Twenty-Second Board Meeting

Mr Simon Bland from the United Kingdom and Australia constituency is designated as rapporteur for the Twenty-Second Board Meeting.

The agenda for the Twenty-Second Board Meeting (GF/B22/1, Revision 1), as amended, is approved.

The report of the Twenty-First Board Meeting (GF/B22/2) is approved.

<p>To provide for a technical change in grant application and management policy so as to align Global Fund funding for crosscutting health systems strengthening actions (HSS) with the Global Fund new architecture as approved by the Board at the Twentieth Board Meeting (GF/B20/DP31), the Board decides as follows:</p> <p>1.  Individual proposals requesting Global Fund funding can address one of the following three components: HIV/AIDS, tuberculosis, or malaria, as well as requests to support related cross-cutting health systems strengthening (focusing on system-wide approaches and actions that significantly benefit more than one of HIV/AIDS, tuberculosis and malaria components) ("cross-cutting HSS component").</p> <p>2.  The Board reiterates that applicants are encouraged, wherever possible, to integrate requests for funding for HSS actions within the relevant disease component(s). Such HSS actions will be assessed by the Technical Review Panel (TRP) as part of its review of that disease component. The Board clarifies that the crosscutting HSS component is for those activities that inherently are more appropriately addressed in a crosscutting or cross-disease manner. When requesting funding for such crosscutting HSS actions applicants are still required to articulate how they address identified health systems constraints to the achievement of improved outcomes in reducing the burden of HIV/AIDS, tuberculosis and malaria.</p> <p>3.  The Board requests the Secretariat to measure, monitor and report - as part of the Key Performance Indicators related to funding for HSS - to the Policy and Strategy Committee (PSC) on funding provided for cross-cutting health systems strengthening proposals.</p> <p>4.  The Board requests the joint Portfolio and Implementation Committee and PSC Eligibility, Cost Sharing and Prioritization Working Group to develop specific criteria for cross-cutting HSS applications as part of the eligibility and prioritization scheme to be approved by the Board in time for the launch of the Round 11 call for proposals.</p> <p>5.  Board policies and decisions that apply to proposals and grants for all three diseases shall apply equally to proposals and grants for the crosscutting HSS component. The Board decision titled "Architecture Review - Transition Provisions" (GF/B20/DP31) shall apply to proposals and grants for the cross-cutting HSS component subject to the amendments outlined in Annex 2 to the PSC's report to the Twenty-Second Board (GF/B22/4).</p> <p>6.  The aspects in the Board decision on Strategic Approach to Health Systems Strengthening (GF/B16/DP10) that relate to funding requests for "cross-cutting HSS actions" (in particular paragraphs 3 and 4) and/or are inconsistent with this decision are revoked</p> <p>7.  This decision does not change the existing scope of Global Fund support to crosscutting HSS activities or create a new funding window for these HSS activities.</p>

<p>The Board:</p> <p>1.  Notes that further to the Board decision on the Health Systems Funding Platform (GF/B21/DP5) the Policy and Strategy Committee (PSC) has approved, in principle, the design of a pilot for 4 to 5 countries for Track 2 Option 2 (the "Pilot");</p> <p>2.  Clarifies that the Pilot shall be conducted in accordance with the Board decision on "Implementing the new grant architecture for health systems strengthening activities" taken at its Twenty-Second Meeting; and</p> <p>3.  Authorizes the Secretariat to make exceptions to existing policies and procedures to the extent necessary and within the parameters described in the paper titled 'Health Systems Funding Platform - Pilot for funding requests based on jointly assessed national health strategies' (GF/PSC14/04) as presented at the 14^th PSC to implement the Pilot.</p> <p>The Board notes that any exceptions to existing policies and procedures made in connection with the Pilot shall be consistent with the Framework Document of the Global Fund, including the principle that the Global Fund supports activities that help health systems overcome constraints to the achievement of improved outcomes in reducing the burden of HIV/AIDS, tuberculosis and malaria.</p>

<p>The Board approves the following amendments to the Board Chair and Vice-Chair nomination and election process:</p><p>1. The incumbent Board Chair and Vice-Chair shall launch the nomination process three months ahead of the Board meeting at which the election is scheduled to take place.</p><p>2. Any individual nominated by a voting constituency, with the attributes stipulated in the Terms of Reference of the Board Chair and Vice-Chair, may stand for office.</p><p>3. The Board Chair and Vice-Chair shall, upon election, become ex-officio members of the Board during their tenure, independent of any constituency, and shall not hold voting rights.</p><p>These amendments are reflected in the excerpts of the revised By-laws, Board Operating Procedures and Terms of Reference of the Board Chair and Vice-Chair contained in Annex 4, Revision 1 of the PSC's report to the Twenty-Second Board (GF/B22/4).</p>

<p>1. The Board acknowledges the work of the sub-committee of the Policy and Strategy Committee (PSC) on the follow-up to the Five-Year Evaluation and on the future of the TERG, starting in May 2009. The Board also thanks the TERG for its involvement in this reflection.</p><p>2. To ensure that the TERG moves forward with sufficient resources, expertise, independence and credibility in advising the Board and its committees on monitoring and evaluation matters, the Board approves the revised Terms of Reference, membership and procedures for the Technical Evaluation Reference Group (as set out in Annex 5 to the PSC Report to the Twenty-Second Board (GF/B22/4).</p><p>3. The Board notes that Dr Ruth Levine resigned from the TERG in April 2010. The Board also notes that the terms of Dr Lola Dare and Dr Atsuko Aoyama on the TERG are due to expire, and decides to extend the terms of these two members of the TERG until the end of February 2011.</p><p>4. The Board requests the Secretariat and the PSC to launch the process of nominations for new members of the TERG with the aim of having a complete TERG to be approved electronically by the Board by the end of February 2011.</p><p>5. The Board requests the TERG to include in its 2011 annual report to the Board an assessment of its own independence and of the independence of the TERG support team within existing administrative arrangements and to make recommendations for change, if appropriate.</p>

