Discussion Paper

The Global Fund Process in Angola: An analysis of the failure of the

second round

Compiled by: Rob Kevlihan Country Director, GOAL Angola1

Date: 21 October 2002

1
The views expressed in this paper are the views of the author and do not reflect the views and position
of any organization; the author was field director for GOAL in Angola when this report was written.
 Contents

Description Page

Summary 3

1. Introduction 4

What is the Global Fund? 4

Partnership concept and the Country Co-ordinating Mechanism 4
Proposal Process 4
Management of the fund in country 4
Experience of the first round grant making process 4

2. Angolan Global Fund Process to date 5

Origins of the CCM and the first round of the Global Fund 5
Constitution of the CCM 5
Organisation of the CCM and requests for Project Ideas 6
Expert Panel 6
Selection of Project Ideas 6
Formulation process for the Global fund proposal 7
First presentation of outline proposal 8
Appointment of Principal Recipient 8
Presentation of draft budgets for HIV/AIDS & TB and
deferral of Malaria to a future round 9
Final CCM meeting – shut down of the proposal by the Government 10

3. Analysis and Lessons Learned 11

Design Issues 11
Implementation Issues 11
Lessons Learned 12

4. Possible way forward for CONGA 13

Appendix A Panel of Experts 15

Appendix B List of members of CCM 16

Appendix C Composition of Working Groups for Development of 17

the Global Fund proposal.

Appendix D HIV / AIDS Project Ideas approved by the Expert Panel 18

but excluded from the draft HIV / AIDS budget

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 Summary

This discussion paper summarises the situation to date in Angola with regard to the Global Fund for
AIDS, TB and Malaria and analyses the failure of the Angola Country Co-ordinating Mechanism (CCM)
to successfully create and submit a proposal for one or more of the three diseases in the second round, the
deadline for which was the 27th of September 2002. GOAL was one five international NGOs represented
on the CCM.2 Along with many other participants, GOAL was severely disappointed with the failure to
submit in the second round, despite a considerable expenditure of time and resources in the process.

This paper notes that there were several weaknesses in the preparation process of the Global Fund
proposal that has made the process particularly difficult. Design flaws included the manner in with the
CCM was formed, its size and composition, the lack of an overarching strategic framework for each
disease prior to development of NGO project ideas, the lack of fully developed project proposals and
weak structures to assist in greater participation by NNGOs given their capacity issues. Flaws in
implementation of the process included the fact that the entire process was too rushed, the timing of
consultants that could have added value to the process was poorly planned, the proposal should not have
been primarily written by MoH personnel, and the actual process of writing the proposal after the work of
the Expert Panel lacked transparency and did not involve sufficient consultation with affected NGOs. For
future rounds, a neutral, authoritative team of consultants is required in order to project manage the entire
process in an equitable manner. More fundamentally, the behaviour of the Angolan Government in the
drafting of the proposal for the second round points to a lack of understanding and / or acceptance on their
part of the partnership principal envisaged by the Global Fund. This will need to change in order for the
CCM process to have any chance of success in the third round.

The paper concludes that for INGOs there are some lessons to be learned. The first is that greater
CONGA involvement is required in the CCM in order to strengthen the NGO position and increase the
flow of information to INGOs. The second is that better links need to be built with NNGOs, including
NNGOs not represented on the CCM, perhaps through FONGA. Thirdly, CONGA needs to consider how
it can better interact with key governmental personnel involved in the process and rebuild confidence on
all sides after the collapse of the second round process. Finally, NGOs now need to develop a strategy in
advance of the third round to ensure that Angola succeeds in submitting a proposal in the third round.

This paper advocates for a pragmatic approach that in the first instance seeks to strengthen and reform the
partnership approach through the CCM. Our primary objective should still be to create a truly
participative proposal that reflects the huge needs Angola faces with respect to these three diseases, that
builds on current capacities to respond and that reflects the legitimate interests of all stakeholders (in
particular beneficiaries).

However, given the failure of the second round process, GOAL also considers it appropriate to enter into
the third round with a contingency plan in the event of continued failure in the CCM process. This must
involve the creation of an independent NGO proposal to be submitted in the event of deadlock or failure
within the CCM. This proposal may also serve as a possible bargaining chip in the CCM process to
ensure a more enlightened approach in the third round. Ideally, such an NGO proposal should include
both international and national NGOs with capability to scale up existing operations and demonstrated
capacity to deliver. Designing such a proposal that includes NNGOs in an equitable manner will be a
challenge.

Possible next steps for CONGA include endorsement of a strategy for the third round, creation of a
CONGA sub group for the Global Fund and commencement of a series of meetings with other
stakeholders setting out CONGA’s position and seeking to move the process forward.

In the final analysis, national ownership, transparency and measurable impact must be the principles that
underlie this entire process. CONGA should play a proactive role in working to maintain these principles,
with its ultimate focus being on service delivery that meets the needs of the Angolan people with respect
to HIV /AIDS, malaria and TB.

