Coordinating funding requests in times of crisis: the example of UNAIDS support in Cameroon
The UNAIDS assignment was led by a roadmap for the entire process up to the point of signing the grants. In order to ensure an effective distribution of tasks, with strong reporting processes to the coordination group, three sub-groups - HIV, tuberculosis, malaria - were set up, under the leadership of the permanent secretary of each respective program.
As part of their coordination role, UNAIDS oversaw the selection of experts to support the completion of the funding request. We consulted with all the Technical Assistance (TA) provision partners. The final list of consultants was submitted to the CCM for approval, to ensure that experts were mobilized in line with the specific mechanisms of each partner.
Restrictions linked to the COVID-19 health crisis have had an impact on the process of preparing the funding request. It wasn't possible for international and Global Fund experts in Cameroon to be there in person, or for the writing, review and validation workshops to happen. The expertise and leadership of UNAIDS were decisive in rapidly developing new strategies, adapting the roadmap and dealing with the COVID-19 pandemic. A virtual approach was put in place, with regular meetings of the Steering Committee, the coordination team and sub-working groups before international experts selected outside the country participated remotely. We set up a permanent consultation mechanism with the Global Fund Secretariat (Country Team) to take stock and provide any necessary guidance on requests. These coordination meetings were open to consultants (national and international), members of the request writing team, national and international partners, agencies providing technical assistance, civil society, CCM members, etc.
Despite the health crisis, all stakeholders have come together to ensure the success of this request. Civil society coordinated the country dialogue. Funding requests were sent to partners in civil society, bilateral and multilateral cooperation, public administration, and the private sector. Leaders from each sector were tasked with collecting and consolidating input from members and share it with the coordination team. This participatory approach made it possible for the views of all stakeholders to be taken into account in the process.
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In response to COVID-19, L'Initiative has been able to adapt quickly and provide support mechanisms to ensure that technical assistance assignments linked to the Global Fund funding cycle could continue. To support this, project officers were available to support blockages and respond to any bottlenecks that could hinder the funding request.
For example, to support particular phases of the application process, which were delayed by COVID-19, L'Initiative was able, in conjunction with UNAIDS, to work with experts to extend technical assistance assignments and ensure, under the best conditions possible, that crucial phases of the request were completed: reviewing strategic plans, developing the new strategic plan, preparing funding requests, etc.
COVID-19 had a very significant impact on following the CCM roadmap. The pandemic has stopped face-to-face meetings, which are often beneficial for interpersonal discussions between stakeholders within the health system and with international consultants. This highlighted the limitations of remote technical assistance and the need to further mobilize technical assistance from local experts.
However, the pandemic also demonstrated that it was possible to lead the coordination and drafting process for the funding request without necessarily investing in very expensive workshops. Virtual meetings have been a successful coordination approach that stakeholders should adopt to save resources in relation to organizing meetings, supervision visits, etc.
In Cameroon, the CCM is carrying out a reform process that it would be relevant to support. Strategic monitoring, which is one of the four main areas of responsibility of CCMs, includes essential issues related to finance, programs and managing the grant portfolio. These components contribute to strengthening the country's health system. The CCM has a very effective Strategic Monitoring Committee, which has been chaired by UNAIDS for seven years. It is crucial to support this to ensure that grants are used in accordance with the plans and objectives set out. UNAIDS should be strengthened and supported in its role of coordinating Technical Assistance (TA) providers in order to avoid duplication.
Technical assistance needs are covered effectively in funding requests. However, under the leadership of the CCM, a consolidated technical assistance plan for the overall implementation of the program should be developed.
L'Initiative can play a key role in supporting CCM reform
This involves supporting strategic monitoring to ensure that resources actually benefit patients. A dialogue could also be conducted with the Global Fund with the aim of revising certain procedures to better assess the impact of grants. Countries spend a lot of time on the process of developing new grants while grants from the previous cycle are still implemented by Principal Recipients. A funding cycle of five years instead of three would leave enough time to assess the impact of programs.