Meeting of the Inter Organization Task Team (IOTT) on Community Systems Strengthening

Note for the Record Geneva, November 25-27, 2013

1. Background:
In November 2013, 25 participants from global, regional and national civil society organizations as well as technical partners and funders working in the field HIV and tuberculosus met to discuss the work of the Inter-Organization Task Team (IOTT) on Community Systems Strengthening (CSS) and the related issues. The meeting was organized by ICASO, as the host of the IOTT Secretariat and facilitated by Robin Gorna from ASAP (AIDS Strategy Advocacy and Policy). The overall goal of the meeting, which was hosted at the Global Fund to Fight AIDS, TB and Malaria Secretariat in Geneva (GFS), was for organizations and individuals involved in convening the IOTT to reorganize, recommit and produce a 2-3 year roadmap outlining the role of the IOTT in moving the CSS agenda forward. Specific meeting objectives, as presented by the facilitator, were as follows: To identify and map key existing and planned CSS related initiatives of IOTT members To identify and promote synergies with CSS efforts between members and other actors To identify gaps in CSS efforts not being addressed by key partners and agree on how to take them forward To present and review draft papers by the four IOTT Working Groups To discuss next steps to update CSS guidance and modules of the NFM To begin ongoing dialogue on CSS, within the context of NFM, between IOTT members with Global Fund Secretariat key focal points

This note for record summarizes the main discussions and decisions taken during the meeting. The agenda and list of participants can be found on page 16. The meeting was broadly divided into three segments: Discussion of current issues in relation to CSS Review of the work carried out by the IOTT to date Discussion and agreement on priorities and next steps
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 This NFR is structured using these three themes. Background of the IOTT The IOTT was founded in July 2012 by the Global Fund, UNAIDS, the International HIV/AIDS Alliance, USAID, Stop TB Partnership, 7 Sisters and ICASO (which also serves as the Secretariat). There are currently 25 individuals/organizations on the IOTT including: Bilateral and Multilateral partners and donors International, regional and local NGOs and networks Representatives from Academia Global governance representatives (GFATM CS Delegations, UNAIDS PCB, StopTB Board) AIDS, tuberculosis and malaria focused agencies and advocates Broader health and development organizations/constituencies

The IOTT on CSS builds on several years of work on CSS including intensive work by multiple agencies in developing the CSS Framework. It was born out of recognition that while there are many supporters of CSS, there is as yet no clear vision for how the concept should be further refined and advocated for, or for how the profile of CSS can be raised. There is also an IOTT listserv with approximately 40 subscribers which is used to share information and seek input on CSS-related issues.

2. Issues and challenges related to CSS

2.1: Setting the scene: current initiatives on CSS David Traynor did a presentation showing the diversity of CSS initiatives undertaken by the organizations at the meeting. The group found this very useful and it was agreed that a broader mapping be undertaken that includes organizations that are part of the IOTT but not present at the meeting. This mapping is attached as Annex 1 1. 2.2 Key Issues around CSS

http://www.icaso.org/files/annex-1-report-on-rapid-scan-of-iott-member-activities-andpriorities
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 Participants identified a number of issues that have hindered progress on CSS. Two papers were used as background for this discussion: Question and Answers on Community Systems Strengthening 2 (by ICASO) and Community Systems Strengthening and Key Populations: A Policy Discussion Paper 3 (by the MSMGF). Key issues that were discussed are summarized below: Definitions, clarity and detail

There are still outstanding questions on definitions, which make CSS challenging to promote and implement at country level. There is a need to develop/share common understanding of terms. It is critical to establish which aspects can be systematized without losing the essence of what makes a community effective, fluid and responsive. There is a need to gather evidence around CSS through operational research and translate it into policy. Furthermore, there is an issue around actors interpreting CSS in the way that fits their focus. Coordination and Collaboration

1. There were several agencies and organizations at the meeting (and around the world) actively working on CSS. There is a lack of awareness of who is doing what and ensuring that synergies are being leveraged most effectively. There is a need to ensure that there is a harmonization between the global policy work and research that is being done on CSS. For e.g. UNAIDS has initiated a virtual task team to help define the role of CSS in treatment scale up. In addition, the JCSAP 4 focuses on CSS particularly in building block 4: Increasing civil society effectiveness in delivery of services. Integration