<p>The Board refers to its decision at the Sixteenth Board Meeting to review the Income Level and Cost Sharing Criteria for determining eligibility for funding (GF/B16/DP18). </p> <p>The Board acknowledges the progress made by the joint Portfolio Implementation Committee (PIC) and Policy and Strategy Committee (PSC) working group (the 'Joint PIC-PSC Working Group') in reviewing such criteria and the prioritization rules which are to be applied where there are insufficient resources to finance all proposals approved for funding ('Prioritization Rules'). </p> <p>The Board recognizes the complexities of the review and acknowledges that further analysis needs to be undertaken by the Joint PIC-PSC Working Group to present more clearly defined options for the PSC and PIC to consider at a joint meeting in March 2011.</p> <p>The Board requests the PSC and PIC to present recommendations to the Board at the Twenty-Third Board Meeting regarding the outcome of its review of the Income Level and Cost-Sharing Criteria and Prioritization Rules. </p>

<p>The Board approves the amendment and restatement of the Quality Assurance Policy for Pharmaceutical Products as set out in Annex 1 to the report of the Market Dynamics and Commodities Ad-hoc Committee (MDC) to the Board (GF/B22/11, Revision 1) (the QA Policy).</p> <p>The Board requests the Secretariat to explain to grant recipients in writing the implications of the termination of the Interim Exception and the changes to the eligibility criteria for the review of Finished Pharmaceutical Products by the Expert Review Panel (ERP) as specified in the QA Policy.</p> <p>The Board requests the World Health Organisation (WHO) to consider evaluating products under the WHO Prequalification Programme in circumstances where the relevant product may only have a limited geographical relevance.</p> <p>The Board confirms that, as requested by the Board at its Twenty-First Board Meeting (GF/B21/DP16), the MDC has reviewed the updated Expert Review Panel (ERP) process to deal with exceptional cases, and considers it to be satisfactory.</p>

<p>The Board approves the quality assurance policy for diagnostic products ("QA Policy for Diagnostics"), as set out in Annex 2 to the Report of the Market Dynamics and Commodities Ad-hoc Committee to the Board (GF/B22/11, Revision 1). </p> <p>The Board requests the Secretariat to work with the World Health Organisation (WHO) towards concluding an agreement under which WHO will manage the technical evaluation of diagnostic products, including, as relevant, the establishment of an Expert Review Panel for Diagnostics, as described in the QA Policy for Diagnostics.</p> <p>The Board further requests the Secretariat to work with WHO to explore measures to ensure principal recipients procure appropriately performing malaria rapid diagnostic tests (RDTs) and the MDC to report back by the Twenty-Fourth Board Meeting. </p>

<p>The Board notes that World Health Organisation (WHO) guidance<a id="_ftnref1" name="_ftnref1"></a>[1] states that fixed-dose combination formulations (FDCs) of artemisinin-based combination therapies (ACTs) are strongly preferred to co-blistered formulations.</p> <p>The Board requests the Market Dynamics and Commodities Ad-hoc Committee (MDC) to present recommendations to the Board at the Twenty-Third Board Meeting regarding appropriate transition by recipients of Global Fund financing to the use of FDCs of ACTs.</p> <p>The Board also requests the MDC to analyze additional measures to accelerate the transition to FDCs of HIV/AIDS and tuberculosis medicines and to present its recommendations to the Board at its Twenty-Fourth Meeting.</p> <p><a id="_ftn1" name="_ftn1"></a>[1] WHO Guidelines for the Treatment of Malaria Second Edition (2010). http://whqlibdoc.who.int/publications/2010/9789241547925_eng.pdf</p>

The Board approves the appointment of Oliver Sabot from the Private Foundations constituency as Chair of the Market Dynamics and Commodities Ad-hoc Committee (MDC) for the period from the date of this decision until the adjournment of the first Board meeting of 2011 to replace the outgoing Chair, Mr Dai Ellis.

<p>The Board refers to its earlier decision regarding the evaluation of Phase 1 of the Affordable Medicines Facility - malaria (AMFm) (GF/B20/DP24), and notes that AMFm Phase 1 is currently funded as a 24-month program.</p> <p>The Board recognizes the shift in the start of the implementation of AMFm Phase 1 and the need to ensure an evaluation that can inform a decision on the future of the AMFm as a business line. Accordingly, the Board decides to extend the implementation period of AMFm Phase 1 by six months and requests the AMFm Ad Hoc Committee to present a recommendation to the Board at its second meeting in 2012 on whether to expand, accelerate, modify, terminate or suspend the AMFm business line.</p> <p>The Board grants the Secretariat the authority to work with relevant countries and Principal Recipients to extend the relevant grants and to make any other consequential amendments to those grants as a result of the extension of AMFm Phase 1. The Board further decides that there are no additional funds earmarked for financing AMFm Phase 1 Supporting Interventions, and countries and Principal Recipients should plan accordingly.</p> <p>In order to support the six month extension, the activities of the AMFm Unit shall be extended by six months. At current budgetary rates, not including the Professional Fees for the Independent Evaluation, an additional US$ 1.6 million will be required in 2012. The six month extension is expected to result in an increase in Professional Fees in 2012 for the Independent Evaluation of US$ 108,000 to cover additional labor costs, inflation and wage increases.</p> <p>The six month extension will likely mean a reduction in 2011 Professional Fees expenditure for the end-point data collection contracts. However, any expenditure saved in 2011 would correspondingly be incurred in 2012. The actual costs of end-point data collection will be known when the contracts for the data collection firms are finalized. The Board notes that this could result in an additional cost or a saving to the estimated US$ 3.9 million budget for the end-point data collection. Any additional cost to the end-point data collection budget will be presented to the Board for approval.</p>