2
The others being Population Services International, IPMP, CUAMM and ADPP.

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1. Introduction

What is the Global Fund?

The Global Fund to fight AIDS, Tuberculosis and Malaria was set up in January 2002 as a
financial instrument complementary to existing programmes addressing HIV / AIDS, TB and
malaria. It is not a UN agency nor can it fund UN agencies in their activities. The purpose of the
fund is to attract, manage and disburse additional resources through a new public-private
partnership that will make a sustainable and significant contribution to the reduction of
infections, illness and death from these three diseases.

Partnership Concept and the Country Co-ordinating Mechanism

National ownership of programmes and partnership should lie at the heart of the Global Fund
process. The Fund requires the establishment of a Country Co-ordinating Mechanism, which
should be ‘an inclusive, collaborative partnership, with all relevant partners engaged in
planning, decision making and implementation.’ CCMs should include broad representations
from the government, NGOs, civil society, multilateral and bilateral agencies and the private
sector. In practice the Global Fund expects that country proposals will be submitted and signed
by all members of the CCM. However, a caveat is that where a public private partnership does
not exist (which would include where a CCM has failed to establish such a partnership), the
fund may support alternative partnerships among NGOs and the private sector.

Proposal Process
The Global Fund issues calls for proposals with deadline dates for submission of Country
Proposals to their offices in Geneva. The first round was held early in 2002, the second round in
late September. It is not yet clear when the third round will be, though it is expected to occur
early in 2003. Proposals may be submitted by the CCM (or alternative partnerships) for one,
two or all three diseases in the same round. Countries can submit for components of particular
diseases in one round and submit for other components in following rounds. Funding can be
sought for up to three years.

The Global Fund places a premium on scaling up existing interventions and on complementing
current initiatives rather than funding completely new initiatives. Demonstrating the availability
of matching funds is also considered an advantage.

Management of the Fund in country

As part of the process of designing the proposal, the CCM must nominate one or more Principal
Recipients (PR). The PR should be a member of the CCM and is responsible for receipt and
disbursement of funds, monitoring and evaluation of Global Fund projects and reporting on
progress back to the Global Fund. It is possible to have a PR for one, two or all three
components. While the Government can in theory act as the PR, to date no country in Africa has
nominated the government to be the PR. Current PR’s include bilateral agencies, IGOs, NGOs
and other pre existing local funding structures.

The Global Fund will also appoint a Local Partner Organisation directly, who will assess the
capacity and systems put in place by the PR, oversee and assist the PR in the financial
management and implementation of the proposal, advise the Global Fund on disbursement and
report to the Fund on implementation and progress. In effect the LPO will be the eyes and ears
of the Global Fund in country. The LPO will not be a member of the CCM.

Experience of the first round grant making process

In the first round the Global Fund approved 40 country proposals, with a total spend of
US$429m. This funding was approved for the first two years of activities with further funding
being dependent upon performance. The geographical spread of funding was as follows:

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Region Countries Funded US$ Amount %
(approx.)
Europe Moldavia, Tajikistan, Ukraine, Yugoslavia 38.6m 9%
Southeast Asia Indonesia, Myanmar / Thailand, Thailand 38.6m 9%
Americas Argentina, Chile, Haiti, Honduras 68.6m 16%
Africa Burundi, Ethiopia, Zambia, Ghana, Kenya, Malawi, 253.2m 59%
Nigeria, Rwanda, South Africa, Senegal, Tanzania,
Uganda, Zambia, Zimbabwe
Western Pacific Cambodia, Laos, Vietnam 21.4m 5%
Eastern Med. Morocco 4.3m 1%
Global 4.3m 1%
Total 429m 100%

Grants ranged in size from as little as US$1 to US$2m to more than US$50m. Approximately
60% of the finding committed for the first two years was assigned to HIV / AIDS programmes.
In two instances grants were made to sub country level CCMs (Kwa Zulu Natal in South Africa
and Zanzibar in Tanzania) and in one instance a grant was made direct to an NGO, instead of to
a CCM (PSI in Madagascar for malaria activities). Many countries submitted more than one
proposal, and in some instances, more than one proposal was submitted to cover different
components of the same disease. Interestingly Nigeria submitted one proposal entitled ‘Proposal
to Assess and Promote the Effective participation of Civil Society Organisations in the National
response to HIV / AIDS’. More information on the Global Fund process and progress to date
can be found at www.globalfundatm.org

2. Angolan Global Fund Process to date

Origins of the CCM and the first round of the Global Fund
The origins of the Angola CCM lie in a pre-existing co-ordination mechanism established at the
end of 2001 for HIV / AIDS. In late 2001 the UN and the Ministry of Health established a HIV /
AIDS Theme group to act as a mechanism for joint policy formulation and strategic decision
making with respect to HIV / AIDS in Angola. This forum included many of the actors that
ultimately became involved in the CCM. The Theme Group met a number of times to discuss
and develop strategies and structures for responding to the HIV / AIDS situation in Angola. In
early February 2002 a Theme Group meeting was held where the question of the Global Fund
was raised for the first time. At this meeting it was proposed that a CCM be rapidly formed to
submit a proposal to the first round for the Global Fund (deadline mid February 02). The
argument was made that the criteria for disbursement in the first round would be light and that it
might be easier to win a grant than in later rounds. This proposal met with strong objections
(particularly from some donors and NGOs) given the short time period available to prepare a
document and the impossibility of having a truly consultative process. As a result it was decided
to wait until the second round, which at that time was expected to fall in July 2002.