From the discussions, it became clear that CSS is a means to an end and not an end in itself: the purpose of CSS is to build and strengthen community action on AIDS, tuberculosis, malaria and health more broadly. There have been efforts in recent years to increase and improve CSS integration. In 2012, the Global Fund, key NGOs and technical partners discussed the idea of having a closer connection between Health Systems Strengthening and Community Systems. At some point
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http://www.icaso.org/?file=23931 (available in English, French, Spanish and Russian) http://www.msmgf.org/index.cfm/id/11/aid/8376 4 The Global Fund Communities and NGO Board Delegations believe that the New Funding Model (NFM) being developed by the Global Fund (GF) requires a comprehensive, coordinated, and consistent partnership approach towards enhanced engagement of civil society (CS) and key populations (KPs) in the country dialogue process, country coordination mechanisms (CCMs), and grant implementation. To this end, communities and NGO delegations, the Global Fund Secretariat and its technical partners (UNAIDS, Stop TB, and Roll Back Malaria) are developing a joint civil society action plan (JCSAP) to ensure and enhance engagement of CS and KPs in country level GF processes.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 in time, CSS and HSS were linked as HCSS and then separated again, based on recommendations form CSS advocates. In part as a result of this discussion HSS programming as articulated in the NFM makes clearer connections to CSS. These are good initial steps but more work needs to be done to further integrate the two and to further clarify how questions of CSS-dedicated financing remain unclear after the separation from HSS. It is also critical to ensure that CSS is integrated with other critical enablers for e.g. gender, human rights and sexual orientation as much of the work that is happening there is inextricably linked. Ownership of the Framework

The CSS Framework currently resides on the Global Fund website in draft form (no logos, no indication of final version). The Global Fund does not consider itself as the owner/author of the framework, but has been an important ally in driving its development and use. This has led to the perception of the CSS Framework being a Global Fund product. In fact, the Framework was developed by a number of stakeholders. It was the result of several years of work by multiple stakeholders and it is understood and used by many organizations involved in Global Fund related work (see discussion 3.2 below reviewing the framework). Lack of prioritization of CSS

Even when proposals include CSS, there is significant attrition following grant negotiations (it was noted that CSS has the highest attrition rate of all programming areas). This is due in part to a lack of understanding of CSS among M&E and finance staff at the Global Fund who recommend it be removed in favor of interventions that can be more readily linked to specific measurable deliverables. Critically, anecdotal analysis from early applicants to the NFM shows that CSS is most likely to be relegated to the incentive funding stream over the indicative, thus also reducing the chances of it being funded. Lack of data

While there was consensus that there are significant gaps in the collection and collation and analysis of data related to CSS, this should not be used as an excuse to resist CSS. There is a long history and numerous examples of working with communities to deliver services and communities empowering and mobilizing themselves to achieve better health and development outcomes. Further systematic documentation of this is required. Moreover, the question how do we know we have achieved allocative efficiency? also needs to be addressed. In other words, how do you know how much strengthening is required for a particular context, disease or intervention? This is information that we can find out if we adapt current tools and systems, since these tools at present focus primarily on mapping and assessing service delivery and activity taking place within health facilities and other parts of the formal health sector.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

CSS across the diseases (HIV, TB, Malaria)

CSS is a relatively well developed concept in the HIV field but less so in TB and Malaria. More attention needs to be paid to the other diseases as well as intersections between TB and HIV. Tensions between service delivery and advocacy role

The role of communities in service delivery is far better defined and less controversial than the role of communities in fostering enabling environments and driving accountability. 2.3 Update on CSS in Global Fund NFM The new funding model (NFM) emphasizes the need to support national systems, defined as all country systems, including both government and non-government systems. Namely, Strategic Action 1.1 (Ensure appropriate targeting of most at risk populations) includes make explicit provision in the funding model for greater emphasis on community systems strengthening. In addition, Strategic Objective 4 (Promote and Protect Human Rights), the Gender Equality and Sexual Orientation and Gender Identity Strategy along with support for community systems strengthening are further contributions made by the Global Fund to advancing human rights in the context of the three diseases. CSS appears as a standalone module in each of the 3 disease measurement frameworks. There are four interventions: Intervention 1: Community-level monitoring and documentation of all services, activities and other interventions related to the disease as well as respect for human rights Intervention 2: Advocacy to ensure accountability and continuous improvement of responses to the disease Intervention 3: Social mobilization, building community linkages, collaboration and coordination Intervention 4: Institutional capacity building, planning and leadership development in the community sector

