Approved by the Board on: 29 April 2008
The Board approves the 2007 Financial Statements of the Global Fund which have been audited by Ernst & Young as set out in Attachment 1 to the Report of the Finance and Audit Committee (GF/B17/6).
Annex 1 to Decision Point GF/B17/DP8:
Principles for AMFm Policy Framework, Implementation and Business Plan
• The timing of the AMFm-launch and implementation in endemic countries should be developed on the basis of the phase-in paper set out as Attachment 3 to the PSC Report (GF/B17/4), to include the following factors:
- A phased launch starting with a first group of countries to be selected according to criteria developed by the Secretariat and agreed at the 18th Board Meeting;
- Roll-out of the AMFm in these selected countries for an initial phase until a Board decision on full roll-out is reached;
- Operational research and extensive M&E efforts carried out in these first countries accessing the AMFm to assess the extent to which the AMFm can meet its objectives and provide lessons learned about the design and implementation of the AMFm that would inform a subsequent Board decision on full roll-out;
- An independent technical evaluation of the roll-out of the AMFm in the selected countries will be commissioned by the Global Fund Secretariat , under the guidance of the appropriate committee, using a set of pre-defined key indicators to be further elaborated and agreed at the Eighteenth Board Meeting to assess potential failures and short-comings("red flags") in the AMFm;
- At its first meeting in 2010, the Board will consider findings from this evaluation for a decision on whether to expand, accelerate, terminate or suspend the AMFm business line;
- Expansion from the initial phase to a full roll-out in all eligible countries will occur within a year of launch unless clear failures ("red flags") in the AMFm design are observed.
• The AMFm should be designed to increase access to ACTs by requiring national roll out plans/strategies that:
- Emphasize reaching women, children and the poor,
- Are fully financed, including sources of funding for supporting interventions to enable safe and broad access (notably among those who are currently unable to purchase ACTs because of their low income);
- Include plans for training, supervision and monitoring of providers, especially to ensure patient safety;
- Explain how the plan and its interventions link with national malaria control strategies and programs and how AMFm will be coordinated with supporting interventions.
- Are reviewed and approved by an independent standing technical body that determines that the AMFm roll-out plan is technically sound, with a particular focus on assuring sufficient investment in necessary supporting interventions, prior to provision of co-payment funding
• The AMFm should pursue responsible negotiations and contracting with manufacturers:
- Manufacturer sales prices for private sector buyers must not exceed the price available to public sector buyers (currently US$1/dose);
- Quality standards applied to drugs that qualify for the co-payment must, as a minimum, meet the quality standards outlined in the Global Fund's Quality Assurance policies; and
- The duration of copayment contracts should not extend beyond the duration of the first phase of roll-out so as to ensure continuation of market competition to reduce prices and encourage market entry of new participants.
• The AMFm should pursue a responsible funding policy and resource mobilization strategy:
- The AMFm will not become operational until sufficient funds have been contributed to cover co-payment costs for the full first phase of roll-out;
- Resources mobilized by the Global Fund Secretariat for the AMFm copayment should be additional to and separate from resources raised for ongoing Global Fund grant making and, must be held in a separate account with the Trustee;
- Resource mobilization for supporting interventions will be part of ongoing resource mobilization for Global Fund grant making and should be integrated into the Global Fund resource mobilization strategy;
- No funds can be transferred from the Global Fund's "general" account with the Trustee to support AMFm co-payments;
- The Global Fund will not make contractual commitments with manufacturers unless the necessary funds are available in the copayment account with the Trustee.
• The AMFm should work with partners to ensure that:
- The process for country access, including the development and assessment of roll-out plans, is simple and well-supported;
- Provider training and supervision emphasizes appropriate use of ACTs; and
AMFm implementation builds on consultation with the Private Sector in participating countries to ensure the co-payment is passed on through the supply chain.