for the concept note development process of the new GF funding cycle. A general mapping exercise was started in March 2016, providing CTB with a general picture of grant performance. The main variables used in the mapping exercise include the GF grant timelines, signed funding amounts, committed funding amounts, disbursed funding amounts, and grant ratings. These variables are also used by GF to monitor grant performance in general. At the end of Year 2, the average performance ratings of GF grants in CTB countries range from B1 to A1, which is good, but most current grants have not yet been rated. Within CTB countries, disbursement of funds runs from 48% of the signed amount down to 3%. In only 6 grants is the level of disbursement at 50% and higher, with only one, Burma, at 93%. Many grants have experienced start-up challenges due to long grant negotiations, delayed disbursement of funds, setting up new teams to manage grants at PRs, and delayed approvals of first annual work plans. Coordination between CTB and GF at the country level is good but has some room for improvement. The GF Hub is working closely with several stakeholders, including USAID Washington, CTB country teams, the USAID GF Advisors in-country, National TB Control Programs (NTPs), Principal Recipients (PRs), Fund Portfolio Managers (FPMs), and other local stakeholders, to identify bottlenecks and "local" solutions to improve GF grant implementation with CTB support. The GF Hub is also monitoring and facilitating STTA planning in CTB countries for the concept note development process of the new GF funding cycle.