As highlighted by the GF Secretariat, the New Funding Model places a strong emphasis on National Strategic Plans (NSPs) and expects country applications to be based on robust NSPs. Participants in the meeting pointed out that in many cases these plans have been finalized and do not include CSS; this could present a significant issue for the inclusion of CSS into concept notes.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

3. Review of work carried out by the IOTT

During 2013, the IOTT Secretariat, with funding from the Global Fund, developed a workplan to address some of the issues identified above. As well as producing the CSS Q&A (referenced above), the IOTT established 4 working groups to: Working group 1: review the CSS Framework Working group 2: develop a CSS research agenda Working group 3: review CSS Indicators Working group 4: produce a mapping of technical support for CSS Papers were commissioned by the working groups and presented at the meeting. The progress of these working groups is summarized in this section. Draft versions of these papers, as well as the members of each of the working groups will be uploaded to the ICASO website http://www.icaso.org/communitysystems-strengthening 3.1 Reviewing the CSS framework

Michael OConnor presented a paper developed on behalf of working group co-chairs (ICASO and the Alliance) that posited two main approaches to reviewing the CSS framework. The first scenario is to revise the framework to better fall into line with the new funding model, which could result in a minor cosmetic revision or a more comprehensive one (either done by an external expert or consultatively within the IOTT). The second scenario was to re-develop a framework with broader relevance within the health and development sectors that can bring on board other partners (see Annex 2 5). Discussion: This was an area of significant debate as some participants highlighted the danger in adapting the framework every time there was a new change at the Global Fund. Given the broad ownership of the Framework it was pointed out that the Framework should not follow Global Fund policy but rather should inform it. The participants nonetheless agreed that in the short term, given the familiarity of most CSS actors with the Framework and its association with the Global Fund, there was a need to do a light revision to the document to remove the references to the service delivery areas (SDAs) as they were specific to the Global Fund and are now obsolete under the NFM. In other words, simplify the relationship between the 6 building blocks and 10 SDAs in the Framework and the 4 Intervention in the New Funding Model. David Traynor agreed to take on this task (under a separate contract with the Global Fund). ACTION POINT WHAT: Focus the revision on removing references to old/irrelevant concepts WHO: David Traynor
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http://www.icaso.org/files/annex-2-scenarios-and-options-concerning-revisions-to-thecommunity-systems-strengthening-css-framework
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 WHEN: End of January 2014.

3.2

Developing a research agenda

Nadia Rafif presented (on behalf of working group chaired by the MSMGF) progress on a paper to set a research agenda for CSS (see Annex 3 6). Although the use of a CSS approach in health promotion program implementation shows promise, it suffers from the lack of a theoretical framework to guide collaborations with communities, a paucity of program designs and evaluation practices; an incomplete evidence-based rationale for investing in CSS; and imprecise definitions of community and CSS. The presentation raised the following questions: How do we define Community, System and Community System? What are we strengthening? What is the primary aim of CSS? To improve health outcomes or to enhance community systems? Does CSS do this? If so, how? How might theory assist in implementing/nuancing CSS?

Discussion: The main focus of discussion was to define who would be responsible for funding and implementing the research agenda. This could also be a future agenda item for IOTT discussion. ACTION POINT WHAT: Finalize the current draft and publish WHO: MSMGF WHEN: end of January

3.3

Revising the CSS indicators

Ken Sklaw and Maria Au from USAID presented on behalf of the co-chairs of the working group (ICASO and USAID). No discussion paper was commissioned by the working group as this was put on hold until broader questions about how to revise the framework could be resolved. However, when the Global Fund consulted with IOTT members (through the IOTT listserv) about the new CSS module and the new info note participants were asked to make suggestions on how to measure progress and their
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http://www.icaso.org/files/annex-3-community-systems-strengthening-toward-a-researchagenda
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 suggestions will be been taken into account in the revision/development of new indicators by the Global Fund. The presentation focused on the strengths and weaknesses of existing CSS indicators (as summarized in the table below). Strengths There are only 2 to 3 indicators for each service delivery area Weaknesses Too Global Fund specific

Strong focus on organizational development and civil society organizations and quantitative measures, numbers and percentage.

Weak focus on systems indicators (organizations are not the same as systems).

