THE PROBLEM

For the past few years, the Angolan government struggled to report the government’s co-financing commitments to the Global Fund. Following a visit from the Office of the Inspector General during the second half of 2019, the Global Fund formally requested the Ministry of Health to demonstrate commitment compliance as a prerequisite to access the 2020-2022 allocation.

Pharos Global Health Advisors was asked by the Global Fund to support the Ministry of Health and to facilitate the efforts of the Government of Angola (GoA) in meeting Global Fund requirements regarding co-financing of the HIV, TB, and malaria programs. This project is divided into two work phases.

We completed the first phase between May and July 2020, during which we achieved the following milestones: 1) developed and submitted a Standard Operating Procedure (SOP) defining a new methodology for collecting and reporting general and specific commitments as established in the current Global Fund grant agreements; and 2) applied the SOP to collect information and reported the actual performance of the Government on co-financing of the HIV and malaria programs for the 2017-2019 period.

The second phase began in September 2020. The objectives of this phase were the following: (1) revise and adjust the SOP and co-financing report based on OIG and GF’s feedback; (2) apply the SOP to collect and report TB commitments; (3) update the SOP according to the new commitments for the 2020-2022 allocation; (4) build monitoring and reporting capacity at the Ministry of Health through targeted trainings and development of reporting tools, and (5) develop a roadmap to promote the long-term sustainability of co-financing reporting.

Pharos was then engaged for a third phase to monitor and track the government co-financing commitments. The main objectives of the third phase are to (1) build and consolidate the systems for HIV, TB, and Malaria expenditure tracking and reporting, focusing on the areas where the Government has made co-financing commitments under NFM3, (2) continue strengthening national teams and capacities, (3) help to generate further co-financing reports due in 2021 and 2022, and (4) evaluate the utility of the SOP.

THE PHAROS SOLUTION

The Pharos team assisted in the creation of a Technical Working Group (TWG) and an Operative Technical Working Group (OTWG) integrated by technicians of the Ministry of Health from the HIV, TB and malaria programs and other key stakeholders. Despite travel restrictions imposed by the COVID-19 pandemic, Pharos conducted virtual meetings with the TWG and successfully completed and submitted the deliverables from phase one. As a direct result of the GoA’s compliance of such commitments to the Global Fund, the Global Fund issued a new Grant Allocation letter for the 2020-2022 period.

In the second phase, Pharos supported the Ministry of Health to create greater engagement from the Ministry of Finance, the CCM and the Directorate of Public Health at the Ministry of Health. With Pharos assistance in the second half of 2020, Angola further refined and finalized the SOP and applied it in generating a second co-financing report covering all three diseases and the years 2018-20. National specialists and Pharos personnel worked together on the SOP and co-financing report and drafted a co-financing commitment letter for NFM3 that was approved and signed by all parties.

In the ongoing third phase, the Pharos team has continued working very closely with the Government, Ministry of Heath, and TWG to deliver detailed co-financing monitoring reports in February and October 2021 covering NFM2. Additionally, this phase has included activities across three major areas: (1) Improving Co-financing Processes, (2) Capacity Building and Strengthening, and (3) Data Production and Analysis. Across each area, the Pharos team is taking a series of actions, including training courses for members of the TWG in Q4 of 2021. The slides used for the training are included below.

In a new fourth phase, Pharos has again been engaged by the Global Fund through the end of 2022. In this phase, Pharos is conducting deep dives on the largest potential risks for co-financing in Angola. For this project, we will (1) analyze financial commitments and expenditures, (2) identity human resources-related gaps and build a roadmap in consultation with the government to ameliorate these weaknesses, (3) continue our technical assistance to support the tracking, monitoring, and reporting of co-financing commitments. This portion of the project allows the Government of Angola to build on its prior successes and fix some of the weaknesses identified throughout the four phases of this project. 

LOOKING AHEAD

To date, Angola is the best and perhaps only example of a country accounting for each dollar of co-financing commitments agreed upon with the Global Fund in the NFM2 and NFM3 grants. This project has become an exemplary model for the Fund across its portfolio of the challenges in tracking co-financing commitments, but also of the successes for the country’s Sustainability & Transition goals when high-quality data on co-financing can be produced and used to assist the country’s national disease responses.

Status: Ongoing, May 2020 – December 2022

Team Members Involved: Robert Hecht, Gabriela Cohen, Ana Diaz, Diana Gonzalez, Nathan Isaacs, and Mila Dorji

For more information, contact Mila Dorji at [email protected].