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January 2016

Your input is needed on the Global Fund’s Key Performance Indicators and the Narrative Summary
The purpose of this Alert is to inform civil society and key and vulnerable populations of opportunities to continue to input into the
development of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) Strategy 2017-2022 through the key
performance indicators.
In 2015, ICASO working in partnership with International Civil Society Support (ICSS), monitored the process to develop the Strategic
Framework and provided input into the Partnership Forums in Addis Ababa, Bangkok and Buenos Aires on key issues of concerns for
community and key and vulnerable populations. A summary of recommendations compiled and reported through this process can be
found here and here.
As a follow up to this work, ICASO has reviewed the key performance indicators (KPIs) being developed by the Global Fund to monitor
the extent to which the concerns raised during the extensive feedback process on the Strategic Framework have been reflected. The
Global Fund secretariat has asked for feedback on the draft KPIs by February 6, 2016 and the narrative summary of the strategy by
February 11, 2016. The KPIs will be reviewed by the Board Committees in March 2016 and approved by the Board at their meeting on
April 27-28, 2016.
The table below summarizes initial gaps and outstanding questions about the KPIs that have been raised over the course of the
consultation process. ICASO welcomes input and will share comments received with the board delegations and the secretariat. Please
send comments to

Objective and sub-objectives
Strategic Vision Invest funds to

KPI 1: Performance

Comments and Questions
The specific targets are still under development with Partners. As discussed

maximize portfolio impact

Objective 1 The Maximize
impact against HIV, TB and
malaria by investing funds to
maximize impact

a) Scale-up evidence-based
interventions with a focus on the
highest burden countries with the
lowest economic capacity and on
key and vulnerable populations
disproportionately affected by the
three diseases
b) Evolve the allocation model and
processes for greater impact,
including innovative approaches
differentiated to country needs
c) Support grant implementation
success based on impact,
effectiveness, risk analysis and
d) Improve effectiveness in
challenging operating
environments through innovation,
increased flexibility and
e) Support sustainable responses
for epidemic control and
successful transitions

against impact targets
KPI 2: Performance
against service delivery
KPI 3: Align investment
with need
KPI 4: Investment
KPI 5: Coverage for key

during the Partnership Forums it is important to monitor targets to ensure
that they are ambitious enough to address the epidemics. (see slide 14 in
Global Fund presentation KPI framework Proposals - constituency
consultations FINAL.pdf)
The KPIs under Objective 1 are strong and it is worth noting that an explicit
KPI on coverage for key populations is a good step forward. The narrative for
the strategy (Draft Global Fund Strategy 2017-2022 22-1-2016 .pdf) presents
what the Global Fund will do to support countries to transition to fully
funding programming. It references supporting efforts to remove policy,
legal and human rights barriers to services for those in need, advancing
gender equality, and ensuring that the barriers which impede the ability of
civil society to provide services and hold their governments accountable are
However, it is not clear how Sub Objective 1 e) will be tracked and reported
on. As the Partnership Forum consultations on the strategy demonstrated,
transition is a crucial area of concern for many constituencies. Successful
transitions will involve funding for policy advocacy for regulatory reform and
legislative/governance changes to ensure funding is included in government
budgets. The Global Fund tends to measure services and commodities as
reflected in the KPIs proposed so far. Measuring ‘soft issues’ such as policy
and systems reform will be a new but important challenge to make sure
Objective 1e) is tracked.
It could be that tracking the success of transitions is being measured to some
extent by KPI 9 c) key populations and human rights in transition countries
but this KPI is too narrow as it stands.