Cover a wide spectrum of interventions except human rights

Insufficient field representation i.e. some of the indicators have not been field-tested

Indicators focused at output level/no outcome indicators

The following questions were raised: How can we develop measurements that can be used by GF and other funders? What would these measurements look like? What measurements should the IOTT provide input to, only those related to the CSS module? What about the community service delivery aspects of programme related modules? How might we address demand for coverage indicators for CSS? Can we develop outcome measurements? Do we need an evaluation framework for CSS? Are there any examples of good relevant indicators/measurements in the field? What are the other organisations doing? What can we coordinate?

Discussion: The experience of the European Harm Reduction Network (EHRN) developing an HIV regional proposal for the Global Fund under the New Funding Model focussed on harm reduction in EECA was highlighted. They used qualitative indicators, milestones and regular assessments and found 8|Page

Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 this approach to be very useful for the design of their M&E framework. Indicators are key to gaining traction on CSS because if there is no indicator, funds will not be allocated for activities or alternatively, the money will be budgeted but not spent. Another issue with CSS indicators is directionality. It is not always clear whether a particular indicator should be increasing or decreasing, therefore making it difficult to demonstrate progress. It was also noted that CSS is unlikely to be linked to direct impact on diseases it is rather about influencing capacity and the environment. The indicator may not be a quantitative but rather a qualitative one which tells a story. ACTION WHAT: Indicators to be reviewed once CSS framework is finalized WHO: TBD (internally by the Global Fund) WHEN: TBD 3.4 Improving technical support for CSS

Kelvin Storey, co-chair of the working group, gave a presentation on the technical support landscape for CSS based on a discussion paper (see Annex 4 7). This discussion paper aimed to deliver insights on key issues that define and influence access to technical support on CSS to understand what challenges and opportunities exist to improve access to technical support on CSS. The presentation raised the following issues: The field of technical assistance/support providers is complex and has many overlaps. There are broadly 4 categories/types of TS on CSS: Grant Management Systems/Civil Society Action Team approach; Technical Support Facilities model; Local capacity development grants-based model; Regional networks and local projects. Databases of technical support providers exist but most are not comprehensive enough to cover CSS explicitly but rather focus on civil society capacity building and therefore this is the primary type of TA available. Providers like the Technical Support Facilities, GMS, Alliance Hubs, and PEPFAR have dominated recognition as TS providers. However, while these projects are strong, they were not designed as mechanisms to strengthen community structures. These models are geared towards building strong civil society organizations and not building community systems. Moreover, these TS providers were created to assist specifically with grant performance. The lack of clarity around CSS has also limited development of TS expertise.

http://www.icaso.org/files/annex-4-towards-improving-access-of-technical-support-oncommunity-systems-strengthening-css
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

Discussion: There is a need for more comprehensive tools to assess CSS gaps and to help build a CSS technical support plan. In contrast, HSS has a number of very good tools that can be used. Generally speaking, there is also a need to shift out of a crisis response model; TSFs are good at resolving problems but more proactive options are required. Moreover, traditional technical support providers need to be convinced to allocate funding to organizations that are not accessing Global Fund funding. This will become even more critical as countries graduate out of the Global Fund portfolio. Technical support needs to be closer to the action (local and regional) and scaling up approaches such as coaching and mentoring will be critical for technical support on CSS. Consultants are generally not given the remit to build capacity. There is a lot of money available but there needs to be a strategy to determine where it is and how it can be accessed. While many technical support providers claim to have programming in these areas, in practice access is often limited to those already in the loop. The Joint Civil Society Action Plan (JCSAP) task team is held a meeting to look at the question of TS for key populations and civil society (Building Block 3: Building the right mechanism to facilitate civil society and key population support) (see Annex 5 8). There was also discussion about the model proposed by the Human Rights cluster at the Global Fund Secretariat which is piloting a model of regional and national technical support hubs. The model will be piloted as of June 2014, in the short-term there will be a call for applications for national and regional technical support providers with a proven track record and endorsement from key affected populations to enter technical support Hubs and build on the capacity that already exists. The group thought it would be useful for this to integrate a gender and CSS component, where possible. ACTION POINT WHAT: Finalize and publish paper WHO: Kelvin Storey WHEN: End of January

http://www.icaso.org/files/annex-5-building-the-right-mechanism-for-civil-society-to-accesssupport
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