Constitution of the CCM

The actual constitution of the CCM began in late April / early May 2002. An initial open
meeting was hosted by Dr. José Eduardo Van Dunem (the Vice Minister of Health) at the
Ministry of Health that was attended by many INGOs. At the meeting a CCM was created by
acclamation, and supposedly constituted the entire gathering of at least 50-60 different
organisations. A Panel of Experts (See Appendix A for list of Experts) was presented to the
meeting by the Vice Minister to assist in the process of identifying projects for submission to
the Global Fund. A subsequent briefing by a US based consultant that had participated in
Nigeria’s successful Global Fund proposal resulted in a change in this structure. The consultant
made clear that the CCM had to constitute a small working group, rather than a large assembly,
in order for it to be effective. The CCM had to have written rules and required complete
consensus in submission of the final proposal (as evidenced by the signature of all CCM
members in the proposal submission).
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As a result, at a meeting held on the 15th of May, a new CCM was established, comprising of
approx. 30 members. The nucleus of this CCM was the UN Theme Group, expanded somewhat
to include some organisations working in other sectors. This revised structure did build on an
existing co-ordination mechanism (which is recommended by the Global Fund), though there
was no consultation with the previous assembly regarding composition of the new CCM. In
addition, the final number of CCM participants was twice as high as recommended and
membership was decided in quite an arbitrary manner largely based on who happened to be
present when the CCM was finally established. See Appendix B for a list of CCM Members.

Organisation of the CCM and requests for Project Ideas

The organisation of the CCM remained a work in progress through May and June. Written
regulations for the operation of the CCM were developed in draft form and ultimately finalised
in mid August. In the meantime, organisations who had attended the first meeting (in late April /
early May) were requested to submit project ideas per a prescribed format to the CCM for
analysis by the end of May. In this first round of proposals a total of 19 concepts were submitted
with a total cost of approx. US$188m (including four separate proposals by the same private
organisation for drugs procurement to the value of US$ 121m). The deadline for submission of
Country Proposals was subsequently extended by the Global Fund until late September.
Because of the extended deadline, the perceived need for a more open process and complaints
by national NGO representatives that there were not enough NNGO proposals included, the
deadline for submission of project ideas for inclusion in Angola’s Global Fund proposal was
subsequently extended to the 01 July 2002. In order to assist in opening the process to other
interested parties, an advertisement was also placed in a national newspaper with regard to the
process / application deadline and a training workshop was organised (for the 20th and 21st of
June) to explain the formatting and application process (this was primarily aimed at NNGOs).
However, the timing of these initiatives remained tight, with little time allowed between the
advertisement, workshop and the submission deadline.3

Expert Panel
Under the new CCM, it was decided to maintain the same expert panel for evaluation of project
ideas. The expert panel met a number of times over the June and July period to develop criteria
for evaluation of the submissions to be accepted. As all had fulltime day jobs, co-ordination of
the panel was difficult, and it was felt there was a general lack of leadership in the structure with
no one person assigned responsibility for convening the panel and organising it correctly.
Nonetheless, a set of transparent criteria were ultimately developed and a work methodology
adopted – each concept to be evaluated by three experts, with an agreed scoring system. It was
also agreed that no expert could evaluate a proposal which they had been involved in writing or
about which it could be perceived that they would not be impartial.

Selection of Project Ideas

A follow-up meeting of the CCM was held in mid August to review the conclusions of the
Expert Panel. A total of 80 Project Ideas had been reviewed (including the previous 19 received
earlier) with a total value of US$160m. See table 1 below.

3
A note was sent around the CONGA listserv on the 19th of June regarding the training workshop to be held on the 20th, while a
second notice was sent on the CONGA listserv on the 20th regarding the extension of the application deadline to the 01 July.

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Table 1: Summary of Projects Analysed by Expert Panel
Project Ideas Number % (by number of Value (US$)4 % (by cost)
proposals)
Approved 43 54% 64,055,808 40%
Rejected 37 46% 96,022,622 60%
Total 80 100% 160,078,430 100%

Of the 43 project ideas approved, some 27 were approved with changes required, while 16 were
approved without any changes.

Formulation process for Global Fund Proposal

In order to develop the actual proposal itself, a Technical Co-ordination group and three
working groups were formed (one for each disease) to write proposals for each constituent part.
See Appendix C for composition of these groups.

