The Global Fund has achieved its key performance indicators (CPIs) in general, according to the mid-2020 strategic performance report submitted to the Council on 11 and 12 November 2020. The organization is on track to meet the resource mobilization, program design, and implementation targets, but it is unlikely to meet its goals for some program results. However, these results did not affect the impact of COVID-19 on KPIs. The Global Fund Secretariat will report to Council in May 2021. Some constituencies have expressed concern about the delay (almost one year) of the secretariat in reporting on the impact of COVID-19 on KPIs, as it does not promote the real-time decision. make.
The Global Fund is in the process of mobilizing resources
The Global Fund uses different KPIs to determine the progress of financing:
KPI 10 determines progress in mobilizing resources. The Global Fund complied with this KPI. As of March 2020, the organization has exceeded its targets for the sixth supplement by achieving 101 percent of the supplement target. The organization also achieved its target on the pledge conversion by matching the actual supplementary contributions to the predicted estimates. The secretariat will report in May 2021 on local investments in programs for HIV, tuberculosis (TB) and malaria (CPI 11) and the availability of affordable health technologies (CPI 12).
The organization is still planning the KPI 9c report, which measures local investment in key populations and human rights, and will present its target at the May 2021 Council meeting.
The Global Fund’s investments are in line with the country’s needs
The organization uses different KPIs to determine the progress with strategic focus and activities:
KPI 3 determines the adjustment of the Global Fund’s investments in countries’ needs in terms of disease burden and economic capabilities. The Global Fund complied with this KPI. The mid-2020 alignment was 0.318 versus a target of 0.320 (the lower the score, the better the alignment). This KPI indicates that the organization allocates its funding to countries with greater needs rather than those with the best survey.
KPI 4 determines the investment efficiency, measured by measuring how the organization performs in terms of reducing the cost per lifetime or preventing infections. The Global Fund is close to complying with this KPI. The organization has reduced the cost per saving life or infections in 88 percent of the countries it supports compared to the 90 percent target.
KPI 6f determines the adjustment of funding requests to the National Strategic Plan. The Global Fund has exceeded its 90 percent target for this CPI. The Technical Assessment Panel (TRP) assessed 35 funding requests submitted in Window 1 of the 2020-2022 allocation period and found them to be in line with their national strategic plan.
KPI 9b measures the progress made by the Global Fund in allocating funding for key populations and human rights activities. The Secretariat has proposed reviewing CPI 9b indicators and will report to Council in May 2021.
Absorbent capacity and allocation utilization are underway
The Global Fund uses KPI 7 to determine the progress of the use of funds. KPI 7 is divided into KPI 7a and KPI 7b:
KPI 7a measures the use of allocated funds. The organization is performing well in terms of this KPI, as 97 per cent of the disbursed funds for the fifth supplement were used as allocation costs at a target of 91-100 per cent. However, its use ranges from 75 percent for health system strengthening grants to 100 percent for HIV / TB grants.
KPI 7b measures the recording capacity of grants. The organization exceeded the targets for this CPI: it was aimed that by 2022, national programs would spend 75 percent of the grant budgets on service delivery and achieve 88 percent for 2017-2019. Absorption varies according to disease program, from 82 percent for TB to 90 percent for HIV / TB. It also varied by region, from 77 percent in Asia to 96 percent in Southeast Africa.
Underperformance in service delivery and service coverage for key populations
The Global Fund’s performance in service delivery is jeopardized because it underperforms on several indicators that are detecting its impact on HIV, TB and malaria:
KPI 1 measures the performance of the Global Fund against the impact targets. The secretariat will report on this KPI in May 2021.
KPI 2 measures the Global Fund’s performance on service delivery targets. The organization performs under several indicators for this KPI:
For HIV, the results of mid-2020 indicate that there are only 19 countries where 80 percent of people with HIV know their status against a target of 33 countries. Coverage of antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT) is at 67 percent and 86 percent, respectively, compared to targets of 78 percent and 96 percent by 2022. The Global Fund is also not on track does not reach its target of 35 countries where 80 percent of people with HIV will start preventive therapy for TB by 2022, as mid-2020 results have reached only eight countries to this target. In terms of TB, the Global Fund’s goal is for 99 countries to successfully treat 90 percent of TB cases by 2022. However, only 65 countries have achieved this drug by mid-2020. For multi-drug-resistant TB, the Global Fund’s goal is for 33 countries to successfully treat 85 percent of these cases by 2022. Only six countries have achieved this goal. The Global Fund is therefore in danger of not achieving these two targets.
For malaria, the organization’s goal is for 36 countries to administer at least three doses of malaria medication to 20% of pregnant women during antenatal care visits by 2022; only 18 countries have reached this target. It is therefore outside the target.
CPI 5 measures the number of countries reporting on key population coverage services. The Global Fund is on track to meet this KPI. The mid-2020 results indicate that only 64% of countries have reached the target, compared to a target of 75% of countries reporting by 2020 on the coverage of services provided to at least two key populations.
The Secretariat will report on the following KPIs in May 2021: KPI 6a on procurement prices, KPI 6b on the supply chain, KPI 6c on financial management, transition efforts and financial systems, and KPI 6d on health management information system (HMIS) coverage for its resilient efforts and set up sustainable health systems (RSSH).
The Global Fund uses several KPIs to identify its efforts to promote and protect human rights and gender equality:
CPI 6th measures the number of countries reporting divergent results. The organization has exceeded its target that 50 percent of countries would report split results by 2019. By mid-2020, 65 percent of countries reported age and gender breakdowns across all relevant indicators.
KPI 8 measures the Global Fund’s performance to reduce new cases of HIV for adolescent girls and young women (AGYW) aged 15-24. The organization is unlikely to comply with this KPI. The organization aims to reduce new cases of HIV among AGYW in 13 priority countries by 58 percent between 2015 and 2022. By 2019, new cases of HIV had dropped by 31 percent under the AGYW.
KPI 9c measures local funding for human rights and key populations in transition countries. The secretariat will report on the CPI to the Council in November 2021.
The constituencies of the Council congratulated the Secretariat for performing well in most KPIs, including those related to absorption, detection of missing TB and antiretroviral therapy. However, they expressed concern about the underperforming KPIs, particularly those for service delivery, gender and age equality, and the provision of services to key populations.
The Global Fund is performing well in some KPIs, but there are others that are unlikely to achieve it. The organization has mitigation plans to underperform KPIs. The Global Fund will continue to scale up new grants in countries with large ART coverage targets. The organization will work with partners to better align PMTCT with testing services. To improve the targets for multi-drug-resistant TB, the Global Fund will invest in oral and shorter treatment regimens. To increase the number of countries where women receive at least three doses of malaria drugs during antenatal care visits, the organization supports ongoing research on how to move from facility- to community-based childbirth. The Global Fund is introducing various measures to further reduce the number of new cases of HIV under AGYW. These include the establishment of new strategic initiatives for this group and the use of innovative HIV prevention technologies.
Council document GF-B44-15A, Strategic Performance Report mid-2020, will be available soon at https://www.theglobalfund.org/en/board/meetings/44