The Board finds that the Global Fund needs to re-examine its business model. It should move away from a one-size-fits-all approach to a differentiated and calibrated model that allocates oversight resources based upon the risks and resources associated with specific and diverse country contexts. Consistent with this approach, the Board adopts the following three broad principles to guide further development of the business model:
i. The Global Fund should actively adapt its business model to place greater importance on disease and health impact and value for money.
ii. The Global Fund should improve allocation of resources by adapting its funding modalities and grant management systems to better take into account: (1) performance record of the grant, Principal Recipient (PR), and country; (2) risk presented by the grant, PR, and country; and (3) relative size and role of the Global Fund in-country.
iii. The Global Fund should measure the effectiveness of its business model, with particular regard to the health impact on the three diseases and transaction costs.
In addition, the Board requests that the Secretariat strengthen two specific reforms to improve the business model, and report on its progress at the Twenty-Fourth Board Meeting:
i. Identify ways to reinforce the application of performance-based funding, such as evaluating the current framework, increasing transparency, further developing methodology, and moving towards payment-for-service.
ii. Further reinforce the tracking and enforcement of additionality, working with other bodies as appropriate.