Several issues at the outset made the job of compiling proper proposals challenging. The first
was the time constraint. The technical working groups really only got going in mid August,
which effectively only gave them five weeks to compile the proposal.

Added to this was a structural issue – the groups had 27 project ideas from NGOs (11 of which
required changes) which came out of the largely transparent Expert Panel process. These had to
be integrated into government plans for the Global Fund. Because there had been no agreed
strategic framework / outline of overall objectives etc. for the proposal in the beginning, this
meant that the drafters of the proposal were presented with a disconnected series of activities
that needed to be integrated into a cohesive whole.5 The TB proposal is perhaps an exception to
this as project ideas for TB reflected the national strategic plan quite closely and as a result
synthesis was not that difficult.

The Global Fund proposals themselves were being written in Portuguese (despite the fact that
the actual proposal had to be submitted in English to the Global Fund) by the Government
appointees to the working groups. While the commitment exhibited by some of these draftees
(particularly with respect to HIV / AIDS) was impressive, they were hampered by a lack of
practical experience in writing funding proposals of this nature. The actual co-ordinating group /
working group structure for writing the proposals also did not work effectively with government
appointees apparently taking over almost sole responsibility (at least in the case of HIV / AIDS
and malaria) for drafting the documents and changes to drafts being made during translation to
English by members of the co-ordinating group without full consultation within the actual
working groups. In the case of malaria the external consultant brought in to assist in the process
was completely excluded from the writing process in the final stages.

As the almost sole drafters of the Portuguese version Government appointees were also the ones
tasked with integrating NGO concepts into what they considered to be a Government proposal.6
In practice these writers did not consult further with NGOs on the status of their proposals, the
degree to which they had been included, or the budgetary amount to be included. Other working
group members contributed to varying degrees, and in some instances ‘fought for’ NGO
projects to be included more fully. However, co-ordination group members also made arbitrary

4
The reduction in the total monetary value of all proposals compared to the first batch of submissions appears to have been due to
the withdrawal of two of the large drugs purchase proposals previously submitted by a private company to the value US$66m. The
two other submissions by the same company with a value of US$54m were turned down.
5
In theory the national Strategic Plans should have provided a baseline for this. In practice these were not referred to in the
introduction stage. Some of the plans are also considerably out of date (particularly for HIV / AIDS) which would have also reduced
their utility.
6
It is also noteworthy that at various stages of CCM discussions, the point was made by some Government officials that the Global
Fund proposal would have to be approved by the Council of Ministers. This position points towards the Governments attitude to the
CCM process itself, which it saw as subordinate to its plans and initiatives and essentially emanating from them, rather than as a
new public / private initiative based on a partnership of equals through the CCM.

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amendments to proposals as drafts were translated to English. This process of excluding and
changing NGO project ideas that had been approved by the Panel of Experts was based on the
rationale that only ‘Project Ideas’ had been approved by the expert panel and not specific
proposals with worked out budgets. This resulted in the steady erosion of NGO inclusion when
compared with the project ideas approved by the Expert Panel. The net result was that in the
final drafts of the Global Fund proposals for TB and HIV / AIDS, only those INGOs that were
actually members of the CCM were still included. See Appendix D for a list of NGOs excluded
from the final draft of the HIV / AIDS proposal. Given that the CCM was never presented with
a draft of the malaria proposal, and the manner in which the malaria proposal was written (i.e.
with even less consultation than the other two), it is not unreasonable to surmise that a similar
process of NGO exclusion occurred.

The governments decision to target only six provinces in the proposal also excluded many NGO
activities from this round.7 This decision was taken arbitrarily by the government without any
consultation in the CCM with partners.

First presentation of outline proposal

The CCM was presented with an outline Power-point presentation by the Technical Working
Groups on the 6th of September. This presentation was quite general and did not include budget
numbers, though Government strategy with regard to targeting only six provinces for the CCM
proposal was made clear at that time, as was the view that ‘project ideas’ approved by the
Expert Panel were malleable and did not need to be included in full.

GOAL, along with some other INGO members of the CCM, expressed strong concerns with
regard to the transparency of the drafting process, the lack of consultation on changes made and
the need to maintain the integrity of the approval process by the expert panel. Assurances were
given by the Vice Minister Van Dunem (who was chairing the meeting) that all projects
approved by the Panel would be included, though this was later contradicted by other MoH
personnel involved in the meeting. In the end the question was fudged and passed to the Expert
Panel for a decision. Ultimately, no definitive decision or agreed process of adjustment to
approved NGO Project Ideas was arrived at.

ANASO also protested the small amounts of funds allocated to them relative to INGOs and the
loss of autonomy inherent in receiving funds through INGOs.

Ultimately, on the basis of the presentations made, the technical working groups were tasked
with continuing to develop draft proposals for review by the CCM.

Appointment of Principal Recipient

The question of the Principal Recipient(s) was first raised at a CCM meeting on the 18th of
September (less than two weeks before the deadline for submission). Per Global Fund
guidelines, the PR has to be a member of the CCM. It was clarified later that if a suitable
candidate was found that was not a member of the CCM, they could be elected to the CCM as
part of their nomination process to be a PR.