<p>The Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria expresses its shock and deep sorrow at the untimely death of Ambassador Richard C. Holbrooke.</p><p>In his position as the United States Ambassador to the United Nations and later as the founding President of the Global Business Coalition against AIDS, Ambassador Holbrooke played a ground-breaking role in ensuring that the world accepted HIV and AIDS as a threat to international security and global business as well as being a humanitarian catastrophe. He was one of the drivers behind the allocation of large, additional resources to fight HIV and AIDS and was a tireless advocate for the engagement of the private sector in the fight against the pandemic and for testing and prevention as a crucial part of this struggle. </p><p>The fight against HIV and AIDS has lost one of its most influential and passionate ambassadors. Richard Holbrooke will be missed by all who knew him and the millions who benefitted from his work.</p><p>The members of the Board and the staff of the Global Fund send our thoughts to Ambassador Holbrooke's wife, their children and grandchildren.</p>

<p>The Board:</p> <p>1. Notes the paper presented by the Secretariat on potential options and implications for enhancing Global Fund contributions to maternal and newborn and child health (GF/B22/DP4, Annex 3), consistent with its previous decision entitled "Exploring Options for Optimizing Synergies with Maternal and Child Health." (GF/B21/DP20);</p> <p>2. Encourages countries, where applicable, to strengthen the MNCH content of their Global Fund-supported investments, maximizing existing flexibilities for integrated programming as noted in the previous Decision Point;</p> <p>3. Requests the Secretariat to develop, under the oversight of PIC and in collaboration with partners, clear guidance (including indicators) for countries on strengthening the MNCH content of their HIV/AIDS, tuberculosis, malaria, and health systems strengthening portfolios. As part of this work, the Secretariat will detail the operational and budgetary implications of rolling out the guidance; and</p> <p>4. Acknowledges the need to define longer-term possibilities for increased engagement by the Global Fund in MNCH, as part of the Strategy Development Process. </p>

<p>The Board recognizes that the Global Fund should be guided by a strategy that reflects the principles in the Global Fund's Framework Document. The work on developing the next strategy should be based on the six broad objectives discussed at the Global Fund Board Retreat on 10 - 11 December 2010 and outlined in the Chair's summary of the Board Retreat (GF/B22/19) and the final report of the Board Retreat.</p><p>The Board decides that the next strategy will cover the period up to the end of 2016, with a mid-point review in 2014. </p><p>The strategy will be a concise, high level document setting out the broad strategic direction of the Global Fund (the "Strategy Document"), with further details captured in an accompanying implementation plan (the "Implementation Plan"). The strategy will take into account the action plan of the reform working group.</p><p>The Policy and Strategy Committee (PSC) will steer the strategy development work and make recommendations to the Board. The Secretariat will be actively involved in the development of and deliberations on the strategy, and will also ensure that any necessary content development work is carried out. </p><p>The Board requests the PSC to develop a complete draft of the Strategy Document including objectives, targets, and strategic initiatives for discussion at the Board meeting in May 2011. The Secretariat shall then develop the Implementation Plan for the strategy. The PSC shall seek appropriate input on the strategy at the Fourth Partnership Forum (in consultation with the Partnership Forum Steering Committee, which shall advise on the nature of such input). The final Strategy Document and its Implementation Plan shall be approved at the Board meeting at the end of 2011.</p>

The Board approves the appointment of Karlo Boras from the Developing Country NGO constituency as Chair of the Ethics Committee for the period from the date of this decision until the adjournment of the first Board meeting of 2011 to replace the outgoing Chair, Dr Bobby John.

<p>The Board acknowledges that a significant percentage of the Operating Expenses Budget is denominated in Swiss Francs (CHF) whereas the budget is presented in United States Dollars (USD) and the reporting currency of the Global Fund is the USD.</p><p>To give greater certainty to the Board at the time of approving the USD budget, the Board decides to give the Secretariat authority to manage foreign exchange transactions in a manner which minimizes the exposure of the budget to volatility in the exchange rate between the USD and the CHF.</p><p>The Board further authorizes the Executive Director to take all necessary steps to manage this exposure.</p><p>The steps taken to manage this exposure will be under the oversight of the Finance and Audit Committee.</p>

<p>The Board approves the 2011 Operating Expenses Budget in the amount of US$ 324.7 million as set out in Annex 1 to the Report of the Finance and Audit Committee (FAC) to the Twenty-Second Board (GF/B22/6), based on the exchange rate applicable on the date of release of the Report of the FAC.</p><p>Following approval of the budget, the Secretariat shall enter into a forward contract with a reputable bank. In the event that the exchange rate determined on the date of signature of the forward contract results in a change in the budget, the Secretariat shall notify the Board of such change. The new amount shall thus be deemed to be the approved Operating Expenses Budget for 2011. </p><p>The use of any amount in the US$ 3.0 million contingency within the OIG budget for 2011 is conditional upon the advance approval of the FAC.</p>

