Technical Evaluation Reference Group

Strategic Reviews

As part of its responsibilities, the Technical Evaluation Reference Group periodically performs strategic reviews on the work of the Global Fund and the implementation of its strategies:

• 2017 Strategic Review
• 2015 Strategic Review

2017 Strategic Review

• Strategic Review 2017
  download in English

The results of the Technical Evaluation Reference Group’s Strategic Review 2015, along with its other evaluations, informed the development of the Global Fund Strategy 2017-2022. Following on, in 2017, the TERG conducted another strategic review to:

1. Look back: Review progress in delivering the Global Fund Strategy 2012-2016
2. Look forward: Assess the Global Fund’s readiness to implement the new Strategy 2017-2022

The TERG presented this completed Strategic Review 2017 to the Global Fund Board in November 2017.

Objectives and methods

The Strategic Review 2017 had two objectives, each with a set of sub-objectives:

1. Review progress in delivering the Global Fund Strategy 2012-2016
   • Review the Global Fund responses to recommendations from the Strategic Review 2015 and subsequent TERG thematic reviews
   • Assess what has changed over the last two years
2. Assess the Global Fund’s readiness to implement the new Strategy 2017-2022
   • Assess the readiness of the Global Fund to implement the new strategy
   • Make recommendations to facilitate strategy implementation
   • Identify areas for further examination

The sub-objectives were further grouped into three clusters:

1. Strategy translation and readiness for implementation
2. Country partnerships and sustainability
3. Measurement and accountability

The review included:

• A document review
• Key informant interviews
• Country case studies

Main conclusions

The Strategic Review 2017 came to a number of overall conclusions based on its findings. Summarized key conclusions include:

• “The vast majority of recommendations generated from Strategic Review 2015 and subsequent TERG and other reviews have been addressed”, such as those pertaining to strategic direction, differentiation, allocation, market shaping, and strengthening health systems.
• Recommendations on differentiated processes, especially in relation to funding applications and grant-making, have been successfully implemented by the Secretariat:
  • “Processes are now streamlined in a significant portion of country portfolios.”
  • These streamlined processes are “highly likely to significantly reduce transaction costs for countries [and] the Secretariat.”
  • However, “monitoring and course correcting the ongoing implementation of differentiation measures and policies” are strongly recommended at this stage.
• “The Global Fund is well prepared to implement the 2017-2022 Strategy.”
• Given the rapidly changing setting of global aid, it is essential to ensure the Global Fund be well positioned as a relevant and value-adding global health initiative for the next Replenishment and beyond 2023.

Recommendations

In order to highlight the level of urgency as well as the kind of actions the Global Fund is recommended to undertake, the strategic review team organized its recommendations into three categories. The TERG endorsed the recommendations, with minor modifications:

*The TERG additionally prioritized this recommendation.

2015 Strategic Review

• Strategic Review 2015
  download in English

In 2015, the Global Fund Board asked the Technical Evaluation Reference Group to conduct a strategic review with the following two objectives:

• Review progress made against the 2012-2016 strategy
• Assess impact made against the three diseases

Methodology

The strategic review included both quantitative and qualitative analysis, including structured document reviews, analyses of existing data, online surveys with key informants and focus group discussions, making maximum use of existing data.

Objective 1

For the first objective, in-depth case studies were carried out on 16 countries, which included on-site visits in four of these countries. These case studies included more qualitative information on:

• How the Global Fund strategy has been operationalized and what impact this may have had on the implementation of national disease programs
• Possible causality between the strategy and changed behavior/outcomes, both at the country level and at the Secretariat

The intention of the case studies was not to produce separate reports for each of the countries or specifically evaluate and judge the Global Fund's performance in each country. Instead, they provided the basic evidence to allow systematic analysis across the differing country contexts.

Objective 2

For the second objective, the reference group looked at the impact made on the three diseases between 2000 and 2014 and, specifically, progress made against the goals outlined in the 2012-2016 strategy of 10 million lives saved and 140-180 million infections averted.

This involved two broad sets of analysis:

1. An “adequacy” impact assessment on 27 countries to assess whether expected changes in impact indicators occurred over the relevant period. Modeling data, country impact profiles and program review data were used for this analysis
2. A “plausibility” assessment to answer the question: Did the program have an effect on the disease above and beyond other external factors?

Principles

The review was based on the following five principles:

1. Use a partner approach which builds on, collaborates and synchronizes evaluations with partners while maintaining rigor and objectivity
2. Conduct periodic evaluations on an ongoing basis rather than through large-scale one-off evaluations (“five years of evaluation rather than a five-year evaluation”)
3. Rely on plausibility designs to the extent possible that provide evidence of program impact, positive and negative, built on agreed monitoring and evaluation results chains and taking into account non-program influences on outcomes
4. Build on country platforms by use of national systems (e.g. disease program reviews) and strengthening of country monitoring and evaluation capacity
5. Focus on practicality for grant management such that reviews provide a limited number of actionable recommendations

The results of the Strategic Review 2015 contributed to the development of the Global Fund Strategy 2017-2022.