It was clear from the outset that this would be a difficult issue to resolve, with the Government
(at least in the first meeting) apparently expecting to be the PR. A subsequent presentation by a
senior UNAIDS consultant on experiences in other countries made clear that no African country
had nominated the Government as the PR. This also reflects comments by the Harvard based
consultant who had come out in June regarding the need for transparency in financial
arrangements. Ultimately a number of candidates were found, though only in the week before
the submission deadline. These included the following:

7
Though expansion to other provinces might have been possible in subsequent rounds.

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International Organisation for Migration (IOM): IOM while not a member of the CCM,
volunteered to act as PR for any or all of the three diseases, though their stated preference was
for HIV / AIDS. IOM is an inter governmental organisation (though not a UN organisation), and
has been nominated to act as PR in Colombia as part of their Global Fund process. IOM
submitted a written proposal to act as PR to the CCM on the 23rd Sept 02.

ASDI (Swedish Co-operation): ASDI is a member of the CCM and offered to act as PR for the
HIV / AIDS component of the Global Fund proposal. ASDI circulated a written proposal to be
PR to the CCM on the 23rd September 02.

FAS (Fundo Apoio Social): FAS (a joint World Bank / Government body) proposed their
candidature for all three diseases. FAS is not a member of the CCM. FAS circulated a copy of
their ‘Manual De Desembolsos’ to members of the CCM, and made a verbal presentation but
did not submit a written proposal to be PR.

CUAMM: CUAMM, an Italian NGO, is a member of the CCM and offered to act as PR for the
TB component. They were also a major proposed implementor in the draft TB proposal for the
Global Fund. CUAMM submitted a written proposal to be a PR to the CCM on the 23rd of
September.

In the end this question was not decided upon because of the failure to agree on final Global
Fund proposals (see below)

Presentation of draft budgets for HIV / AIDS and TB and deferral of Malaria to a future round
On Friday the 20th of September the CCM met to review the draft proposals for all three
diseases. It was anticipated that written drafts would be presented to the CCM for review and
comment prior to possible signature on Monday the 23rd September. For a hard copy of the
proposal to be submitted to Geneva using DHL by the deadline of the 27th of September,
Monday the 23rd was the last possible day for signature, unless the proposal was hand carried,
in which case Wednesday the 25th was the absolute last day.

Unfortunately, all that was presented to the CCM at that time was draft budgets for TB and HIV
/ AIDS. No written information was presented for malaria, though a verbal report from the
(government appointed) head of the malaria working group indicated that the proposal was in
good technical condition and still being drafted.

Tuberculosis: The amount requested from the Global Fund was relatively modest at US$
3,593,473, split 50.6% for NGOs (mostly CUAMM) and 49.4% for the Government.
Additionally matching funds from other sources of US$1,558,399 were listed, comprising both
contributions from the Government and from donors. A WHO TB consultant pointed out that
the budget could be reduced further by accessing essential drugs from the Global TB Drug
facility and that some revision would be required to reflect this over the weekend. Nonetheless,
the budget was reasonable, apparently open to easy revision to reflect the availability of the
Global TB drug facility and generally uncontroversial. After a vote by the CCM it was agreed
that the drafters should work over the weekend to try to finalise the budget and present the
proposal to a specially convened CCM meeting on Monday for review and possible approval.

HIV / AIDS: The amount requested from the Global Fund as per the draft budget of the 20th of
September totalled US$12,885,678 over two years, 70% allocated to NGOs and 30% to the
government. Major activities to be implemented by NGOs included Voluntary Counselling and
Testing (split between PSI, GOAL, MSI, IPMP and ADPP, with further subcontracting planned
to other NGOs) of US$4.2m and social marketing of condoms of approx. US$8.2m (for PSI
with local partner NGOs to be subcontracted). Smaller grants totalling US$ 473,000 were also
allocated to local organisations (CAJ, PLWA group and MAR).

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It is notable that only preventative activities had been included, and with regard to international
NGOs, only those INGOs proposals that involved members of the CCM had been included.
Proposed project ideas with a total value of US$14.6m for HIV / AIDS activities which had
either been fully approved or approved with changes by the Expert Panel were excluded (See
Appendix D). Of those NGOs included in the draft budget, funding of US$12.8m was included,
compared to US$21m requested in their Project Ideas submitted and approved by the Expert
Panel. All removals and changes were made without any substantive consultation with the
affected NGOs.

While clearly it would have been unrealistic to expect that all funds requested would have been
included, the arbitrary exclusion of most NGOs and the reduction of those that were included
without consultation was clearly unacceptable. This information became available on a Friday
with the following Monday being the deadline for signature.