<p>The Board decides that the names of implementer organizations and the United States Dollar (USD) equivalent of amounts owed to the Global Fund shall be disclosed in the Annual Report.</p><p>The Board further decides that the names of donors and USD equivalent amounts committed to the Global Fund but which are overdue for payment shall also be disclosed in the Annual Report.</p>

<p>The Board acknowledges the serious challenges and risks faced by Global Fund staff in the discharge of their duties in many countries, and reiterates the importance of states granting to the Global Fund such privileges and immunities as are necessary for the effective exercise of its functions and efficient use of its resources (as approved by the Board in its Electronic Decision Point on 14 December 2009 (EDP/09/32).</p> <p>The Board recognizes the measures taken by the Secretariat to secure privileges and immunities for the Global Fund from countries around the world. In this connection, the Board welcomes the signature by the Government of Moldova of the Agreement on Privileges and Immunities of the Global Fund.</p> <p>The Board reiterates the critical need for the Global Fund to pursue its drive to obtain privileges and immunities, and urges relevant stakeholders, including all Board members and their respective constituencies, to support, facilitate and promote the Secretariat's efforts to secure privileges and immunities for the Global Fund with all deliberate speed.</p> <p>The Board requests the Secretariat to update the Board regularly on the status of progress on this matter.</p>

<p>In order to ensure that funding is available within a replenishment period (or a pre-determined period) for grant renewals, the Board decides that a new commitment reserve be created for this purpose. Under this measure, the amount of assets determined to be available for approval of a new round may be reduced by an amount to be added to this reserve to ensure that funding is available for forecasted grant renewal needs during the subsequent three years.</p><p>The Board amends the Comprehensive Funding Policy¹ by deleting the existing Section 3.d and replacing it as follows:</p><p>"<i>The Board may approve proposals and commit funds for the resulting financial commitments up to the cumulative uncommitted amount of assets that the Board determines will be available at the time the Secretariat commits the funds in the related grant agreements. When making this determination, the Board will set aside the amount of assets required to meet forecasted grant renewal needs in respect of the subsequent three years (a 'Commitment Reserve'), taking into account projections regarding available donor contributions for the same three-year period provided by the Finance and Audit Committee with the support of the Secretariat</i>."</p>

<p>Taking note of Board's decision (GF/B21/EDP20, 10 September 2010) to approve the use of multi-year contribution agreements (MYCAs), preferably on an unconditional basis, as the principal mechanism through which donors should pledge and contribute to the Global Fund, the Board decides that the unqualified portions of MYCAs are considered as assets under the category 'or similar obligations' in Section 4 of the Comprehensive Funding Policy.</p>

<p>The Board: </p> <p>1. Refers to its decision entitled "Multi-Year Contributions and Promissory Notes from Private Donors" taken by electronic vote on 13 September 2010 (EDP/B21/20) to permit the use of promissory notes by private donors when providing contributions to the Global Fund. </p> <p>2. Acknowledges the potential for the Global Fund to mobilize additional resources from private foundations through the use of innovative long-term promissory notes, while being mindful of the associated opportunity costs.</p> <p>3. Notes that the forms of contribution instruments provided by donors should not conflict with the principles and requirements set forth in the Comprehensive Funding Policy (CFP), including the conditions under which instruments may be characterized as assets for the purpose of determining commitment authority. </p> <p>4. Notes the practice of the Global Fund of accepting promissory notes with encashment schedules for annual payments over the next succeeding three years, which is in line with grant disbursement profile and thereby ensures that the Global Fund will continue to meet grant disbursement needs. </p> <p>5. Decides that, for an initial period of three years, and upon the approval of the Finance and Audit Committee, the Global Fund may accept promissory notes issued by private foundations available for encashment only at the end of terms exceeding three years ("Long-Term Promissory Notes"). However, the acceptance of Long-Term Promissory Notes is contingent upon the compliance of such instruments with the requirements of the CFP and the right of the Global Fund to automatic early encashment where the Global Fund requires cash to meet grant disbursement needs. </p> <p>6. Decides that contributions to the Global Fund through Long-Term Promissory Notes shall be limited to those from private foundations. </p> <p>7. Requests the Secretariat to establish a minimum cash policy in order to ensure a requirement of a minimum cash threshold equal to six months of projected disbursements at any given time, as may be amended from time to time by the Finance and Audit Committee. The minimum cash threshold requirement established by the Secretariat would underpin the early encashment provisions of the long-term promissory notes to allow for payment at any point at which the cash available to the Global Fund to fund disbursements falls below the required minimum cash threshold.</p>