4. Priorities for the IOTT for 2014

The two days of discussion yielded important insights for the role of the IOTT moving forward. It was agreed that the IOTT had an important ongoing role and should, inter alia, continue to raise the profile of CSS, given that CSS remains poorly understood, insufficiently financed, and yet critically important for ongoing efforts supported by external and domestic financing designed to have impact on the three diseases and that ICASO should continue its role as Secretariat (coordination). To improve the functioning, it was agreed that the IOTT needed a much clearer ToR. To that end, a number of principles were proposed: a. While immediate focus of the IOTT should be on the Global Fund given the launch of the NFM, the IOTT should commit to ensuring that CSS is more broadly used as a concept for the health and development community. b. The IOTT could act as a reference group 9 for the Global Fund Secretariat in developing policy guidance, and respond to information requests, as needed. The GFS could use the membership of the IOTT to select members of this reference group. c. The IOTT should be a vehicle for information sharing (tools, resources, and information) as well as joint strategizing but should not be creating products. d. The IOTT should have a broad focus on all three diseases (for e.g. the Global Plan on TB provides an opportunity to further integrate CSS in the TB response in 2014). e. The IOTT should advocate for increase recognition of CSS at the national, regional and global levels (policy frameworks, NSPs) and resourcing for CSS in national/regional responses. f. The IOTT should support the strengthening and expansion of the evidence-base on CSS via operational and other research. Key areas for future research are: CSS in the context of malaria and TB, understanding systems thinking in relation to communities and the impact of strengthened community systems on health. g. The IOTT should engage with national governments. The IOTT membership currently has funders, partners, civil society but no government representatives.
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Further online discussions provided some more information on how to roll out the CSS Reference Group. Issues included: The Global Fund expressed their desire to establish a reference group that is GF-specific and entirely dedicated to informing the roll out of the new funding model, GF policies, etc. There is a need to identify a group of IOTT members that are willing to invest their energy and time on advising the Global Fund, ensuring a quick turn, sometimes with non-disclosure / confidentiality agreement on issues that may be too sensitive or not ready to be shared with a broader group. There needs to some thoughts about the blurring or conceptual boundaries between working groups and reference groups. The latter should presumably be, literally, a group to which work is referred or concepts consulted. If the two are the same body of people then in effect those who produce rules, tools and direction, consult themselves and the group becomes less of a reference group and more of a self-reference group. Apart from obvious issues with potential group think, etc. there is a very practical danger. Those organizations with fewer resources, less connections and larger distances to travel will potentially slide out of the ambit of being referenced or consulted at all. The CSS Reference Group will fit well with thematic reference groups on human rights, key populations and gender and their role in the (broader) GDR advisory group.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 ACTION POINT WHAT: review and redevelop the IOTT ToR WHO: Matt Greenall (with support from Mauro, Kataisee, Chris, Jennifer and Blessi) WHEN: End of January It was also noted that given the imminent launch of the Global Funds New Funding Model there were priorities for promoting CSS in the NFM requiring immediate attention. The priority issues include the following: a. b. c. d. e. Monitoring CSS uptake in the NFM rollout. Capacity strengthening of the GF Secretariat (including internal capacity building for time to engage in processes). Ensuring CSS training is a core part of the JCSAP technical assistance work. Ensuring coordinated technical responses on CSS, Human Rights, Gender (country/regional). Targeted advocacy with governments and country teams to promote CSS.

Immediate next steps (in addition to the ones included through the note) a. Identify what other taskforces and global entities on CSS are doing to avoid duplication. b. Develop a CSS related-tool to help communities to design and implement activities. c. Create a roadmap highlighting where and how CSS can be integrated into national plans and processes.

