Board Decisions

GF/B06/DP10

Approved by the Board on: 17 October 2003

Portfolio Management and Procurement Committee (including related TRP Recommendations)

The Board adopts the following decisions:

Decision 1

1. Following TRP renewal, approximately one-quarter of the TRP members will be rotated each Round.
2. Members appointed from 2003 onwards will be appointed to serve a term of up to four Rounds.
3. After each Round, the Chair and Vice Chair of the TRP will recommend with specific explanation to the selection panel the members whom should be asked to remain on the TRP (up to a maximum of four Rounds' service for each TRP member).
4. The selection panel will select replacement TRP members from among the TRP Support Pool.

Decision 2

For the Fourth and subsequent rounds of applications to the Global Fund:

1. Countries classified as "Low Income" by the World Bank are fully eligible to apply for support from the Global Fund.
2. Countries classified as "Lower-Middle Income" by the World Bank are eligible to apply for support from the Global Fund but must meet additional requirements, including co-financing, focusing on poor or vulnerable populations and moving over time towards greater reliance on domestic resources.
3. Countries classified as "High Income" by the World Bank are not eligible to apply for support from the Global Fund.
4. Regional proposals that include a majority of eligible countries may submit applications to the Global Fund.

Decision 3:

The Board approves Option One for Round Four.

1. Option 1:Countries classified as "Upper-Middle Income" by the World Bank are eligible to apply forsupportfrom the Global Fund only if they face very high current disease burden. This is defined (based on technical input from WHO and UNAIDS) for each disease as follows:
   
   1. HIV/AIDS: if the country's ratio of adult HIV seroprevalence (as reported by UNAIDS, multiplied by 1000) to GNI per capita (Atlas method, as reported by the World Bank) exceeds 5;
   2. Tuberculosis: if the country is included on the WHO list of 22 high-burden countries, or on the WHO list of the 36 countries that account for 95% of all new TB cases attributable to HIV/AIDS;
   3. Malaria: if the country experiences more than 1 death due to malaria per 1000 people (as reported by WHO).
2. Eligible countries must meet additional requirements, including co-financing, focusing on poor or vulnerable populations, and moving over time towards greater reliance on domestic resources.
3. The Board requests that the PMPC review the issue of future applications focusing exclusively on vulnerable populations that do not receive significant funding from domestic or external sources from Upper-Middle Income countries ineligible under Option 1.
4. The PMPC will present recommendations to the Board for consideration at the Seventh Board Meeting.

PROCUREMENT AND SUPPLY MANAGEMENT

Decision 4:

National Drug Regulatory Authorities (NDRA) laboratories or laboratories recognized by the NDRA should be used for quality monitoring by the PR. To ensure the respective laboratories have adequate capacity for full pharmacopoeial testing, they must meet one of the following criteria:

1. Acceptance for collaboration with WHO pre-qualification project;
2. Accredited in accordance with ISO17025 and/or EN45002;
3. Accepted by a stringent authority. For the purposes of this policy a stringent drug regulatory authority is defined as a regulatory authority in one of the 28 countries which is either a Pharmaceutical Inspection Cooperation Scheme and/or International Conference on Harmonization.

Decision 5:

1. The principles for procurement and quality assurance of pharmaceuticals that were adopted during the Third Board meeting of the Global Fund apply to diagnostics and other non-pharmaceuticals: namely that a Principal Recipient (PR) is responsible for procurement, and is required to conduct competitive purchasing in order to obtain the lowest possible price for products of assured quality:
2. For non-durable products, the same principles as for pharmaceuticals should be followed, namely that a PR is required to select from lists of pre-qualified products, where they exist, or products accepted by stringent regulatory agencies or products accepted by national standards.
3. For durable products the lowest possible price should take into account the Total Cost of Ownership (TCO), including the cost of reagents and other consumables as well as costs for annual maintenance.
4. Procurement methods for durable products may include either lease or purchase. The PR must provide a plan for service and maintenance of the products.
5. The Secretariat will work with technical partners such as WHO, UNAIDS and bilateral agencies to ensure availability of information to recipients in regards to quality assurance and procurement systems related to high priority consumables and durables such as condoms, HIV rapid testing kits, CD4+ T cell monitoring, bed nets, microscopes, etc.

Decision 6

1. The Board recognizes the potential role of in-kind donations in significantly expanding the impact of the GF and in making a significant contribution to resource mobilization efforts through providing leverage for cash resources. In-kind donations also constitute a significant means by which the private sector may be involved with the Global Fund and contribute to achieving its goals, thus reflecting the public - private partnership principles upon which the Global Fund is based.
2. The Board recognizes the considerable challenges to be confronted in operationalizing in-kind donations. There are different issues involved in managing in-kind donations in the form of services, non-health products, or health products, particularly pharmaceuticals, at both the global and country level.
3. The Board requests that the PMPC, on the basis of input from the PSM-AP, and working jointly with other Committees, particularly with the Resource Mobilization Committee, to consider further the different operational and other issues surrounding in-kind donations of services, non-health, and health products. These general issues include, inter alia:
   • Guarding against conflicts of interest;
   • Potential legal liabilities;
   • Long term sustainability;
   • Valuation of contribution.
4. The Board requests that, on the basis of work done by the private sector and others, the PSMAP will propose strategic options, capturing issues relating to the diversity of products and services, the managerial capacity of the Global Fund Secretariat and Principal Recipients, and the advantages/costs of channeling donations through the Global Fund vis-à-vis other existing mechanisms.

Decision 7: Board refers to the Governance and Partnership Committee the issue of potential conflict of interests when products are manufactured in a state-owned laboratory and the Principal Recipient is a public entity and when products are manufactured or purchased in a state-owned structure and the state is responsible for quality.