THE GLOBAL FUND AS A PRODUCER OF GOVERNANCE INSTRUMENTS: FROM FORMATTING THE DEMAND TO A MECHANISM FOR RESPONDING TO THE OFFER

More than a simple funding mechanism, the Fund is also a producer of norms, especially the instruments (Lascoumes and Le Gales, 2004) that shape AIDS governance at the global and national levels. The two main instruments promoted by the Fund are the CCM and performance-based funding (PBF). The concept of PBF comes from the New Public Management. Its goals are to improve the results of development projects and to demonstrate the validity of the strategies implemented through international cooperation. The two key elements of PBF are rationale development and “accountability”.

Designed and presented as the most "neutral” and "effective" way of allocating funds, the Global Fund imposes a particular, external type of governance on countries through the CCMs. Like the Global Fund’s Board of Directors, CCMs are inclusive, multi-sectoral partnerships, which include government and international representatives as well as representatives of people living with the diseases, NGOs, and religious, scientific, and private sector actors.

The CCM is responsible for putting together funding applications for the Global Fund, but also for identifying the Global Fund beneficiaries and monitoring grant implementation. More than “jurisdictions”, CCMs are real institutions that are intended to be at the centre of national AIDS governance. These institutions are also shaped by the Fund, which issues guidelines, recommendations, and incentive schemes (CCM self-assessment grids, etc.), all of which help determine the eligibility of applications.

Ownership of this governance modality seems to be uneven across countries, and dysfunctions in the CCMs create obstacles to the effective functioning of the Fund. The CCMs' composition is extremely variable (see Figure 2.1), and

Composition of CCMs in six African countries in 2012. Source

Figure 2.1 Composition of CCMs in six African countries in 2012. Source: Demange (ANRS projects 12251 and 12266)

AIDS and governance in Africa 57 its members are not always the same people who actually produce the country’s national AIDS response. In what follows, we aim to understand how this governance instrument is invested or not by national AIDS actors, and to what extent it really promotes collaboration in the production of public action.

Performance-based funding (PBF) is implemented through a multi-phase financing process: development of appropriate national-level applications; grant negotiation; major target seeking and determination of quantifiable performance indicators; gradual disbursement of funds in instalments based on regularly reported results. The five-year funding cycle is divided into a two-year phase and a three-year phase. The second phase is dependent on the global evaluation of the first phase of grant implementation. Each grant receives a performance score. This has practical effects, including the suspension of funding, and contributes to taking stock of the “good”, “average”, and “poor” implementers of the Fund (see Figures 2.2 to 2.5).

The number of applications the Fund accepted and rejected in the Rounds presented in Figures 2.4 and 2.5 contributed to the interpretation of dissonance between the international level and the national level as a problem of "failure" or problem of capacity.

The failure or success of an application or of a grant’s implementation seems to have been due less to a problem of capacity than to the difficulty countries experienced in complying with the issues and the programmes the Fund was likely to finance. Rather than expressing their needs, the grant-writers sought to identify with those issues and programmes (Brugha et al., 2005). The heavy demand for international consultants specialised in grant-writing confirms this argument.

Rather than merely shaping the demand, the Fund seems have envisioned a partial return to a mechanism of responding to the offer, or supply. The Fund’s reform, which the Technical Evaluation Reference Group (TERG) had called for,

Countries’ Global Fund performance before New Funding Model. Source

Figure 2.2 Countries’ Global Fund performance before New Funding Model. Source: Demange (ANRS projects 12251 and 12266)

Total sums allocated by the Global Fund. Source

Figure 2.3 Total sums allocated by the Global Fund. Source: Demange (ANRS projects 12251 and 12266)

Number of applications approved before New Funding Model. Source

Figure 2.4 Number of applications approved before New Funding Model. Source: Demange (ANRS projects 12251 and 12266)

and the nomination of a new executive director, Gabriel Jaramillo (former director of the commercial Sovereign Bank), could lead the Fund to define not only the issues (such as vulnerable populations), but also the priority countries, thus moving the Fund closer to classic development aid mechanisms, like PEPFAR and the Gates Foundation, which are guided by the funding supply.

Number of applications rejected

Figure 2.5 Number of applications rejected.

Source: Demange (ANRS projects 12251 and 12266)

 
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