<p>The Board agrees to adopt the measures outlined below in order to enable the launching of funding opportunities described in GF/B22/DP26. </p> <p>The Global Fund Strategy Development Process and Reform Agenda</p> <p>The Board acknowledges the processes underway for development of a new strategy and the agenda for creating a more efficient and effective Global Fund. Nothing in these decisions seeks to prejudge or prejudice the outcomes from these processes.</p> <p>Eligibility, cost sharing and prioritization</p> <p>The Board affirms the importance and urgency of the ongoing review of the Global Fund's eligibility criteria, cost sharing and prioritization requirements and that the Board will make a decision on these matters at its first meeting in 2011 (GF/B22/DP8). The Board now decides that the revised requirements on eligibility, cost sharing and prioritization, to be approved at the Twenty-Third Board Meeting, shall apply for all funding opportunities described in GF/B22/DP26. </p> <p>Assessment of the impact of program interruption at the May 2011 Board Meeting</p> <p>The Board requests the Secretariat to undertake an analysis of the potential impact of program implementation being interrupted as a consequence of the timing of funding decisions on Round 11 being at the first meeting of 2012 rather than at the end of 2011 and to report its findings to the Finance and Audit Committee (FAC) and the Portfolio Implementation Committee.</p> <p>Based on this analysis, the FAC will make a recommendation to the Board on any necessary measures to mitigate the impact of identified cases of program interruption. Consequent to this the Board will decide, at its meeting in May 2011, whether to extend the provisions relating to Funding of Additional Commitments, as described below for Round 10, to also apply to Round 9 with a view to:</p> <ul> <li>Making available resources to mitigate the impact of program interruption arising from the timing of Round 11; and</li> <li>Making available resources to contribute towards the demand including from the Second Wave of NSAs and the Health Systems Funding Platform Pilot.</li> </ul> <p>Funding of Additional Commitments for Round 10</p> <p>The Board refers to its decision at the Twentieth Board Meeting (GF/B20/DP9) to make funding commitments in respect of Additional Commitments in two tranches of an initial two-year period and an additional one year period.</p> <p>The Board now decides in respect of Additional Commitments, arising from Round 10 Proposals only, to make such commitments in three tranches of one year each. This measure is being adopted on an exceptional basis in order to enable a more effective and even commitment of resources within the Third Replenishment term and as an exception to the provisions of paragraph 3.c of the Comprehensive Funding Policy.</p> <p>The Board requests the Secretariat to implement this decision in a manner that minimizes funding uncertainty and transaction costs. </p> <p>Increase in Current Ceilings on Additional Commitments for Round 8 and Round 9 Proposals and the First Learning Wave of National Strategy Applications</p> <p>The Board decisions to increase the limits on Round 8, Round 9 and First Learning Wave of National Strategy Application proposals from 75% to 90%. In doing so, the Board refers to its decision at the Eighteenth Board Meeting (GF/B18/DP13) and its decision at the Twentieth Board Meeting (GF/B20/DP9) which provided for the limits described in these decisions to be increased from 75% to 90% when new resources become available, subject to Board approval.</p> <p>Application of Performance Based Funding</p> <p>The Board acknowledges the importance of implementing Performance Based Funding as a core principle of the Global Fund.</p> <p>In this context, the Board requests the Secretariat to strengthen its application of Performance Based Funding principles having regard to utilization of funds and performance of existing grants. Accordingly the Board requests the Secretariat to consider reductions in Additional Commitments, where appropriate for reasons of performance, and to work with CCMs and Principal Recipients in order to adjust performance targets in light of the revised lifetime budgets; this will result in overall savings that will then be available for approval of new funding opportunities.</p>

<p>The Board refers to its decision at the Twenty-Second Board Meeting entitled "Measures Associated with Round 10 and Future Funding Opportunities".</p> <p>The Board acknowledges its responsibility to take a decision on eligibility, cost-sharing and prioritization at its Twenty-Third Board Meeting in order to launch Round 11, Second Wave of National Strategy Applications (NSAs) and Health Systems Funding Platform pilot (HSFP) as follows:</p> <p>Launch of Round 11</p> <p>a.  The Board requests the Secretariat to make a call for proposals on 15 August 2011, with a submission due date of 15 December 2011.</p> <p>b.  The Board acknowledges that the Portfolio and Implementation Committee will approve the proposal forms and guidelines for Round 11, which will incorporate requirements for transitioning to the new Global Fund grant architecture and reflect the eligibility, cost sharing and prioritization requirements arising from Board decisions taken by the Board in May 2011.</p> <p>c.   The Board requests that Round 11 proposals be reviewed by the Technical Review Panel in time for approval at the first Board Meeting of 2012.</p> <p>Second wave of National Strategy Applications</p> <p>The Board refers its decision GF/B21/DP4 to initiate the second funding opportunity for National Strategy Applications (NSA)("the Second Wave") and now approves the launch of the Second Wave of NSA under the following timeline:</p> <p>a.  The Board requests the Secretariat to initiate the Second Wave of NSA in January 2011.</p> <p>b.  Notwithstanding this launch date, Board decisions concerning new requirements on eligibility, cost sharing and prioritization will apply to the Second Wave of NSA.</p> <p>c.   The Board requests that Second Wave of NSA proposals be reviewed by the Technical Review Panel (TRP) in time for approval at the first Board Meeting of 2012.</p> <p>Health Systems Funding Platform Pilot (HSFP)</p> <p>The Board refers to its decision at the Twenty-First Board Meeting GF/B21/DP5, such that the Board could approve funding requests emanating from a pilot in four to five countries at the same time that it approves Round 11 proposals.</p> <p>The Board notes that, at its 14^th meeting in October 2010, under delegated authority of the Board, the Policy and Strategy Committee approved the design of the pilot for the approach identified as 'Track 2 option 2' of the HSFP.</p> <p>Accordingly, the Board approves the launch of the HSFP pilot as follows:</p> <p>a.  The Board requests the Secretariat to initiate the HSFP pilot on or about January 2011.</p> <p>b.  Notwithstanding this launch date, Board decisions concerning new requirements on eligibility, cost sharing and prioritization will apply to the HSFP pilot. </p> <p>c.   The Board acknowledges that the Portfolio and Implementation Committee will approve the proposal form and guidelines for the HSFP pilot.</p> <p>d.  The Board requests that HSFP pilot proposals be reviewed by the TRP in time for approval at the first Board meeting of 2012.</p> <p>Launch of Funding opportunities beyond 2011: </p> <p>The Board refers to its decision at its Fourteenth Board Meeting entitled "Establishment of Fixed Dates for Rounds" (GF/B14/DP12) to announce to the public, with significant advance notice, future Rounds of funding.</p> <p>Accordingly, the Board decides to launch Round 12 (and other funding opportunities¹) within the Third Replenishment period, i.e. no later than 31 December 2013. Based on the availability of assets, the Board may decide to make this call for proposals well in advance of 31 December 2013 with the goal of making funding decisions during 2013 and acknowledges the value this would have in supporting the urgent need for continued scale-up in the fight against the three diseases.</p>

