Office of the Inspector General

Country Coordinating Mechanism

02 June 2023

Country Coordinating Mechanisms (CCMs) are core to the Global Fund’s contribution to health governance in helping to end HIV, tuberculosis (TB) and malaria while investing in resilient and sustainable systems for health. CCMs are a key element of the Global Fund partnership and play a critical role in realizing the principle of country ownership by undertaking inclusive, transparent, multistakeholder and multisectoral decision-making.

The 2016 OIG audit found that CCM oversight over Global Fund-supported programs was weak, and significant issues were identified with the implementation of CCM policies and procedures. Following this review, the Board approved the CCM Evolution Strategic Initiative to enhance the way the partnership works in countries and regions in May 2018. Set to conclude in December 2023, the CCM Evolution Strategic Initiative is expected to increase the maturity of CCMs and optimally support the implementation of the Global Fund strategy.

Many CCMs have benefited from this CCM Evolution Strategic Initiative, attesting their appreciation of the efforts. Its catalytic effect has however yet to be assessed. Although the CCMs that participated in the CCM Evolution's pilot phase from 2018 to 2019 have improved their operations, not all the gains were sustained, and not all of the planned activities were implemented in these countries after the pilot. The Project threshold assessment process has not been fully optimized to support CCMs to prioritize interventions that could move them to more strategic maturity.

Implementation of the Evolution interventions has been materially delayed, mainly due to the disruptions caused by the COVID-19 pandemic and related competing priorities of CCMs and the Global Fund Secretariat’s CCM Hub. Additional delays were caused by limitations with the initial project design, the absence of a Monitoring and Evolution framework at inception, as well as the limited availability of technical assistance. As a result, the desired maturity shift of CCMs is yet to be achieved. Despite significant delays in the implementation of the CCM Evolution Strategic Initiative, there is no plan to adjust the project scope or timelines. Implementation of the CCM Evolution Strategic Initiative to improve CCM maturity and to deliver the Global Fund strategy is considered partially effective.

Significant improvement in CCM policies and processes has been noted since the last OIG audit in 2016. However, there is limited differentiation in CCM policies and guidelines, or support to CCMs with unique contexts. The OIG noted limited systems for recording and tracking CCM funding and financial performance at the Global Fund Secretariat. Access to timely and quality data by CCMs for decision-making also needs to be improved. The support provided by the Global Fund Secretariat to CCMs to help them execute their mandate is partially effective.

  • Country Coordinating Mechanism (GF-OIG-23-012 - 2 June 2023)
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