Objective 2 Build resilient and
sustainable systems for health
(RSSH) by improving the
performance of strategically
important components of national
systems for health

a) Strengthen community
responses and systems
b) Support reproductive, women’s,
children’s, and adolescent health,
and platforms for integrated
service delivery
c) Strengthen global and incountry procurement and supply
chain systems
d) Leverage critical investments in
human resources for health
e) Strengthen data systems for
health and countries’ capacities for
analysis and use
f) Strengthen and align to robust
national health strategies and
national disease-specific strategic
g) Strengthen financial
management and oversight

KPI 6: Strengthen
systems for health
KPI 7: Fund utilization

The draft KPIs for Objective 2 includes a list of operational KPIs, which are
tracked by the secretariat as a way of measuring progress in meeting the
overall objective and helping to identify areas where course-correcting is
required. The Operational KPIs for resilient and sustainable systems for
health (RSSH) track important issues such as procurement, supply chain,
financial management, ability to report on key indicators, use of data and
health management information systems. Most of these measures are key
components of a health system and they have well document links to strong
health systems as defined by the WHO.
Unfortunately, this set of operational KPIs does not seem to measure sub
objectives: 2 a) and 2 b). In light of this, these Operational KPIs should be
reviewed to make sure 2a and 2b can be tracked and reported on as
contributed to Objective 2

During the Partnership Forums, civil society noted several other
important issues that should be considered in regards to measuring
community systems. They include:
 setting a specific funding target in each country for community and
key population lead activities including advocacy and ‘watchdogging’
 developing better resources and tools to deepen country level
expertise in the community response and community systems
 building the evidence to justify funding community responses and
CSS and provide focused capacity-building with governments to help
them appreciate the importance of a comprehensive, inclusive
 developing a KPI to measure improved community engagement in
the responses to the three diseases and a tool to quantify crosscutting matters such as meaningful engagement and investing in

developing KPIs that track scale-up of support to vulnerable and key
populations (note this may the intentions of KPI 9b)

These suggestions may be appropriate topics to be included at
operational KPI in support of this objective. (see recommendations on
Objective 3 Promote and
protect human rights and
gender equality by reducing
human rights barriers to service
access and reducing gender and age
disparities in health

a) Scale-up programs to support
women and girls, including
programs to advance sexual and
reproductive health and rights
b) Invest to reduce health
inequities including gender- and
age-related disparities
c) Introduce and scale-up
programs that remove human
rights barriers to accessing HIV,
TB and malaria services.
d) Integrate human rights
considerations throughout the
grant cycle and in policies and
policy-making processes
e) Support meaningful

KPI 8: Gender & age
KPI 9: Human rights:
a) Reduce human rights
barriers to services
b) key populations and
human rights in middle
income countries
c) key populations and
human rights in
transition countries

As indicated in the draft KPIs the gender and human rights KPIs will be
challenging since the data is not routinely collected. Despite this, these
KPIs are an important step forward on both gender and human rights
fronts. We note that the indicators suggested tend to focus on HIV.
Measurements relevant to malaria and TB need to be specified and/or
It is not clear from the KPIs how sub Objective e) will be measured—
perhaps an operational KPI would be required.
It is also worth noting that the civil society input to the strategy noted a
number of other ways to promote and protect human rights and gender
equality including:
 developing institutional and Global Fund staff-level performance
indicators on gender equality
 increasing the visibility of gender equality and women and girls
issues in Global Fund communications and advocacy materials
 ensuring that gender- and age-disaggregated data is collected
through the right indicators to monitor the effectiveness of program
outcomes for women and girls
 increasing investments in programs that address barriers women
and girls face in accessing information, education, support services

engagement of key and vulnerable
populations and networks in
Global Fund-related processes

Objective 4 Mobilize increased
resources by increasing available
resources for HIV, tuberculosis and
malaria, and ensuring the
availability of affordable quality
assured health technologies

a) Attract additional financial and
programmatic resources for health
from current and new public and
private sources
b) Support countries to use
existing resources more efficiently
and to increase domestic resource
c) Implement and partner on
market shaping efforts that
increase access to affordable,
quality-assured key medicines and
d) Support efforts to stimulate
innovation and facilitate the rapid

KPI 10: Resource
KPI 11: Domestic
KPI 12: Availability of
affordable health

investing in programs that transform harmful gender norms and
address unequal power relationships
supporting the meaningful participation of women’s groups in
country-level mechanisms and processes through sustained funding
and technical assistance

These suggestions may be relevant at the operational KPI level --(see p. 3
of recommendations )
There are no specific comments at the moment


introduction and scale-up of costeffective health technologies and
implementation models