During the discussion at the CCM, it was noted that there were still issues with the HIV / AIDS
budget that needed to be resolved. As it transpired these issues came as much from the MoH
(who were unhappy to be receiving only 30% of funds allocated) as with the INGOs.
Nevertheless, it was felt that there was some room for negotiation, compromise and possible
resolution before Monday. After a vote it was decided that the HIV / AIDS team should work
the weekend and present a revised budget together with the narrative proposal to the CCM on
Monday.

Malaria
No budget or other information was presented to the CCM for the malaria proposal. The head of
the drafting group (who it seems was also primarily responsible for drafting the proposal) made
verbal assurances that the proposal was technically in good condition. However, the CCM
decided after a vote that, because they been presented with no information to the contrary, the
malaria proposal should be deferred to the next round.

Final CCM meeting – shut down of the proposal by the Government

The final CCM meeting on Monday the 23rd September, draft proposals for TB and HIV /
AIDS in Portuguese were circulated to the CCM. This meeting was chaired by the Angola
Minster of Health (Dra Albertina Hamukaya). She was accompanied by her second Vice
Minister of Health (and not by Dr. José Van Dunem or his deputy, who had been the chair
throughout the Global Fund proceedings).

The draft proposals circulated to the CCM were incomplete, in Portuguese and were not in a
condition to be signed.8 It was proposed that more work could be done on the proposals – in
particular the TB proposal, in order to at least submit one proposal to the Global Fund for the
second round. An offer was made by WHO to finance someone to hand carry this proposal to
Geneva in advance of the Thursday deadline.

This offer was followed by a scathing speech by the Vice Minister of Health criticising the
CCM in extremely strong terms for the ‘exclusion’ of malaria from the Global Fund in this
round. Her speech ranged from the topic of Angola as a sovereign nation to the ills of malaria,
and criticism of the allocation of funds to social marketing. This was followed by the Minister
informing the meeting that in view of the reservations of the Angolan government, Angola
would not submit a proposal for the second round. It is to be noted that the Angolan
Government (including the Ministry of Health) was represented at the previous CCM meeting
that took the decision to defer the malaria proposal (though by less senior people).

8
With respect to the draft HIV / AIDS proposal, the allocation of proposed funds had also changed so that of the US$12.3m now
being requested, 44% was now allocated to the government and 56% to NGOs. A total of US$1.8m had been cut for NGO activities
including US$600k from NGO VCT activities and US$1.2m from PSI social marketing.

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Representations were made by INGOs representatives (ADPP and GOAL) appealing for the
submission of at least the TB proposal on the basis that it was closest to being ready, was
uncontroversial and by submitting to the Global Fund it might actually assist in getting other
Angola proposals funded in the following round. It was also pointed out that the reason malaria
had been excluded was due to the failure of the drafting group to submit any document to the
CCM, and that it could be submitted in a future round. UNAIDS made a similar plea for the
HIV / AIDS proposal to be submitted. The Minister informed the meeting the decision had been
made and the meeting was closed shortly thereafter.

3. Analysis and Lessons Learned

In the final analysis, the failure of the CCM to submit a proposal in the second round was a
failure in the exercise of partnership as envisaged by the Global Fund. The reasons for this
failure are manifold, but can perhaps be analysed under two separate heading:

Design Issues

1. The process of formation of the CCM and drafting of the global fund proposal was
fundamentally flawed from the beginning. The CCM was constituted in haste and was too
large. CCM meetings took literally hours and progress was extremely slow. While
protracted discussions may be required in order to build partnership and consensus, CCM
meetings lasted up to 5 hours at a time often with little tangible output.

2. Paradoxically, despite its large size, the CCM was not sufficiently representative – as one
example there was no INGO involved in malaria present, while there were four INGOs with
HIV / AIDS activities (including GOAL). This left participating INGOs open to allegations
and perceptions of bias. It is possible that the NNGOs present were unequally
unrepresentative of all NNGOs operational in Angola.

3. There was no overarching plan or framework within which NGO project ideas could be
placed. There was also no joint planning in the early stages (i.e. prior to submission of
project ideas) with Ministry counterparts to build confidence and to come to a common
understanding of what the final proposal might look like at an early stage. Instead, INGO
ideas were submitted and were mostly discarded. In the context of developing a joint plan, it
would also have been sensible to seek to agree a total amount to be requested from the
Global Fund and possible splits between Government, INGOs and NNGOs at the outset in
order to avoid confusion and competition for resources in the final drafting stages.

4. There was also no provision for project ideas being expanded into full project proposals,
even for those few ideas that did ultimately make it to the draft stage.

5. The capacity of many NNGOs to develop even project ideas was low. A two day workshop
to assist them, while useful, was insufficient. This point underlines a further question with
regard to the actual capacity of many NNGOs to design, implement and report on projects
to the standard required by the Global Fund, and how this capacity can be supported and
built up.

Implementation Issues

1. The process itself was slow to start and then too rushed, even with the extension of the
Global Fund deadline to September. There was also poor dissemination of information to
NGOs, particularly those that had submitted project ideas.