<p>1.  The Board approves all the Round 10 proposals recommended for funding by the Technical Review Panel (TRP) as "Category 1", "Category 2" and "Category 2B", subject to the below provisions. </p><p>2.  The Board approves for funding for an initial two years all those Round 10 proposals recommended for funding by the TRP as "Category 1", "Category 2" and "Category 2B" as listed in Annex 1 of GF/B22/13, subject to paragraphs 3, 4 and 5 below. This includes all Round 10 proposals focusing on Most-at-Risk Populations for HIV/AIDS, which have been submitted under the dedicated reserve referred to in its decision entitled "Prioritization for funding amongst Round 10 TRP-recommended Proposals" GF/B21/DP18 and recommended for funding by the TRP. </p><p>3.  The applicants whose proposals are recommended for funding as 'Category 1' (as indicated in Annex 1 of GF/B22/13) shall conclude the TRP clarifications process, as indicated by the written approval of the Chair and/or Vice Chair of the TRP, not later than eight weeks after the applicant's receipt of notification in writing from the Secretariat of the Board's decision.</p><p>4.  The applicants whose proposals are recommended for funding as 'Category 2', including the subset of proposals identified as 'Category 2B' (as indicated in Annex 1 of GF/B22/13), shall:</p><p>a.  provide an initial detailed written response to the requested TRP clarifications and adjustments by not later than six weeks after the applicant's receipt of notification in writing by the Secretariat of this Board decision; and</p><p>b.  conclude the TRP clarifications process, as indicated by the written approval of the Chair and Vice Chair of the TRP, not later than three months from the Secretariat's receipt of the applicant's initial detailed response to the issues raised for clarification and/or adjustment. </p><p>5.  As required under the Income Level and Cost Sharing Policy, the lifetime grant amount of approved Round 10 proposals that will be implemented in Upper-Middle Income Countries ("UMI Proposals") shall be subject to a collective maximum limit of 10 percent of the lifetime grant amount of all Round 10 approved proposals. The Board notes that this limit will be applied at the time of approving additional commitments for approved Round 10 UMI Proposals. </p><p>6.  The Board declines to approve for funding those proposals recommended by the TRP as 'Category 3', as indicated in Annex 1 of GF/B22/13. These applicants are encouraged to re-submit a proposal in a future funding round after major revision of the proposal. </p><p>7.  The Board declines to approve for funding those proposals recommended by the TRP as 'Category 4', as indicated in Annex 1 of GF/B22/13. </p><p>8.  The Board notes the TRP's request to have additional financial analysis support as part of the clarifications process and requests the Secretariat to make the necessary arrangements.</p><p>9.  Prior to the signing of a grant, the Secretariat will provide confirmation that, as far as can be determined based on data available to the Secretariat, the grant budget is in accord with value for money considerations including unit costs.</p>

In accordance with Section 26 of the Board Operating Procedures and based on the satisfactory performance appraisal of Professor Michel Kazatchkine in the role of the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Board decides to extend his appointment for a further term of three years from the end of his current term till the end of the month of the first Board meeting in 2014.

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)^[1].</li> <li>Reaffirms that the maximum funding amount for Phase 2 of each proposal shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol> <p>See attached tabledetailing total recommended funding amount of US$ 140,505,542 for the following grants: ZAR-708-G06-H ; ETH-708-G08-H ; GNB-708-G05-H ; HND-102-G04-H-00 ; MDG -708-G10-M ; MLW-708-G06-T ; MON-102-G01-T-00 ; MON-202-G02-H-00 ; RWN-304-G03-M ; STP-708-G03-M ; TNZ-708-G10-M</p>

The Board approves additional funding up to US$ 13,055,416 for the Phase 2 period of the Round 6 South Africa HIV grant (SAF-607-G06-H) to improve the quality and scale of PMTCT activities, subject to Technical Review Panel (TRP) clarifications and conditions within a limited timeframe. The Board approves the revised Phase 2 incremental amount up to US$ 37,951,822 which includes an additional sum of US$ 13,055,416 allocated for PMTCT activities. This funding may also be subject to additional conditions to be cleared by the Secretariat as part of its risk management function.

<p>The Board:</p><ol><li>Refers to condition number 5 in its decision approving as a „Conditional Go‟ the Phase 2 of the Kenya Round 6 TB grant (KEN-607-G08-T) (“Condition 5”) which states that: “Not later than 30 September 2010, the Principal Recipient must finalize and submit to the Global Fund the reports for the audits of the Financial Management Agent and the Procurement Consortium,” and</li><li>Decides to extend the deadline in Condition 5 from 30 September 2010 to 31 March 2011.</li></ol>

<p>The Board decides:</p> <p>1. to revise Conditions 2 and 3 to its Phase 2 approval for the Round 6 Zanzibar HIV (ZAN-607-G05-H) grant as follows:</p> <ul> <li>Condition 2 shall be revised to: “Within 6 months of the signing of the Phase 2 extension the Secretariat will review a repeat LFA On Site Data Verification (OSDV) to determine whether 1) this reconfirms the number of people on ARV treatment at that time, 2) actions recommended from the first OSDV have been implemented and 3) there are appropriate systems in place to ensure quality data.”</li> <li>Condition 3 shall be revised to: “Within 6 months of the signing of the Phase 2 extension the PR shall have completed working with technical agencies on an independent performance review of the Program and provide this independent performance review to the Global Fund. Continuation of funding for years 4 and 5 under the Program is subject to a determination by the Secretariat that the independent performance review demonstrates an efficient use of resources under the Program.”</li> </ul> <p>2. that if Condition 3, as revised, is not fulfilled within the timescale set then the Secretariat is to proceed to terminate the grant.</p>