5. Commitments
IOTT Secretariat Review IOTT terms of reference and membership list (By January 30, 2014) Finalize and publish 3 discussion papers on research agenda, CSS framework revision and technical support for CSS (By January 30, 2014) Disseminate mapping of CSS initiatives (By January 30, 2014) Make CSS-related resources available online (By January 30, 2014)

Global Fund Secretariat Finalize CSS information note Revise CSS indicators and circulate to IOTT review Revise the CSS framework to be coherent with the new funding model 12 | P a g e

Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 Convene a reference group on CSS drawing on the IOTT membership

At the end of the meeting, all participants made individual/personal commitments related to CSS, as follows:

Ken End of Jan support the development of the indicators and M&E approach. End of 2014 to have engaged the World Bank in CSS and IOTT, promote CSS with the OHA and other offices at USAID and review and provide feedback on the framework Matt End of Jan, contribute to the ToR of the IOTT, Inform Note, CSS research piloting, write and post about CS data gaps on Blog End of 2014 document CSS research results Maria Assist with the development of CSS measurements and refine the research agenda/ needs based recommendations from the pending CSS research gaps. Better inform USAID and CSS. Jenny Investigate whether there is enough CSS in the TB investment framework. Ask TBReach org commissioned for M&E for CSS examples for the dropbox. Jono Communicate extensively with CCS in 6 countries in Southern Africa and feedback. Translate IOTTese for civil society in Southern Africa. Feedback on most significant failures and successes on CSS in 80 communities. Feedback to regional network. Commit to pilot TB in our CSS work. Kate Review the draft CSS Guidance Note Kataisee I will work on revising ToRs with Matt Chris, Mauro and Blessi by Dec 15. I will circulate the update list of who is part of IOTT. I will deliver the report by the end of the year. I will review the report for the research agenda. Caoimhe I could investigate what information sharing platform we could use and support the coordination of the GF reference group and IOTT reference group as needed. Michael Following up on /supporting / resourcing CSS outside of GF grants. (linked to JCSAP). Kelvin Determine capacity for roll out of CCS modules. Jan 2014. Complete TS paper on CSS. Update / share CSS modules in simplified form. Document/ case studies on CSS. End of 2014.understand how CSS is reflected in the NFM and develop/engage local TA providers on CSS. End of 2015. Learn how CSS has reflected in the posit MDFGs agenda. David T. End year Jan IOTT survey revision to CCS framework, input into information note. End of 2014 - Consult with community reps going through the NFM and feedback to IOTT. End
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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

2015- support community organizations to critically engage in CCS development and visibility. Wrap head around what CSS would look like in an HIV and TB (co) and Malaria and TB.. Chris. Report back to UNAIDS and demonstrate to IOTT how CSS has been applied to treatment 2015. Flanny Participate in WG on development of CSS framework. Kanna Share information on TS hub support for NFM next year in my region and share CS documentation in dropbox. David R Work and support on links between CSS and human rights (through the human rights reference group and IOTT). Keep CSS in the Post 2015 key messages. There are other commitments related to: document (case study). Mauro Advocate for CSS beyond NFM GF. Strengthen capacity in the country team and make sure they can champion CSS during the country dialogue. There is a budget for IOTT next year. Strengthen the community and this partnership. Anton Help establish CSS reference group, better under understand and prepare to champion the CSS model and CSS components in the disease modules, profile NFM at ICASA, CSS Page on Alliance Page on All documents. Indicators and guidance note. Mette Trying to get the thinking into other networks. Try to get the thinking and discussion of where CSS is into the paper to be presented to the WB in March and the aim is to keep them on the commitment that they will have a workshop with IOTT and government by late 2014 to think how to integrate. IHP+ CS consultative group. Get West Africa in and other CS groups and bring them up to speed. Make sure AMREF is up to speed. Nadia Go back to researcher and George to give IOTT feedback to ensure the research agenda is actionable. Share the paper on CSS Research Agenda by mid-December. Go back to researcher and George t give IOTT feedback to ensure that the agenda is actionable. Gather documents n CSS best practice. Collect feedback on the Report. Blessi: Take outcomes to larger coalition of TB activists. 6 regional focal points in all the regions. Look at how capacity can be built by TS providers. Bring back info to contribute to info note. TB needs to come strongly thru the framework as well. Keep GTCA as the main player in that. Contributing to the indicators. Community engagement and mobilization and strengthening and what is available there and feedback and bring ground level realities to the research agenda.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

Raminta: Reporting back to EHRN. Discuss with EHRN once it receives money on proposals and HR mgmt. How to work with other EECA TS providers at regional level and in a few countries on CSS. Tool adaptation and regional workshop. Tools to assess the status of community systems of PID. How to document that and make available beyond Russian language.