2. The arrival of many of the consultants were poorly timed – a UNAIDS advisor that could
have contributed a lot to the process in May or June arrived two weeks before the deadline
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 in mid September. A consultant hired to compile the monitoring and evaluation section
arrived only days before the deadline. There also seemed to be poor co-ordination between
these consultants. They certainly did not constitute a coherent team.

3. The proposal should not have been written by Ministry staff. Aside from a lack of
experience in writing proposals, and an inability to write the proposal in the language in
which it was to be submitted (i.e. English), the issue of bias in decision making is relevant.
There was a real need for a neutral party in this process. A project management team of
experienced and authoritative consultants was required. This team needed to be in-country
for a longer period of time in order to take responsibility for project managing this process;
including providing advice on initial design issues, assisting with the actual writing of the
proposal, liaison with all stakeholders and to act as a neutral party in the inevitable
negotiations that are required to finalise such a proposal.

4. Above all, the process of writing the proposal after the selection of project ideas by the
Panel of Experts was not transparent enough and was apparently subject to arbitrary
changes by Ministry personnel. In this respect, malaria has to have been the most extreme
example of this. The CCM still has not even seen a draft malaria proposal, nor do we
actually know for sure whether one exists or not, though verbal assurances have been
received by the CCM from the head of the malaria drafting group that a draft proposal does
in fact exist. This points to a deeper problem – the apparent assumption by the Angolan
Government that the Global Fund proposal was theirs to do with as they wished, rather than
a genuine public / private partnership.

Lessons Learned

From an INGO perspective, there are also strategic lessons to be learned from this second round
process.

CONGA Co-ordination and Participation

It is clear that there was insufficient co-ordination between the INGO members of the CCM and
CONGA. As a result, there was no CONGA voice to be heard in CCM deliberations. This,
combined with the heavy involvement of member INGOs in HIV / AIDS left those participating
open to allegations and perceptions of bias and self interest. This will only have been reinforced
by the reality that only those INGOs actually on the CCM managed to get their proposals
included in the TB and HIV / AIDS draft proposals in the second round.

Building links with National NGOs

Combined with this weak link to CONGA was the question of INGO links with national NGOs.
Some NNGO representatives seemed to spend more of their time criticising the amount of funds
allocated to INGOs (ignoring capacity issues with regard to NNGOs and sub-contracting
arrangements to NNGOs built into INGO project ideas) rather than on constructive debate.
Questions also arise with respect to the degree to which NNGO representation on the CCM is
actually representative of NNGOs.

Perhaps a more constructive avenue would be to work on a broader strategy with FONGA to
develop a stronger cross NGO alliance on some Global Fund issues. However, realism has to
prevail in these discussions. ANASO, a network of national HIV / AIDS NGOs represented on
the CCM was extremely critical of what they regarded as the undue weighting in favour of
INGOs and the perceived paternalism involved in sub contracting arrangements for NNGOs
through INGOs. These concerns need to be balanced with the pre-occupations of the Global
Fund for funding effective and transparent operations that involve scale up of existing activities.

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Liasing with Government Personnel
In the final stages of the proposal writing process NGOs had no direct links with the proposal
writers – i.e. key government personnel. This certainly contributed to the lack of transparency
and debate in drafting the proposal. Having INGO representatives in place that have built up
long term relationships with key governmental personnel and hence could more easily access
them could prove extremely useful in the process of rebuilding confidence after the collapse of
the second round.

Having a Plan B – Independent NGO Proposal

NGOs need to strongly consider the necessity of submitting a separate proposal direct to the
Global Fund in the third round. In order to do this, we will have to be able to show that the
current CCM is not operational. NGOs will also require donor backing (i.e. letters from major
donors) supporting the proposal. It might even be prudent to have one or more donors
nominated as PR (e.g. ASDI for HIV / AIDS) if they will accept this position.

Given the debacle of the second round, it is quite reasonable to suppose that such an approach
could be justified now. However, the decision to go it alone should not be taken lightly as it is
likely to sour relations with the government. It will also destroy whatever little progress that has
been made in improving relations and building partnership to date. GOAL’s recommendation
would be to give the CCM process one last chance to work, building on the lessons learned
from the second round. However, as a parallel process, NGOs should consider developing an
NGO proposal to have on stand by for submission should the CCM process fail once more.
Having such a process on-going will also strengthen our position within the CCM, allowing us
to push for a more transparent and equitable approach to the CCM proposal creation process.

Possible way forward for CONGA

1. CONGA to endorse a strategy of support for the CCM process in the third round, but also
preparation of a ‘stand by NGO proposal.’

2. A CONGA sub group should be appointed to act as focal point for development of the NGO
proposal and CONGA advocacy activities related to the Global Fund (see below).

3. Decision taken regarding appropriate CONGA representation on the CCM by CONGA. Note
that new appointments to the CCM will need to be approved by the CCM, though in the interim,
current CCM members can invite along other interested parties to attend CCM meetings.

(Note: Order of points #4 to #7 to be decided).