The Board acknowledges that additional time is required for the Phase 1 implementation period for the Tanzania Round 7 Malaria grant (TNZ-708-G10-M) in order to allow the grant to be consolidated with the Round 9 grant into a Single Stream of Funding and to ensure that AMFm activities are not interrupted during this time. The Board therefore approves the extension of the Phase 1 period for the Round 7 malaria grant (TNZ-708-G10-M) by an additional 3 months until 31 March 2011 without committing additional funding for the Phase 1 period.

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)^[1].</li> <li>Reaffirms that the maximum funding amount for Phase 2 of each proposal shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol> <p>See attached tabledetailing total recommended funding amount of US$ 44,256,536 for the following grants: AGO-708-G04-M ; TCD-708-G03-M ; MOZ-708-G07-T</p>

<p>The Board approves additional incremental funding up to US$ 30,000 for the Phase 2 period of the Round 7 Afghanistan HIV grant (AFG-708-G04-H) with conditions stipulated in its B21/EDP/27 decision of 19 November 2010. The Board approves the revised Phase 2 incremental amount up to US$ 513,579.</p>

<p>The Board declines approval of additional funding for the Phase 2 period for the Round 6 Mauritania Malaria (MRT-607-G04-M) and TB (MRT-607-G05-T) grants.</p><p><span style="font-size: 12px; line-height: 1.5;">See attached table.</span></p><h5></h5>

<p>The Board extends the deadline for the signing of grant documentation for the proposals listed in Table 1 for three months to 20 May 2011.</p><p>Table 1: Extension of grant signing deadline for four grants in three countries</p><table class="table" dropzone="copy"><tbody><tr><td style="cursor: default;">No </td><td style="cursor: default;"> Country, Disease, Round</td><td style="cursor: default;"> Grant information</td><td style="cursor: default;">Deadline for signature </td></tr><tr><td style="cursor: default;"> 1</td><td style="cursor: default;">Central African Republic, TB, Round 9</td><td style="cursor: default;"><p>Principal Recipient: Ministry of Public Health, Population and the fight against HIV/AIDS</p><p>Total approved amount: Euros 20,972,227 over five years</p><p>Phase 1 approved upper ceiling: Euros 8,961,795</p></td><td style="cursor: default;">20 May 2011</td></tr><tr><td style="cursor: default;"> 2</td><td style="cursor: default;">Nigeria, TB, MDR-TB Component, Round 9</td><td style="cursor: default;"><p> Principal Recipient: IHVN</p><p>Total amount: US$ 113,332,101 over five years</p><p>Phase 1 (total): US$ 31,515,160</p><p>Phase 1 (MDR TB component): US$ 9,002,945</p></td><td style="cursor: default;">20 May 2011</td></tr><tr><td style="cursor: default;"> 3</td><td style="cursor: default;">Democratic Republic of Congo, Round 9 TB/HSS <br/>(2 grants)</td><td style="cursor: default;"><p>Principal Recipients: i) Ministry of Health and ii) CARITAS</p><p>Total amount (over 5 years): US$ 275,383,647</p><p>Phase 1: US$ 100,261,325</p></td><td style="cursor: default;">20 May 2011</td></tr></tbody></table>

