operational research in the context of hiv/aids, tb and malaria control efforts from the perspective...
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Operational Research in the context of HIV/AIDS, TB and Malaria control efforts from the perspective and experience of the Global Fund
Serge Xueref John Puvimanasinghe
Jean-Paul MoattiEdward Addai
Monitoring, Evaluation & Learning Unit The Global Fund, Geneva
I. The Global Fund: mandate & portfolio review
II. Operational Research in GF grants: status & the way ahead
III. Conclusion: ‘m e’ OR
The Global Fund (GF) has a mandate to raise and disburse substantial new funds in a transparent manner to achieve sustained impact on HIV/AIDS, TB, and malaria
Raise it
Spend it
Prove it
Financing instrument -Country Ownership
-Performance-based funding
Introduction
• $6.6 billion disbursed, 562 grants in 136 countries
• 58% of total funds approved (by TRP) are for grants in sub-Saharan Africa
• 61% for AIDS; • 14% for TB; • 25% for Malaria
GF Portfolio overview:As of 31st October, 2008
• 35% of approved financing is for key health systems components
• Innovative cross-cutting HSS funding:– $186 million approved in Round 7– $ 290 million recommended by TRP in Round 8 (health workforce, information
systems, supply chain management, community service delivery)
• Global Fund supports workforce capacity: 96% of grants have a training component
GF Portfolio overview (2):Health systems strengthening
GF-supported programs: Acceleration of scale up
Accelerating Results
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Dec-04 Jun-05 Dec-05 Jun-06 Dec-06 Jun-07 Dec-07 Jun-08
AR
Vs a
nd
DO
TS (m
illions)
-
5
10
15
20
25
30
35
40
45
50
55
60
ITN
s (millions)
DOTS
ARVs
ITNs
OR in GF grants
• Scaling up programs to fight AIDS, TB & malaria offers a unique opportunity to experiment alternative ways of delivering key health care services and prevention interventions
I. The Global Fund: mandate & portfolio review
II. Operational Research in GF grants: status & the way ahead
III. Conclusion: ‘mORe’
OR in GF Grants
The Global Fund encourages the inclusion of OR in the control programs it supports.
Programs are encouraged to spend 5-10% of their grant budget on monitoring and evaluation (M&E), which could include spending on relevant OR.
OR in the GF Grants
Definition* of OR:Any research that produces practically-usable knowledge (evidence, findings, information, etc) which can improve program implementation (effectiveness, efficiency, quality, access, scale-up, sustainability) regardless of the type of research (design, methodology, approach) falls within the boundaries of OR.
* from the Framework for OR/IR in health and disease control programs (TDR/WHO/USAID/UNAIDS/WB/TGF)
Overview of OR in Global Fund Grants
Global Fund ‘Round’
Number of
Approved
Proposals (At date of Analysis)
Number and
Percentage
of Grants with
OR Component
Average budget for OR (per proposal) /
Percentage of Total Proposed
Budget
Round 1 - 5 363 70 (19%) 400,000 USD
2.6%
Round 6 85 44 (52%) 434,000 USD
4.4%
Round 7 64 37 (58%) 360,000 USD
2.5%
Words from the GF Exec. Director
‘With a few exceptions, operational research that really guides and informs implementation is still under-represented at this conference. Too often, investments worth many millions of dollars are being made in the absence of good data, and too often we fail to learn from and share all our experience in scaling up AIDS programs.
The AIDS field has always been innovative, unafraid to criticize and challenge. It now needs to be much more creative in fostering collaboration between science and implementation, so that research becomes an integral part of all programs.
Similarly, we must also do more to link science and policy.’
Prof. Michel Kazatchkine, Mexico AIDS Conference, August 2008
GF goal and objectives
• Goal: scale-up of OR in GF grants
• Driving Principles:– Respect Country Ownership– Foster Partnerships– Reach Consensus, being not ‘GF specific’– Transparently share data
• Objectives:– To develop and implement a joint OR Framework– To facilitate the building of local capacity in OR– To develop a GF OR information system
I. The Global Fund: mandate & portfolio review
II. Operational research in GF grants: status & the way ahead
III. Conclusion: ‘mORe’
‘mORe’
- OR embedded into Programs to improve quality and/or quantity of services
- Part of the M&E funds (5-10% of total grant)
Monitoring
Learning
Evaluating
Conclusion
Role of Countries/Partners
• Countries to include OR in GF grants– GF supports/encourages OR– Develop and submit OR proposals within GF
applications and/or reallocate within existing grants (collaboration with the FPM)
• Partners to support countries in OR– Partners to support OR (protocol writing, capacity
building…)
• GF to facilitate scaling-up of high quality OR
OR@theglobalfund.org
MerciMerciThank youThank you
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