Board Decisions

GF/B14/DP22


Approved by the Board on:
03 November 2006


UNITAID MDR TB Initiative

The Board acknowledges UNITAID's offer to finance the purchase by the Green Light Committee of the Stop TB Partnership ("GLC") as procurement agent of MDR-TB medicines (the "MDR-TB Contributions"), to eligible programs financed by the Global Fund (the "GF Programs") for scale-up of their existing MDR-TB targets. The Board acknowledges, further, UNITAID's initial approval of USD 7.9 million (the "Initial MDR-TB Funding") to finance MDR-TB Contributions and acknowledges UNITAID's intention to approve additional funding for MDR-TB Contributions (the "Additional Funding") once the Global Fund Secretariat has determined the estimated maximum amount needed for the scale-up of potentially eligible GF Programs through their Phase 2 (the "Maximum MDR-TB Amount"). The Additional Funding shall be equal to the difference between the Maximum MDR-TB Amount and the Initial MDR-TB Funding.

The Board accepts, in principle, UNITAID's request that the Global Fund assume sole responsibility for (a) the determination of which GF Programs shall receive MDR-TB Contributions; (b) the adjustment of the relevant grant agreements to reflect MDR-TB scale-up; (c) the monitoring of GF Program results linked to MDR-TB scale-up; (d) the authorization of the delivery of shipments of MDR-TB Contributions to GF Programs procured by the GLC based on performance; and (e) the determination at the end of Phase 1 of funding (where applicable) of whether GF Programs receiving MDR-TB Contributions shall continue to receive MDR-TB Contributions during their Phase 2.

The Board acknowledges that UNITAID's funding is limited to medicines and diagnostics only, and does not include operational costs that enable scale-up in MDR-TB treatment. The Board acknowledges UNITAID's intention, where a GF Program is covered by MDR-TB Contributions and a material increase in expenditure on operational costs is caused by the scale-up in MDR-TB targets, to finance up to the entire purchase price of MDR-TB medicines that the Global Fund is already committed to purchasing, so as to allow the Global Fund to shift expenditure to required operational costs that UNITAID could not finance.

The Board requests the Secretariat to contact Country Coordinating Mechanisms and Principal Recipients which, based on past performance, appear to have demonstrated the capacity to scale up existing MDR-TB targets, and invite them to apply for MDR-TB contributions, stating in their applications the value of such requested MDR-TB contributions. Based on these applications, the Secretariat shall calculate the Maximum MDR-TB Amount so that the UNITAID Board can approve the Additional Funding.

Once UNITAID has approved the Additional Funding, the Global Fund Board shall, if appropriate, delegate to the Secretariat the authority to do the following:

  1. enter into contracts with UNITAID and the GLC to document how MDR-TB Contributions by UNITAID will be financed and made available;
  2. determine which GF Programs shall receive MDR-TB Contributions ("Approvals"), subject to the following:
    1. the Local Fund Agent shall make recommendations with respect to the capacity of Principal Recipients to implement the proposed scale-up, and the Secretariat shall consider such recommendations prior to any Approvals;
    2. the Technical Review Panel ("TRP") shall make funding recommendations with respect to applications where the scale-up in MDR-TB targets causes material variations in other objectives of the relevant GF Program; and
    3. the total value of the MDR-TB Contributions authorized by the Secretariat shall not exceed the Maximum MDR-TB Amount;
  3. negotiate and execute amendments of grant agreements to reflect the approved scale-up and MDR-TB Contributions; and
  4. monitor the GF Program results linked to MDR-TB scale-up, and authorize the delivery of MDR-TB Contributions procured by the GLC to GF Programs based on performance.

The Board requests the Secretariat to report back to it on implementation of this decision at the Fifteenth Board meeting.