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

The Inter Organization Task Team (IOTT) Community Systems Strengthening (CSS) Agenda
Global Fund Secretariat Chemin de Blandonnet 8 1214 Vernier Geneva, Switzerland 25-27 November 2013
Overall Goal: For organizations and individuals involved in convening the IOTT to reorganize, recommit and produce a 2-3 year roadmap outlining the role of the IOTT in moving the CSS agenda forward. Additional Objectives: To identify and map key existing and planned CSS related initiatives of IOTT members To identify and promote synergies with CSS efforts between members and other actors To identify gaps in CSS efforts not being addressed by key partners and agree on how to take them forward To present and review draft papers by the four IOTT Working Groups To discuss next steps to update CSS Guidance and modules for the NFM To begin ongoing dialogue on CSS, within the context of NFM, between core IOTT members with Global Fund Secretariat (GFS) key focal points

Day 1, Monday, November 25, 2013 Room R8B, Global Fund (8th Floor) Key objectives: To welcome and orient participants to the purpose of the meeting To exchange information and build common levels of understanding about current CSS activities being undertaken by IOTT members, as well as within the Global Fund To identify synergies and gaps in current activities To explore enhanced approaches to coordination and collaboration among IOTT members

Time Item 08:00 Coffee (outside meeting room) 08:30 08:30 - 09:00 Registration Housekeeping 09:00 9:30 Welcome Introductions Why are we here? Hopes for Change Objectives

Presenters/ Resource Robin Gorna, ASAP Kate Thomson, Head, Community, Rights and Gender Dept., Global Fund Secretariat; Mary Ann Torres, ICASO, IOTT Secretariat

Guiding Documents

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

Time 09:30 10:45

Item Update on CSS, in context of NFM History of CSS 2007-2013 How has CSS been understood, and what do we know about how funding has been delivered? The new funding model (NFM) How is CSS developing in the Global Fund: CSS Framework & CSS Module

10:45-11:15 11:15-12:45

What has the IOTT & its members been doing? Mary Ann Torres, ICASO - Mapping of CSS activities The mandate, role and timelines for the IOTT - Summary of CSS activities IOTT members initiatives on CSS review and David Traynor, GF from IOTT members Communities Delegation updates Presentations and Q & A LUNCH (Provided) The future of CSS: what role does the IOTT have in advancing political dimensions? Small Group Facilitators Leadership Advocacy Ownership Small group work BREAK The future of CSS: what role does the IOTT have in advancing technical dimensions? Evidence-base Coordination, synergy, alignment Ownership Small group work Plenary Review of Day 1 Group Dinner

Presenters/ Resource Anton Kerr, International HIV/AIDS Alliance; Matt Greenall, consultant; Abigail Moreland, Global Fund Secretariat Mauro Guarinieri, CSS Adviser, Global Fund Secretariat BREAK

Guiding Documents

- Global Fund CSS Framework; modules - Global MSM Forum CSS & Key Populations Discussion paper - NFM Explained

12:45-13:45 13:45-15:15

15:15 15:45 15:45-17:00

Small Group Facilitators

17:00 17:30 19:30 21:30

Matt Greenall Robin Gorna

Omnibus Caf, http://www.omnibuscafe.ch/

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 Day 2, Tuesday, November 26, 2013 Room R9B, Global Fund (9th Floor) Key objectives: To present and review draft papers by the four IOTT Working Groups To discuss next steps to update CSS Guidance and modules for the NFM To raise awareness of the importance of CSS with key GFS staff To develop a 2-3 year roadmap outlining the role of the IOTT in moving the CSS agenda forward and the key steps to be taken and structures that will be put in place.

Time 08:30 09:00 09:00 09:30 9:30 10:15

Item Coffee (outside meeting room) Review of Day 1 Outstanding questions Overview of key issues to be addressed (from Day 1) Revision of CSS Framework Working Group One Paper discussion of draft CSS Information Note update Presentation, Q & A Defining next steps BREAK Revision of CSS Indicators Discussion of progress to date Links with Human Rights Indicators Presentation, Q & A Defining next steps

Presenters/ Resource

Guiding Documents
- Agenda

Robin Gorna and Mauro Guarinieri Michael OConnor Matt Greenall

- Draft Framework Paper - New CSS Information note

10:15 10:30 10:30 11:15

11:15 12:00 12:00 14:00 14:00 14:15 14:15 15:00

Development of Research Agenda Nadia Rafif, MSMGF - Slide deck Working Group Three Paper Presentation, Q & A Defining next steps BROWN BAG LUNCH (Provided) Presentation on CSS to all interested GFS, Stop TB, Roll Back Malaria and UNAIDS staff Dialogue on how to advance CSS through the Global Fund Draft Paper Recap of morning session Robin Gorna Technical Support on CSS Working Group Four Presentation JCSAP TA paper Human Rights technical support links Presentation, Q & A Defining next steps Kelvin Storey Michael OConnor Meg Davis
- Slide deck - JCSAP TA paper