4. CONGA sub group (or members of the group) to approach FONGA and / or respected
NNGOs to discuss possible joint action with regard to the CCM process. CONGA strategy with
respect to ANASO also needs to be considered.

5. The CONGA sub group to arrange individual meetings with major donors and bilaterals
involved in the CCM process (USAID, ASDI, Italians, UNICEF; WHO, UNAIDS) to discuss
CONGA’s strategy for the third round.

6. Representatives of the CONGA sub group to request a meeting with Dr. José Van Dunem
(Vice Minister of Health) to express CONGA concerns and recommendations for an improved
and reformed Global Fund process for the third round. Issues to raise could include CONGA’s
analysis of why the second round process failed and recommendations on how to better
structure the process for the third round. This approach may have to be adjusted if a rumoured
Ministerial reshuffle changes personnel within the Ministry of Health.

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7. CONGA sub group to investigate the possibility for opening some line of communication
with the Global Fund itself.

8. CONGA Global Fund sub group to consider how best to develop a parallel NGO proposal
and to organise the formation of three proposal writing working groups (one for each disease) at
the appropriate time.

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Appendix A Panel of Experts (Panel de Peritos)

Dr. Raul Feio (EU)

Dr. Rui Gama Vaz (WHO)
Dra Melánie Luick (UNICEF)
Sra. Laurel Fain (USAID)
Dr. Stefano Ferroni (Italian Co-operation)
Dr. Filomeno Fortes (MoH Head of Infectious Diseases)
Dr. Carlos Alberto Fernandes (MoH Head of INSP)
Dr. Alberto Stella (UNAIDS)
Sra. Susan Shulman (PSI)
Dr. João De Deus (FAA)
Dra Balbina Felix (WHO)
Dra Arlete Borges (Sonangol)

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 Appendix B List of Members of the CCM

(May not be complete and final list)

Government (8): MINSA, MIRED; MINARS, Familia e Promoção da Mulher, Conselho

De Ministros, MAPPESS, FAA (Servicos da Saudé do Estado Maior),
Faculdade de Medicina.

Private Sector (1): SONANGOL

UN (4): WHO, UNAIDS, UNICEF, UNFPA.

Donors (4): EU, USAID, Italian Co-operation, ASDI (Swedish Co-operation).

INGOs (5): PSI, IPMP, GOAL, ADPP and CUAMM.

NNGOs (6): ACJ, LPV, ACOSIT, AIA, ANASO, Caritas

Total: 28

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 Appendix C: Composition of Working Groups for Development of the Global Fund
Proposal

1. Technical co-ordination Group

Three national consultants (two MINSA and one Ministry of Finance)

One external consultant (Teresa Harrison)
UNICEF (Dra. Melánie Luick) – (Listed as a participant but actually more involved in the HIV /
AIDS working group)
USAID (Intended as a participant but not actually involved).
WHO (Dra Balbina Felix)
UNFPA (Dra Antonella / Dra Julia Grave)

2. HIV / AIDS

Programma Nacional Para Luta Contra Sida (Dra Dulcina Serrano)

DSS / EMG FAA (Dr. João de Deus) – (Listed as a participant but not actually involved in the
process).
UNAIDS (Dr. Alberto Stella)
External Consultant (Teresa Harrison)
UNICEF (Dra. Melánie Luick)
UNFPA (Dra. Luisa Melgar)

3. TB

Programma Nacional Para Luta Contra TB

WHO (Dr. Sampaio)
Cooperação Italiana (Dr. Stefano Ferroni)
USAID (Listed as a participant but not actually involved in the process).
External Consultant (Teresa Harrison)

4. Malaria

Programma Nacional Para Luta Contra Malaria (Dr. Philomeno Fortes)

UNICEF (Dr Kanga Guimarães)
WHO (Dr Nkuku Sebastião)
USAID (Listed as a participant but not actually involved in the process).
External Consultant (Teresa Harrison – Listed but effectively did not participate in the
formulation of this proposal in the final changes).

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Appendix D: HIV / AIDS Project Ideas approved by the Expert Panel but excluded from
the draft HIV / AIDS budget

Ref. Organisation Fully Approved or Amount Comment

Approved with (US$)
changes

1. Hospital Divinia Pr. Fully 1,456,930 TB and HIV

2. IPMP Fully 1,781,600
3. Save UK Fully 1,530,750 Prevention
4. CCF With changes 3,164,700 Care and Support
project
5. NPA With Changes 950,000
6. IMS Huambo Fully 106,015
7. Red Cross Fully 431,536
8. Rede Mulher With changes 644,300
9. ANGOBEFA With changes 76,180
10. CRS With changes 423,329
11. Cruz Vermelha With changes 1,358,768
12. LPV With changes ?
13. Hospital Div. Prev With changes 913,367
14. ALISEI With changes 1,204,000
15. CEAST With changes 228,574
16. COSV With changes 369,781

Total 14,639,830

Fully Approved 5,306,831

Approved with changes 9,332,999

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