<p>The Board approves to change:</p> <p>1) Article 8. Secretariat, paragraph 8.1 of the By-Laws to read as follows:</p> <p>8.1 Composition</p> <p>The Secretariat is responsible for managing the day-to-day operations of the Foundation.</p> <p>The Secretariat is headed by an Executive Director, who is selected by the Foundation Board based on merit, in a non-political, open and competitive manner. The Executive Director acts as the chief executive officer of the Foundation and serves for a term of four years<span style="text-decoration: line-through;">, renewable for not more than one additional term of three years.</span></p> <p>The Executive Director is responsible to the Foundation Board for the day-to-day management of the Foundation, and for specific duties and responsibilities assigned to him or her by the Foundation Board.</p> <p>Secretariat staff are selected by the Executive Director, under policies and procedures approved by the Foundation Board.</p> <p>2) Section D. ROLES AND RESPONSIBILITIES, paragraph 17 of the Board Operating Procedures to read as follows:</p> <p>17. Executive Director</p> <p>17.1 The Executive Director shall attend all Board Meetings, and shall be responsible for the preparation and distribution of all materials required for the meeting, and for such other duties and responsibilities as may be assigned by the Board or the Chair. The Executive Director shall be appointed by the Board for a term of four years<span style="text-decoration: line-through;">, renewable for not more than one additional term of three years.</span></p> <p>3) Section G. PROCEDURES FOR APPOINTMENT AND ASSESSMENT OF THE EXECUTIVE DIRECTOR, paragraph 26 of the Board Operating Procedures to read as follows:</p> <p>26. Appointment of the Executive Director</p> <p>26.1 No later than six months prior to the end of the term of the incumbent Executive Director, the Board shall, in accordance with Article 8.1 of the Bylaws and this Section of the Board Operating Procedures, <span style="text-decoration: line-through;">decide on a procedure for the appointment of the next Executive Director.</span></p> <p><span style="text-decoration: line-through;">26.2 At this time, the Board shall normally</span> launch a competitive recruitment process, publicly inviting applications for the position of Executive Director. Where the incumbent Executive Director has not served more than one term of office, the Board <span style="text-decoration: line-through;">shall</span><u>may</u> invite him or her to re-apply, together with other candidates, for such position and publicly announce such invitation<span style="text-decoration: line-through;">. Where appropriate the Board may launch such a recruitment process without inviting the Executive Director to re-apply for the post or,</span> based on a satisfactory performance appraisal <span style="text-decoration: line-through;">and if the incumbent Executive Director has not served more than one term, extend the appointment of the Executive Director for a further term of three years without the normal recruitment process. </span></p> <p><span style="text-decoration: line-through;">26.3</span> 26.2 <span style="text-decoration: line-through;">If</span><u>When</u> the Board decides to launch a recruitment process, it shall be assisted by an ad hoc Nomination Committee. At least six months prior to the end of the term of the incumbent Executive Director, or at any other time decided by the Board, the Chair of the Board shall, notwithstanding the otherwise applicable procedures under these Board Operating Procedures and the Committee Rules and Procedures, recommend for Board approval the terms of reference of the Nomination Committee and nominate for Board approval a Chair and the membership of that Committee. Membership in the Nomination Committee shall not count towards the two committee limit referenced in Section 23 of these Board Operating Procedures.</p> <p><span style="text-decoration: line-through;">26.4</span> 26.3 The Chair of the Board may also recommend for Board approval updated terms of reference of the Executive Director and the criteria for his <u>or her</u> selection. Following approval of the membership of the Nomination Committee, the recruitment process is launched.</p> <p><span style="text-decoration: line-through;">26.5</span> 26.4 The Nomination Committee shall interview and rank candidates, and present the highest ranking candidates to the Board, which shall then select a candidate, consistent with the terms of office of the Executive Director that are stated in Section 17 of these Board Operating Procedures.</p> <p><span style="text-decoration: line-through;">26.6</span> 26.5 The mandate of the Nomination Committee shall expire upon the appointment of the Executive Director.</p>

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)^[1].</li> <li>Reaffirms that the maximum funding amount for Phase 2 of each proposal shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol> <p>See attached tabledetailing total recommended funding amount of US$ 69,047,796 for the following grants: CAM-708-G12-T ; KGZ-708-G05-H ; NIC-708-G04-M ; SUD-708-G10-M ; TMP-709-G05-M</p>

<ol><li>The Board approves funding for the Round 10 Ethiopia Tuberculosis proposal for the Phase 1 Period of up to USD 21,107,334, as a „Category 2‟ proposal recommended by the Independent Appeals Panel, with the clear understanding that the amount approved is an upper ceiling rather than a final funding amount and subject to satisfactory completion by the applicant of the requirements set out in paragraph 2 below:</li><li>The applicant shall: <ol><li type="a">Provide an initial detailed written response to the clarifications and adjustments requested by the Independent Appeals Panel not later than six weeks after the receipt of the notification in writing by the Secretariat to the applicant of this Board decision; and</li><li type="a">Complete any further clarifications or adjustments, as required by the Chair or Vice-Chair of the Technical Review Panel, not later than three months from the Secretariat‟s receipt of the applicant‟s initial detailed response to the issues raised for clarifications or adjustments.</li></ol></li></ol>

The Board approves the appointment of the Latin America and Caribbean Constituency as a member of the Ethics Committee until the adjournment of the Twenty-Third Board Meeting.

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)^[1].</li> <li>Reaffirms that the maximum funding amount for Phase 2 of each proposal shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol> <p>See attached tabledetailing total recommended funding amount of US$ 64,134,199 for the following grants: BRN-202-G05-M-00 ; ETH-708-G07-H ; GYA-708-G04-M ; SUR-708-G04-M ; SWZ-708-G05-H</p>

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period of the Round 7 West Bank and Gaza Strip (PSE-708-G01-H) grant as a „Conditional Go‟ in the amount of up to US$ 4,985,587, subject to TRP clarifications and conditions within a limited timeframe, and also subject to possible additional conditions to be cleared by the Secretariat. Approval is also subject to paragraph 3.c. of the revised Comprehensive Funding Policy (GF/B20/DP9).</li> <li>The Board reaffirms that the maximum funding amount for Phase 2 of this grant shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol>

The Board extends the Phase 1 Ending Date of the Ghana Malaria Grant GHN-809-G08-M from 31 December 2011 to 31 December 2012, and subject to approval of Phase 2 of this Grant, authorises the extension of the Phase 2 Ending Date from 31 December 2014 to 31 December 2015.

<p>The Board:</p> <ol> <li>Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)^[1].</li> <li>Reaffirms that the maximum funding amount for Phase 2 of each proposal shall be the sum of the amount approved by this decision and the amount of any funds approved for Phase 1 which have not been disbursed by the Global Fund at the end of the Phase 1 period.</li> </ol> <p>See attached tabledetailing total recommended funding amount of US$ 18,884,840 for the following grants: KEN-708-G10-H ; TNZ-102-G01-M-00</p>

<p>The Board approves additional funding for two years for the Continuity of Services for the proposal listed in Table 2 and described in Annex 1, with the clear understanding that the amount approved is an upper ceiling rather than a final funding amount, and based on the understanding that the Secretariat shall pursue implementation arrangements for such proposal consistent with the recommendation set forth in Annex 1.</p><p>See attached tabledetailing total recommended funding amount of US$ 400,572 for the following grant: YEM-307-G05-H </p>