Ken Sklaw, USAID Meg Davis, Human Rights Adviser, Global Fund Secretariat

- Draft indicators

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013

Time 15:00-17:00

Item Future working together on CSS: completing the road map How will we work together over the next 6 months, 1 year, 2-3 years? Organisational and personal commitments Small group work BREAK Plenary Review Wrap Up CLOSE

Presenters/ Resource Small Group Facilitators Matt Greenall Mauro Guarinieri Robin Gorna

Guiding Documents

As needed 17:00 18:00 18:30

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 Day 3, Wednesday, November 27, 2013 Room R8B, Global Fund (8th Floor) Goal: To begin a dialogue on CSS between the IOTT and key focal points at the Global Fund Secretariat (GFS) Key objectives: To engage with GFS focal points and explore strategic opportunities to take forward CSS priorities To identify where leadership and action on CSS sits in Global Fund processes and initiatives, and entry points for influence within the Global Fund To plan next steps for joint work between the IOTT CSS and the Global Fund Secretariat

Time 09:00 10:00

Item Review of large group meeting discussions Outstanding questions Overview of key issues to be addressed (from Day 1)

Participants Robin Gorna (Facilitator) Matt Greenall Raoul Fransen David Traynor Michael OConnor Anton Kerr David Ruiz Maria Au Revanta Dharmarajah Flanny Chiganze Kataisee Richardson Kate Thomson Mauro Guarinieri Robin Gorna (Facilitator) 10 IOTT members Sally Smith/Chris Mallouris, UNAIDS; Kate Thomson, Mauro Guarinieri, GFS; GFS Focal points (TBC) LUNCH and CLOSE

Guiding Documents

10:00 12:00

Next steps on joint work, to include: GFS guidance Technical capacity in GFS Political commitment and leadership Next steps through JCSAP Technical support on CSS Prioritisation of support on CSS Engaging with UNAIDS & others

Summary of 25-26 Nov meeting

12:00

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Draft Note for the Record (NFR) 28 February 2014 IOTT meeting Geneva, November 2013 Participant List Family Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
Storey Rafif Dietrich Gunthorp Traynor Fransen O'Connor Ofield-Kerr Ruiz Sklaw Au Greenall Torres Guarinieri Thomson Smyth Chong Dharmarajah Chiganze Stuikyte Kinoti Richardson Kumar Smith Mallouris Gorna

First Name
Kelvin Nadia Jenniffer Jonathan David Raoul Michael Anton David Ken Maria Matthew Mary Ann Mauro Kate Caoimhe Susan Revanta Flanny Raminta Mette Kataisee Blessi Sally Chris Robin

Email
storeyk@ratn.org nrafif@msmgf.org dietrichj@who.int gunthorp@satregional.org david@citechange.com rf@icssuport.org michocon@gmail.com aofield-kerr@aidsalliance.org druiz@stopaidsalliance.org ksklaw@usaid.gov mau@usaid.gov mgreenall@gmail.com MaryAnnT@Icaso.org Mauro.Guarinieri@theglobalfund.org Kate.Thomson@theglobalfund.org caoimhe.smyth@theglobalfund.org S.Chong@latrobe.edu.au revanta@hotmail.com; rdharmarajah@khana.org.kh chiganze@satregional.org raminta.stuikyte@gmail.com Mette.kjaer@Amref.org kataiseer@icaso.org 'blessi.k@gmail.com' smiths@unaids.org mallourisc@unaids.org robin@asapltd.com

Organization
Consultant MSMGF Stop TB Partnership Southern African AIDS Trust Communitities Delegation ICSS Consultant International HIV/AIDS Alliance Stop AIDS Alliance USAID USAID Consultant ICASO Global Fund Global Fund Global Fund La Trobe University Khana (Cambodia TS hub) Southern African AIDS Trust EHRN AMREF ICASO Global Coalition of TB activists UNAIDS UNAIDS ASAP

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